According to the American Academy of Dermatology (AAD), acne is caused by four factors: an overabundance of oil, clogged pores, bacteria and inflammation. The acne cycle starts when extra oil blocks the pores leading to the surface of your skin. Bacteria grow in the oil and irritate your tissues. If the blocked oil is close to the surface, you'll develop whiteheads or blackheads. Deeper blockages cause pimples, and oil way below the surface can cause a pus-filled cyst. Dermatologist-recommended acne treatments address one or more parts of this acne cycle.
Since excess scrubbing can irritate the skin and make acne worse, the AAD recommends washing your face once or twice a day using a mild facial cleanser and lukewarm water. If you use makeup, choose oil-free products that don't clog pores. The label will say the product is non-comedogenic or non-acnegenic. While acne isn't caused by specific foods, avoid any foods that seem to make your acne symptoms worse, dermatologists say.
According to the AAD, it's best to treat mild acne by applying topical products that come in gels, creams, solutions and lotions. Mayo Clinic experts say these products are often available over the counter, and contain ingredients such as benzoyl peroxide, antibiotics, salicylic acid or retinoids that dry up excess oil, kill bacteria, and help remove dead skin cells.
Moderate to Severe Acne
Oral antibiotics are the best option for moderate to severe acne, as well as acne that doesn't respond to topical treatments and acne that involves large areas of the body, says AAD. Some popular antibiotics for acne include doxycycline, tetracycline and minocycline. In some cases, your doctor may recommend a combination of oral antibiotics and topical products. The AAD also says some oral contraceptives, or birth control pills, may be effective against moderate to severe acne in women.
According to the AAD, isotretinoin is the only medication approved by the U.S. Food and Drug Administration for the most severe form of acne that causes pus-filled cysts. Because this drug causes severe birth defects if a woman takes it during pregnancy, you must register with the FDA's iPLEDGE monitoring program before your doctor can prescribe the drug.
According to the Mayo Clinic, an individual with serious acne may benefit from laser treatments that damage the oil-producing glands that start the acne cycle or from light-based therapies that attack bacteria. Some dermatologists also offer chemical peels and microdermabrasion to remove acne lesions.
Mayo Clinic experts list a number of procedures to treat severe scarring from acne. The doctor may inject a soft tissue filler such as collagen under your skin to make the scar less noticeable, perform dermabrasion to remove the top layer of skin with a rotating wire brush or resurface the skin with a laser, light source or radiofrequency waves. In some cases, a surgeon may remove the scarred area of skin and close it with stitches or a skin graft.