How to get acne treatment

Where do you start?

1. 1For a few mild spots, ask a pharmacist about a treatment you apply to the skin.
2. 2If home treatment is not helping, arrange an appointment with a primary care doctor. In the UK, this is your GP; family doctors and pediatricians also diagnose and treat acne.
3. 3For persistent or more severe acne, discuss prescription treatment and whether you need a dermatologist, a doctor who specializes in skin conditions.

Some adult acne can be treated at home, but treating acne early can help prevent problems rather than leaving it to run its course. Different types of spots need different treatments.3

When should you see a doctor?

Arrange medical help if:

• You have lots of spots, deep painful lumps, or scarring.
• Your acne is getting worse or is not improving with treatment at home.
• Your skin is hot, swollen and red, which can indicate an infection. Redness can be harder to see on brown and black skin.
• Acne is causing anxiety, low mood or other emotional distress.

Acne treatment is not a cleanliness test

Acne develops when hair follicles under the skin become clogged. It commonly affects the face, neck, chest, shoulders and back. Blackheads and pimples are not caused by dirt, so acne treatment is not an audition for being better at washing. Clean gently rather than trying to scrub the spots away. Stress can make acne worse, but does not cause acne. Chocolate and greasy foods are often blamed, although there is little evidence that food has much effect on acne in most people.6

What happens at an acne appointment?

The doctor examines your skin and asks how long you have had acne, about your family history, and which medicines you take or recently stopped. Menstrual cycles can also be relevant. Bring those details to the appointment. Acne is usually diagnosed by looking at the skin, without tests; lab work is sometimes needed to investigate another condition. Treatment aims to heal existing spots, prevent new ones and reduce scarring.25

Which treatments are available?

Prescription skin treatments usually come as creams, gels or lotions. Oral antibiotics are generally used for moderate to severe acne. A dermatologist often combines two or more treatments, and topical antibiotics are usually used alongside another skin treatment. The choice depends on the type of spots, severity and contributing factors rather than simply choosing the strongest product.2347

How do you use acne treatment at home?

Follow the product directions carefully and apply nonprescription treatments sparingly. Frequency, strength and application instructions depend on the treatment you choose. Skin treatments can cause dryness, peeling, burning or redness; discuss side effects with your doctor. Benzoyl peroxide can bleach towels and clothing.25

• Use a mild cleanser in the morning, evening and after heavy exercise, and rinse with lukewarm water.
• Avoid strong soaps, astringents and rough scrub pads.
• Remove makeup before bed, and do not squeeze or pick spots.
• Choose oil free cosmetics and hair products labeled noncomedogenic, meaning designed not to clog pores. Even these products can worsen acne in some people.
• Use sunscreen outdoors and avoid tanning. Many acne medicines make skin more prone to sunburn.

How long does treatment take?

Acne often responds well to treatment, but improvement can take 6 to 8 weeks, and flare ups can still occur. Contact your doctor if home care and nonprescription medicine have not helped after several months. Seek help sooner for worsening acne, cysts, developing scars or emotional distress.5

What if acne starts or returns in adulthood?

Acne can continue into your 30s, 40s and 50s, or appear for the first time in adulthood, because apparently it never agreed to a graduation date. A treatment that worked during your teens can stop helping or make acne worse. Hormonal changes around periods, pregnancy, menopause or starting or stopping birth control can contribute. Family history, stress, hair products and skincare products can also play a part.7

If you suspect a prescribed medicine is causing breakouts, keep taking it and speak to the doctor who prescribed it. Ask whether acne is a possible side effect and whether an alternative is suitable. If changing the medicine is not possible, a dermatologist can help manage the acne. Sometimes an underlying medical condition contributes, and treating that condition helps clear the acne.7

What about pregnancy and isotretinoin?

Pregnancy can trigger acne through hormonal changes. Isotretinoin must not be taken during pregnancy because it causes severe birth defects. Treatment requires close monitoring and regular blood tests. In the US, isotretinoin treatment also requires enrollment in the iPledge program, with contraception requirements for women who take it. Discuss pregnancy with your clinician before choosing acne medicine.57

Do you need a procedure?

Some severe acne or scarring that does not respond to medicines needs additional treatment. Options include corticosteroid injections and doctor applied chemical peels. Researchers are still studying which light treatments and doses work best.2