Anyone battling acne understands the frustration of having to deal with this skin condition. It is embarrassing and keeps coming back. An oft-repeated question is, "what is the best treatment for acne?" The answer really is simple: it depends. Choosing your treatment depends on the type of acne you are having and your skin's response to your chosen regimen.
Remember that as far as treating acne goes, there is no one-size-fits-all product! What works for other people may not necessarily work for you. Luckily we do have several acne vulgaris treatment options available to minimize if not stop breakouts.
Be patient and give your chosen acne medications time to do their work, which is anywhere from 1 to 3 months, sometimes even more. You may also expect to see an initial worsening of symptoms before the condition gets better.
If you are suffering from mild acne, it is best to start with over-the-counter (OTC) acne preparations first as stronger medications may be unnecessary and may even bring unwanted side effects. Due to the wide array of acne products out in the market, choosing an acne product or system may be overwhelming, to say the least.
It is therefore important to get familiar with the active ingredients behind the OTC treatments you are considering. You will soon notice that typical acne treatment products contain a narrow list of active components. They usually contain any of the following:
- Sulfur - a traditional acne medication. Smells awful but cheap and effective.
- Salicylic acid - a versatile exfoliating agent
- Benzoyl peroxide - the mainstay of many commercial OTC acne products
- Other constituents are added to complement these ingredients, such as gentler acting exfoliants and moisturizers.
These OTC products are available as creams, ointments, lotions, gels, or solutions. There are also kits or systems that combine one or more products, usually consisting of a cleanser, a toner, and a lotion. These acne kits vastly simplify acne skin care by removing a lot of guesswork on the user's part, allowing for a more systematic, integrated, and convenient approach to treating acne.
Sulfur kills bacteria and causes the skin to dry and peel, preventing skin oiliness and subsequent blockage of the sebaceous glands. It is the active component in medicated soaps like Thylox, Novacet, Derma Klear, & Adovia. It is also the key ingredient in Proactiv Solution Refining Mask and Murad Acne Spot treatment.
Salicylic acid, meanwhile, works by causing faster skin cell turnover thus opening clogged pores. It works really well for those suffering from non-inflamed pimples like whiteheads and blackheads. Salicylic acid is the key ingredient behind Clearasil Ultra Acne Solution System (Steps 1 to 3), Murad's Clarifying Cleanser and Exfoliating Acne Treatment Gel, Exposed Facial Cleanser, and the Proactiv Gentle Formula system (not their "regular" formula which uses benzoyl peroxide).
If your acne is inflamed you may consider benzoyl peroxide instead. Benzoyl peroxide works by killing the bacteria responsible for acne and has a drying effect, decongesting the pores. It is effective and well tolerated by most people. It is available in concentrations ranging from 2.5% to 10%. Benzoyl peroxide is the active ingredient in well-known products such as Clearasil Ultra Quick Start Treatment Cream, Proactiv System (Renewing Cleanser, Repairing Lotion, & Advanced Blemish Treatment), Neutrogena On Spot Acne Treatment, Acne.org Treatment, and AcneFree Severe Acne Treatment System.
OTC preparations remain effective for moderate cases of acne. If your condition does not respond to them, your dermatologist may prescribe topical retinoids. Retinoids are vitamin A derivatives that work by promoting skin exfoliation thus unclogging the pores and preventing new pimples from forming. The best known of the retinoids is tretinoin (e.g., Retin-A, Renova). Newer types of retinoids include adapalene (e.g., Differin) and tazarotene (e.g., Tazorac).
Retinoids works best for whiteheads and blackheads. At the beginning your acne will probably get worse and irritated but upon continuous use for 2-3 weeks at the earliest and sometimes up to 6 weeks or more, the acne should start clearing up. Unless directed by your doctor, do not use other topical acne products to avoid further skin irritation.
Severe acne is characterized by inflamed or infected acne with large, painful, or pus-filled nodules. You should promptly see a doctor if you suffer from severe acne to prevent extensive damage to your skin and scarring. Powerful but effective medications for severe acne include the following:
Antibiotics, applied topically or taken orally, are the mainstay of therapy for such cases. These antibiotics include clindamycin, erythromycin, metronidazole, and tetracyclines such as minocycline and doxycycline. These would be given on top of other topical anti-acne agents.
Hormonal treatment like spironolactone and oral contraceptives may alternatively be prescribed for adult females suffering from hormone-related acne. For long-term remission and control, oral isotretinoin (e.g. Accutane) may have to be prescribed.
Isotretinoin is a potent drug related to vitamin A and is the closest thing to an acne cure, controlling it in 4 ways: limiting sebum production, preventing clogged skin pores, inhibiting growth of p. acnes bacteria, and reducing inflammation. However, it is a strong medication with potential severe side effects, albeit reversible upon discontinuance of the drug, so it has to be taken under close medical supervision by a dermatologist.
Other acne treatment methods
In addition to topical and oral medications outlined above, doctors also use other procedures to hasten healing of acne and prevent acne scar formation. These include chemical peels, surgical extraction and drainage, and photo therapy using laser and light treatments.