You may associate acne with teenagers and hormones, but the truth is it can last well into middle age or even affect babies. When the pores of your skin become clogged with too much oil, they collect dirt and bacteria, inflaming the skin. When an acne lesion, or pimple, ruptures, the inflammation can spread. Sometimes, inflammation is deep beneath the skin and causes nodules or cysts, which are hard and painful. You can use over-the-counter medications to control acne, but if the acne is not responsive within several weeks, you may need to see a dermatologist for prescription-strength medication.
Benzoyl Peroxide
Use benzoyl peroxide to treat mild-to-moderate acne. Benzoyl peroxide is a topical treatment and available over the counter, though it also comes in prescription-strength. It works by reducing oil made by the oil glands in your pores. It can come in a liquid wash or bar form, lotion, cream or gel and is recommended for use one to two times daily. In prescription forms, it is sometimes combined with topical antibiotics such as erythromycin. Benzoyl peroxide, like all acne medications, can cause dryness and peeling of the skin, as well as redness and irritation, which will often get better or go away with continued use. Take care when using benzoyl peroxide--it will bleach the color from clothes and hair. Benzoyl peroxide products include Fostex, Desquam, Oxy 10, PanOxyl, Benoxyl, and Benzac.
Topical Salicylic Acid
Salicylic acid is a topical medication that reduces swelling and redness and unclogs blocked pores, allowing pimples to shrink. It is also available in both over-the-counter and prescription strengths, as wipe-on saturated pads or in a cream, lotion, liquid, gel, ointment or patch. Because salicylic acid may cause your skin to become dry or irritated initially, do not also use other potentially irritating products on your skin at the same time without checking with your doctor. Children and teenagers should not use salicylic acid if they have the flu or chickenpox, as there is a risk of developing Reye's syndrome, according to the National Institutes of Health. Clearasil, Neutrogena, Noxzema, and Stri-Dex products contain salicylic acid.
Antibiotics
Available only by prescription, both topical and oral antibiotic products are used to treat acne and are effective in treating inflammatory acne. Topical antibiotics, such as clindamycin and erythromycin are often combined with benzoyl peroxide to target both the bacteria and the inflammation. Oral, or systemic, antibiotics may be prescribed for moderate and severe acne and inflammatory acne that is resistant to treatment. Some systemic antibiotics used to treat acne include minocycline, doxycycline, tetracycline and erythromycin. However, bacterial resistance to antibiotics is an increasing problem, according to the Guidelines of Care for Acne Vulgaris Management. Use of antibiotics can also make your skin more prone to sunburn.
Retinoids
Topical and systemic retinoid acne treatment is available only by prescription. Used to treat acne since the 1980s, topical retinoids come in liquid, cream or gel form and work by promoting peeling of affected skin areas and unclogging pores. They will make your skin more sun-sensitive and will probably cause a temporary increase in acne as they also work below the skin. You may not see an improvement in your acne for several weeks. Topical retinoids include tretinoin products such as Retin-A, adapalene products such as Differin, and tazarotene products such as Tazorac.
Isotretinoin is a potent systemic retinoid, taken in capsule form and used to treat severe recalcitrant nodular acne that has not responded to other treatments. It works by shrinking the oil glands in hair follicles beneath your pores. It will cause severe birth defects if taken when pregnant. Girls and women of childbearing years are required to use two forms of birth control and comply with the iPledge program, a mandatory registration program for all patients, male or female, taking isotretinoin. Isotretinoin brand names include Accutane, Amnesteem, Claravis and Sotret.
References
- National Library of Medicine: Medline Plus: Benzoyl Peroxide
- National Library of Medicine: Medline Plus: Salicylic Acid Topical
- National Guideline Clearinghouse: Guidelines of Care for Acne Vulgaris Management
- National Institutes of Health: Acne: Questions and Answers About Acne
- National Library of Medicine: Medline Plus: Isotretinoin
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