Acne Treatments

Treatments for acne come in two forms; topical treatments (applied to the skin) and oral medicines (taken by mouth). While mild acne usually responds to self-care measures and topical treatments, moderate to severe cases may require prescription medicines.

It’s a good idea to try to get an understanding of your acne and how severe it is. This will help you to select the most appropriate treatment.

• Minimal: Acne cleansers and OTC treatments

• Mild: Acne cleansers, OTC treatments, Topical benzoyl peroxide, Topical antibiotics

• Moderate: Topical retinoids, Topical benzoyl peroxide, Topical antibiotics, Oral antibiotics, Hormone pills

• Severe: Oral retinoids ((Isotretinion or Accutane)

Home and OTC Treatments

OTC means Over-The-Counter and you can get these products from your pharmacist, you don't need a prescription. The following are all appropriate for milder cases of acne. 

• Self Care: Keep acne prone areas clean but avoid aggressive cleansing with strong soaps. Do not pick pimples or spots as this can aggravate your acne and result in scarring.

• Skin cleansers: are available over the counter and are usually useful in the treatment of mild acne (e.g. Oxy and Clearasil Max). More on skin cleansers.

• Benzoyl peroxide: (Benoxyl, Benzac) helps shed excess skin, unblock the hair follicles and decrease skin oiliness. It’s antibacterial properties help to reduce the amount of bacteria on the skin. Benzoyl peroxide is a bleaching agent and can stain clothes and towels. Wash your hands after applying. More on benzoyl peroxide.

• Natural Treatments: there are a number of natural treatments that can help manage acne. More on natural products.

If these do not work you may want to see your doctor who can give you a prescription for a stronger medicine.

Topical Prescription Treatments

Most suitable for moderate to severe acne. Topical treatments are applied to the skins surface. All of the following are prescription medicines available only from your doctor or skin specialist. Your doctor will be able to help decide if they are the right medicines for you.

• Topical Retinoids: Chemically related to vitamin A, retinoids ‘unplug’ follicles and help unclump cells. These are also available only on prescription and must not be used during pregnancy.

• Topical Antibiotics (Clindamycin and erythromycin): antibiotic liquids for pus-filled spots, not blackheads or whiteheads. They are applied to the skin to decrease bacteria and sebum.

Oral Prescription Medicines

Suitable for moderate to severe acne. These are prescription medicines. Your doctor will be able to help decide if they are the right medicines for you.

• Oral Antibiotics: Oral antibiotics are prescribed for moderate to severe acne. Treatment with these usually continues for months, often in combination with products meant for topical application.

• Isotretinoin: This drug is prescribed for the most severe forms of acne and is effective where most other treatments fail. Like topical retinoids, isotretinoin is a chemical relative of Vitamin A and reduces the formation of sebum. That means fewer skin bacteria and less inflammation of the skin follicles. Isotretinoin generally is not used at the same time as topical anti acne preparations.

• Hormone contraceptive pills: in females these help regulate hormones that are responsible for acne and greasy skin.

Nutritional Treatments

• Wholefood diet: A diet high in refined sugars and starches tends to increase quantities of insulin in your body. This may in turn increase the levels of male hormones that cause acne. Cutting back on refined carbohydrates may help although there is little evidence to support a consistent link between diet and acne.

• Antioxidants: Antioxidants neutralise damaging free radicals that are believed to play a role in acne and inflammation. Fresh fruit and vegetables are naturally rich in antioxidants. You could also try a drink like carot juice which contains beta-carotene - a powerful antioxidant and precursor to Vitamin A. Alternatively there are many good antioxidant supplements availabe.

• Zinc: 60 to 90 mg a day of this mineral improves some people’s acne. Several double-blind trials indicate that zinc supplements can reduce the severity of acne.

Herbal Treatments

• Tea Tree Oil: Applied to the skin Tea Tree Oil has been growing in popularity as an alternative to over the counter and prescription acne treatments. Tea Tree Oil has powerful anti-fungal and anti-bacterial qualities. Many people with acne find that their skin is very sensitive to Tea Trea Oil, so start with a mild dose and test it on a small area of skin. For topical treatment of acne, the oil is used at a dilution of 5–15%

• Olive Leave Extract: Olive Leaf Extract is belived to have powerful antibacterial properties.

• Licorice Root Extract: Licorice root extract possesses natural anti-inflammatory agents that may soothe skin affected by acne.

• Gree Tea and Green Tea Extract: Green tea is rich in bioflavanoids and antioxidants (particularly EGCG) which are useful in fighting free radicals.

• Burdock: Burdock has been used historically to treat a range of skin problems. It is believed to have a cleansing action although there is little scientific evidence to support this. Burdock root tincture may be taken in the amount of 2 to 4 ml per day and can also be found in herbal teas.

Alternative Treatments

• Acupuncture: Acupuncture may be helpful in the treatment of acne. Several studies have reported that acupuncture can help with acne treatments however the general consensus is that more study is required.

• Hypnosis: Anecdotal evidence suggests that hypnotherapy may help in preventing scarring from acne.

Acne Treatment Time Scale

Many acne treatments may take a while to work (anywhere from 2-6 months). Don’t stop using the treatment within this time period. If your acne does not improve talk to your doctor or pharmacist. Your should also talk to them about any side effects from, or irritations to, your acne treatment. Some acne treatments tend to dry out the skin during the initial stages but the skin usually adjusts.