Acne and you

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. Treatments work to clear away bacteria and dry up the excess oils that lead to acne. Different acne treatments include lifestyle remedies, topical medication, oral medication, and medical procedures.

The treatment that’s right for you depends on your individual condition. If you have mild to moderate acne, such as whiteheads or blackheads, your treatment should be relatively easy. However, if you have cystic or inflammatory acne, your treatment may be more challenging. Cystic acne is one or more large, painful, red cysts under the surface of your skin. Your doctor or dermatologist can help you figure out what type of acne you have.

Many people with mild acne or pimples can manage their condition with lifestyle changes. Oil is a major cause of acne, so keeping your face clean and your hair away from it is important, especially if your hair tends to be greasy. Oils from your hair and face also build up on your bedding. Changing your pillowcase daily or weekly can help prevent this buildup.

Wash your face two to three times per day with lukewarm water and a gentle cleanser that’s not abrasive. Don’t scrub your skin too hard. This can aggravate your skin even more. Also, try not to use skin care products that can be irritating, such as scented lotions or oil-based makeup. Choose moisturizers and sunscreens that are labeled “noncomedogenic.” This means that the product won’t clog your pores.

These adjustments can go a long way in helping you resolve mild acne. If you need something a little stronger, your doctor may suggest you also use topical or oral medication.

Topical medications are lotions, gels and creams that you apply to your skin. You typically apply a thin coat on your skin in the morning and before bedtime after washing your face. Some are available over the counter, and others require a prescription.

OTC acne products usually contain the active ingredient salicylic acid or benzoyl peroxide. These substances reduce the amount of oil your body produces. They also fight inflammation. These effects help treat existing blemishes and prevent new ones from forming.

Prescription topical medications can help when OTC products aren’t strong enough. These 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 your acne is moderate to severe.

Oral medications for acne are also called systemic treatments because they are absorbed throughout your entire body. They’re only available with a prescription from your doctor. These drugs are commonly used to treat moderate to severe acne that doesn’t respond to topical agents. The three types of systemic drugs used to treat acne include:


Your doctor may prescribe a daily antibiotic pill, such as tetracycline. It can help fight bacteria and infection from the inside out. Antibiotics are commonly used with topical medication when gels and creams alone don’t improve your condition.

Birth control pills

Regulating hormone levels can help improve acne for some women. However, you should not use birth control pills during pregnancy. If you’re pregnant, ask your doctor what you can do to banish breakouts.


Isotretinoin is a strong drug in the retinoid family. It reduces the size of oil glands so that they make less oil. It also helps regulate skin cell turnover so that the cells don’t block the release of bacteria and excess oil from your pores. Isotretinoin is mostly reserved for people with severe cystic acne. Your doctor may prescribe it when other acne drugs haven’t worked. However, the side effects can be severe, so it isn’t for everyone.

Though not prescribed as commonly as medication, a few medical procedures may be used to treat severe acne. These procedures can all typically be performed in your doctor’s office. They may be painful and in some cases cause scarring. Health insurance plans don’t always cover them, either. You should confirm that your health insurance will cover these procedures before you schedule them.

Drainage and extraction

During drainage and extraction, your doctor manually drains large cysts that form under your skin. They remove fluids, dirt, pus, and dead skin inside the cyst to reduce infection and pain. Your doctor may inject antibiotics or a steroid into the cyst to speed healing and reduce the risk of scarring.

Laser therapy

Laser therapy may also help improve acne infection. Laser light helps reduce the amount of bacteria on your skin that causes acne.

Chemical peels and microdermabrasion

Chemical peels and microdermabrasion remove the top layer of your skin. In the process, whiteheads and blackheads are also removed.

Almost everyone experiences acne at one time or another. It’s most common among teenagers. However, adults can have a breakout now and then, especially during pregnancy. But pregnant women 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 to use during pregnancy, or the safety of the drug isn’t known.

Topical retinoids are category C drugs. This means that animal studies have shown that they’re harmful to a developing fetus if given in large amounts. Check with your doctor before using tretinoin.

Isotretinoin and tetracycline can harm a fetus. Isotretinoin has been linked with birth defects, and tetracycline can discolor your baby’s teeth. Do not use either of them during pregnancy.

The acne products that are safe to use during pregnancy are the ones that use benzoyl peroxide.

Side effects of acne treatments vary depending on the method you choose and the strength of the medication.

For topical acne drugs, the most common side effects are skin dryness and irritation. Fortunately, these symptoms are temporary. They often improve as your body gets used to the medication. If your skin itches, burns, or peels heavily, tell your doctor.

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 also taking birth control pills, use a back-up birth control method. Some antibiotics reduce how well birth control pills protect you from pregnancy.

If you’re using birth control pills to manage your acne, be aware that side effects of oral contraceptives include an increased risk of blood clots and high blood pressure.

Oral isotretinoin can cause severe side effects, especially if you become pregnant while taking it. 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 and affect your cholesterol levels and liver function.

Acne is a very treatable condition. When basic lifestyle changes don’t seem to do the trick, try the least invasive treatment, OTC products. If you need something stronger, schedule an appointment with your doctor. They will assess your acne and suggest next steps for treatment. Advanced medical research is finding new ways to fight infection.