The treatment of Acne

Acne comes in all shapes and sizes: it can range from small blackheads to painful nodules and cysts. The severity of the outbreak, to a large extent, determines the choice of treatment, which can range from mild over-the counter (OTC) treatments to prescriptions from a skin specialist.

Acne comes in all shapes and sizes: it can range from small blackheads to painful nodules and cysts. The severity of the outbreak, to a large extent, determines the choice of treatment, which can range from mild over-the counter (OTC) treatments to prescriptions from a skin specialist.

Acne tends to affect the majority of people at an age when appearances are important. Few teens would be willing to just let things take their course. Most teens would be prepared to try just about anything, and in desperation, many try things that might not work, or might even make things worse. Before doing anything, it is always wise to speak to a pharmacist or a doctor. It must be remembered that the vast majority of acne treatments do not work overnight, and it is necessary to be patient before deciding that the treatment has not been successful. 

A quick word on the causes of acne, as it is essential to understand this before choosing treatment options. All forms of acne start in the same way: oil (sebum) or dead skin cells clog (or partially clog) up a skin pore or a hair follicle. Each follicle contains one hair and sebaceous glands that produce oil. Hormonal fluctuations can cause excess oil production, which could block up the pore. In addition to that, makeup or dirt could also cause a blockage. 

Acne treatments are aimed at two things: reducing oil production in the skin (by drying out the skin, or changing certain hormonal levels) and/or treating bacterial infection in the case of acne that is inflamed. The use of prebiotics is also under investigation as a possible treatment for inflammatory skin conditions, which are aggravated by poor gut health.

Treatments can be topical (applied to the problem area of the skin) or oral (taken by mouth). Oral medication is usually prescribed under the supervision of a doctor, as it can affect how your body works and cause different side effects in people, depending on their state of health, their age, their gender, and the other medications they might be taking.

What can be frustrating to an impatient teenager, is that many acne treatments can take anything from four to six weeks to work and to bring about an improvement. It is important not to give up after a few days if things don’t get better. This can differ from person to person. 

And on a much simpler level, it is also essential to wash your face properly with a mild face wash every day, as this will reduce the chances of dirt clogging up the pores. Avoid washing it too much, or using a product that is too harsh for your skin type, as this could make the problem worse.

Over-the-counter products

These topical treatments can be bought at a pharmacy or a supermarket and you do not need a prescription for them. For the treatment of mild acne, this is usually where most people start. And for the lucky ones, that could be the end of the problem.

These products range from creams, lotions and gels and special facewash for skin affected by acne. These facewashes often contain salicylic acid, which helps the skin to shed dead cells and also to decrease inflammation. This removes the oil, and helps to clear your pores. OTC products also sometimes contain alpha-hydroxy acids, which also remove the top layers of dead skin cells.

Some creams and gels also contain about five percent of benzoyl peroxide, which works as an antiseptic and reduces the number of germs on your skin’s surface. It can take a month to start working, so it is important not to give up too soon. Many OTC treatments contain benzoyl peroxide. Don’t use this on skin that is broken, and speak to your doctor if your skin becomes very dry, or starts peeling.

Natural products

Many people swear by natural home treatments when treating acne, but more research is needed on how effective they really are. Many of them cleanse the skin, and reduce oil production. Before you try and of the following, speak to your doctor or pharmacist. 

Check on the internet exactly how to apply the following home remedies that you might have in your kitchen cupboards:

  • Apple cider vinegar
  • A honey and cinnamon mask
  • Tea tree oil
  • Green tea (as a skin application)
  • Witch hazel
  • Aloe vera

Natural remedies which you can try (after speaking to your pharmacist or doctor), which may reduce inflammation levels and help fight bacteria, include the following:

  • A zinc supplement
  • Green tea
  • A fish oil supplement

Prescription products

Prescription medication for acne can also be divided into topical and oral treatments. Medication that requires a prescription are stronger than OTC medications, and therefore may also have more severe side effects, which is why they should be taken under doctor’s supervision. Side effects can differ tremendously from person to person, and from medication to medication, but could include dry, flaky or peeling skin, skin redness, digestive problems, a feeling of dizziness, increased sensitivity to the sun, and hormonal problems.

Topical retinoids (also referred to as Vitamin A acid) are applied to the skin. They remove dead skin cells, and boost production of new skin cells and unblock the pores.

Topical antibiotics are used to treat mild to moderate inflammatory acne. It treats bacterial infections by inhibiting the growth of bacteria. They come in various formats, such as lotions and gels.

Azelaic acid (also a topical treatment) has antimicrobial and anti-inflammatory properties, so it can reduce acne inflammation, clean bacteria from the pores and prevent future outbreaks of acne. Research also points to azelaic acid being effective in diminishing skin blemishes.

Antibiotic tablets can be taken in the case of severe acne. These can be taken for four to six months, and can take up to six weeks before you notice an improvement in the condition of your skin. Antibiotics fight bacterial infections, and so reduce the severity of acne. Overuse of antibiotics can lead to antibiotic resistance in the future.

Oral contraceptives are used to treat acne in women. They mostly work by blocking or reducing levels of androgens, of which testosterone is one. Acne is a symptom of high androgen levels.

An oral retinoid, such as Roaccutane, and is used in the case of severe acne which can cause permanent scarring. It is often used when nothing else has worked. Its side effects can be severe and include depression, skin reactions, allergic reactions, dry eyes and inflammatory bowel disease. It must only be taken under strict medical supervision.


American Academy of dermatology Association

National Health System (UK)

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National Institutes of Health

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