Almost everyone experiences acne at one time or another. It’s most common in the teenage years, but even adults can suffer a breakout now and then, especially during pregnancy.
Simply put, acne results from plugged hair follicles. Oil, dirt, and dead skin cells on the surface of your skin clog your pores and create pimples or small, localized infections. Acne treatments work to clear away bacteria and dry up the oils that cause skin problems.
There are many different types of treatments for acne, including medication, medical procedures, alternative medicine, and lifestyle remedies. The type of treatment that’s right for you will depend on your individual condition.
Just like there are different treatment options, there are several types of acne. People with mild-to-moderate acne may have pimples that appear white or black in color (whiteheads and blackheads). These are relatively easy to treat. Cystic acne, however, is more challenging. Cystic acne consists of large red cysts under the surface of the skin that can be very painful. Cystic acne is sometimes also called inflammatory acne.
Your primary care doctor or dermatologist can help you determine the type of acne you have. They’ll determine the form of treatment that’s most appropriate for your condition.
Many people with mild acne or pimples that appear only occasionally can manage their condition with lifestyle adjustments. Oil is a major cause of acne, so keeping your face clean — and keeping your hair off your face — is important. Wash your face two to three times daily with lukewarm water or a gentle cleanser that’s not abrasive. Avoid vigorous scrubbing, which can aggravate your skin even more. And try not to use skin care products that can be irritating, such as scented lotions or oil-based makeup. Look for moisturizers and sunscreen that’s labeled “noncomedogenic.” This means the product won’t clog your pores.
If your hair tends to be greasy at the end of the day, change your pillowcase daily or weekly. Oils from your hair and face rub off onto your bedding and may cause new breakouts.
Even if you’re making lifestyle changes, your doctor may suggest also using medications to control acne.
Topical medications, commonly used for acne, are those that you put on your skin. They are available in over-the-counter (OTC) and prescription strength formulas.
Lotions, gels, and creams are examples of topical medications. OTC acne products usually contain one of two active ingredients: salicylic acid or benzoyl peroxide. These substances reduce the amount of oil your body produces and fight inflammation. These chemicals help existing blemishes heal and prevent new ones from forming. You’ll typically apply a thin coating of a topical acne treatment on your skin in the morning and before bedtime after washing your face.
Stronger topical medications can help improve your complexion when OTC products aren’t strong enough to do the job. Prescription acne gels or creams may contain tretinoin, a retinoid drug that comes from vitamin A, a stronger version of benzoyl peroxide, or an antibiotic called clindamycin. These may do a better job of killing bacteria when acne is moderate-to-severe. Like over-the-counter treatments, prescription topicals are often used twice daily.
Oral medications, also called systemic treatments, are available only by prescription from your doctor. They’re commonly used to treat acne that doesn’t respond to topical agents. The three types of systemic drugs used for severe acne are:
- Antibiotics. Taking a daily antibiotic pill, such as tetracycline, helps fight bacteria and infection from the inside out. They are commonly used together with a topical medication when gels and creams don’t improve your condition.
- Birth control pills. Regulating hormone levels can help improve acne for some women, but not during pregnancy. If you’re pregnant, ask your doctor what you can do to banish breakouts.
- Isotretinoin. This is a very strong drug in the retinoid family. It is mostly reserved for people with severe cystic acne. Side effects can be serious, however, and isotretinoin isn’t appropriate for everyone. Your doctor will typically prescribe it as a last resort medication option.
You’ll usually take an oral medication once or more daily for a few months. You should continue to follow the lifestyle changes you’ve made and use any topical medications as directed by your doctor.
Though not prescribed as commonly as medication, a few medical procedures may be used to treat severe acne.
Drainage and extraction is a procedure in which your doctor manually drains large cysts that form under the skin. They remove fluids and materials inside the cyst to reduce infection and pain. Medications may be injected into the cyst to speed healing and reduce the risk of scarring.
Laser therapy may also be helpful in improving acne infection. The light helps reduce the amount of bacteria on your skin that’s causing acne. Both laser therapy and extraction procedures are performed at your doctor’s office.
Other procedures, including chemical peels and microdermabrasion, remove the top layer of your skin. In the process, whiteheads and blackheads are also removed. However, these treatments can be painful and may cause scarring. Insurance companies don’t always cover them. Confirm your coverage before your appointment.
The normal hormonal changes that come with pregnancy can lead to a less-than-rosy complexion. But mothers-to-be who find themselves faced with acne may not have all of the same treatment options as others.
Most of the medications used to treat acne in teens and adults are not safe — or the safety isn’t known — for a developing baby. Products with benzoyl peroxide, however, are safe during pregnancy.
Topical retinoids are category C for pregnancy, meaning that little of the medication passes through the placenta to the baby. Check with your doctor before using either type of product.
Tetracycline and isotretinoin can harm a fetus. Do not use them during pregnancy. Tetracycline can cause the baby’s teeth to come in discolored. Isotretinoin has been linked with birth defects.
Some people prefer to use alternative or natural treatments instead of or in addition to conventional methods. Alternative treatments for acne may include:
- lotions containing tea tree oil
- products with alpha hydroxy acids
- zinc supplements
Alternative medicine isn’t always studied as much as traditional remedies. Discuss alternative therapies with your doctor before choosing a product.
Side effects for acne treatments vary depending on the method you choose and the strength of the medication. The most common side effect for topical acne drugs is dryness and irritation of the skin. Fortunately, these symptoms are temporary and often improve as your body gets used to the medication. However, if your skin itches, burns, or peels heavily, let your doctor know.
The potential side effects for oral medications can be more serious. Antibiotics can give you an upset stomach or make you dizzy and lightheaded. If you’re taking birth control pills and antibiotics, use a back-up method. Some antibiotics reduce how well birth control pills protect you from pregnancy.
If you’re using birth control pills to manage acne, be aware that side effects of oral contraceptives include an increased risk of blood clots and high blood pressure.
Isotretinoin is very effective in treating acne. The American Academy of Dermatology estimates that 85 percent of people who take this drug see a permanent improvement in their skin condition. However, the side effects can be devastating, especially if you become pregnant while taking the drug. Severe birth defects have been reported in babies whose mothers took isotretinoin during pregnancy. The medication can also increase the risk of depression and suicidal thoughts. Cholesterol levels and liver function may also be affected.
With advanced medical research being done on new ways to fight infection, acne is a very treatable condition. Start with the least invasive treatment (over-the-counter products) and schedule an appointment with your doctor if your complexion doesn’t improve.