Medication

There are numerous ways of treating acne. Finding the appropriate individualized therapy is the job of a dermatologist, who will determine the severity of the acne, the types of lesions present, any other co-existing conditions, as well as the patient's age, skin type and lifestyle.

Benzoyl peroxide

Bactericidal products containing benzoyl peroxide may be used with mild to moderate acne. The gel or cream containing benzoyl peroxide is rubbed, twice daily, into the pores over the affected region. In addition to its therapeutic effect as a keratolytic (a chemical that dissolves the keratin plugging the pores), benzoyl peroxide also prevents new lesions by killing Propionobacterium acnes. Benzoyl peroxide products should be used in a low concentration, combined with suitable non-comedogenic moisturisers to help avoid over-drying the skin.

Topical antibiotics

Externally applied antibiotics, such as Erythromycin and Clindamycin, aim to kill the bacteria in the blocked follicles. While the topical use of antibiotics is equally as effective as oral use, this method avoids possible side effects, including upset stomach and drug interactions (e.g. it will not affect use of the oral contraceptive pill).

Oral antibiotics

When acne is resistant to topical therapies, oral antibiotics may be used. Erythromycin or one of the Tetracyclines decrease acne and has anti-inflammatory effects. Oral antibiotics often have to be taken for months at a time and may have to be used in combination with topical products.

Hormonal treatments

Some women suffering from acne may be helped with hormonal treatments. Common hormonal contraceptive therapies can have some effect, but anti-androgen in combination with an estrogen is particularly effective at reducing androgenic hormone levels.

Cortisone

A dermatologist may administer an injection of cortisone directly into a pimple which will usually reduce redness and inflammation almost immediately. This has the effect of flattening the pimple, thereby making it easier to cover up with makeup, and can also aid in the healing process.

Topical retinoids

Topical reinoids are a group of medications used for normalizing the follicle cell lifecycle and are related to vitamin A. They help to prevent the hyperkeratinization of the cells.

Oral retinoids: Isotretinoin

A daily oral intake of vitamin A derivative isotretinoin (marketed as Accutane, Amnesteem, Sotret, Claravis) over a period of 4-6 months can result in the long-term reduction or complete eradication of acne. It is believed that isotretinoin primarily works by reducing the secretion of oils from the glands. Isotretinoin has been shown to be very effective in treating severe acne and over 80% of patients have reported improvement. The drug has a much longer effect than anti-bacterial treatments and has cured some cases of acne.0 This treatment requires close medical supervision by a dermatologist because the drug has many known side effects (many of which can be severe).