This updated guide reviews current acne treatments: topical agents (benzoyl peroxide, retinoids, azelaic/salicylic acid), oral options (antibiotics, hormonal therapy, isotretinoin), and procedures for scarring (fillers, subcision, peels, lasers). It also covers gentle skincare, diet considerations, and the role of mental-health support, with emphasis on individualized care and medical supervision for prescription therapies.

Overview

Acne treatments aim to reduce inflammation, unclog pores, control bacteria, and limit scarring. Choices range from over-the-counter topicals to prescription oral medicines and procedural scar treatments. Treatment selection depends on acne type (mild, moderate, severe), skin type, and personal health goals.

Topical treatments

Topical medicines are first-line for mild to moderate acne. Common options include benzoyl peroxide, topical retinoids (adapalene, tretinoin), azelaic acid, salicylic acid, and topical antibiotics (usually combined with benzoyl peroxide to limit resistance).

Apply a gentle cleanser first and use topical agents as directed - typically once daily for retinoids and benzoyl peroxide, sometimes twice depending on the product. Expect gradual improvement: most people see benefit by 6-12 weeks. Side effects can include dryness, irritation, and increased sun sensitivity; use moisturizer and sunscreen.

Oral treatments

For inflammatory or widespread acne, dermatologists may prescribe oral antibiotics (for example doxycycline or minocycline) for a limited duration to reduce bacteria and inflammation. Hormonal treatments for females - combined oral contraceptives or spironolactone - can lower sebum production and help hormonally driven acne.

For severe nodulocystic acne, oral isotretinoin is a highly effective option but carries significant risks (notably teratogenicity) and requires careful monitoring and pregnancy-prevention programs (e.g., iPLEDGE in the U.S.). Oral therapies can have side effects and need medical supervision.

Procedural and scar treatments

Procedures focus on active lesions and scar management. Options include:
  • Injectable fillers (hyaluronic acid) for rolling or shallow atrophic scars.
  • Subcision and punch excision/grafting for tethered or deep scars.
  • Microneedling and chemical peels (glycolic, salicylic, trichloroacetic acid) to remodel skin texture.
  • Laser resurfacing and mechanical dermabrasion for more extensive scarring.
A dermatologist will match the procedure to scar type and skin tone to reduce risks.

Complementary measures and lifestyle

Maintain gentle daily cleansing, avoid harsh scrubbing, and choose non-comedogenic (oil-free) skincare and makeup. Evidence suggests a low-glycemic-load diet and reducing high-dairy intake may help some people, but results vary. Avoid picking or squeezing lesions to lower scar risk. Some herbal or traditional remedies are used in complementary care; consult a qualified practitioner before trying them.

Mental health and support

Acne can affect self-esteem and mental health. Counseling or support groups can help people cope with the emotional impact of acne and its treatment.

When to see a dermatologist

See a dermatologist if acne is moderate to severe, painful, leaving scars, or not improving after several months of appropriate over-the-counter and prescription topical care. A specialist can offer tailored medical therapy and procedural options.

FAQs about Acne Medicines

How long before acne treatments start to work?
Topical and oral therapies usually need 6-12 weeks to show meaningful improvement. Some change may appear earlier, but give treatments time and follow-up with your clinician if there's no progress.
Are over-the-counter products effective?
Yes. OTC options like benzoyl peroxide, salicylic acid, and some adapalene preparations can be effective for mild acne when used consistently and with gentle skincare.
When is isotretinoin appropriate?
Isotretinoin is reserved for severe nodulocystic acne or acne that has failed other treatments. It requires strict monitoring because of serious side effects, especially teratogenicity, and enrollment in pregnancy-prevention programs where required.
Can diet or supplements help acne?
Some people see improvement with a low-glycemic-load diet or reduced high-dairy intake, but evidence is mixed. Talk with a clinician or nutritionist before starting supplements or major dietary changes.
How are acne scars treated?
Scar treatment depends on scar type. Options include fillers, subcision, punch excision, microneedling, chemical peels, and laser resurfacing. A dermatologist evaluates scars and recommends the best combination of procedures.

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