Recommended Acne Treatments by Dermatologists
Dermatologists consider numerous factors before recommending specific treatments for acne, including the age and gender of the patient, the type of acne involved and, if the patient is female, whether she is or plans to become pregnant. Acne treatments are never quick fixes, according to the American Academy of Dermatology. They generally require one to two months to begin working effectively, and patients must continue treatment past that point to prevent acne from returning.
To treat mild acne, dermatologists usually recommend products that patients apply to their skin. The products come in several formats, including creams, gels and lotions, and they contain various drugs, such as antibiotics, benzoyl peroxide, salicylic acid and retinoids. The drugs work by drying up pores to unclog them and killing bacteria, both of which help reduce inflammation.
Some topical treatments require a prescription and others are available over the counter. Nonprescription products that dry out pimples, such as salicylic acid creams, tend to work less effectively than benzoyl peroxide and antibiotics. If topical drugs do not work, dermatologists can use an instrument, such as a sterile needle or loop extractor, to drain pores and clear up pimples.
Dermatologists often recommend prescription oral antibiotics alone or combined with topical products to treat acne that is moderate, spread over large areas of the body or resistant to topical products when used alone. Available antibiotics include azithromycin, doxycycline, erythromycin, minocycline, tetracycline, trimethoprim and trimethoprim-sulfamethoxazole.
Patients may have to take antibiotics anywhere from weeks to years to stop acne from recurring, although the antibiotics can cause side effects that include discolored skin, dizziness and increased sensitivity to sunlight. Women are at risk of developing vaginal yeast infections after long-term use.
Women with moderate to severe acne may take birth control pills containing estrogen or certain medications containing antiandrogens, which reduce the impact of male hormones. Dermatologists may also help clear up large acne lesions with injections of corticosteroids.
While some cases of severe acne respond to antibiotics and/or topical drugs, nodular cystic acne, the severest form of acne, may require the very effective--and potentially very dangerous--prescription medication isotretinoin. The only drug with approval from the U.S. Food and Drug Administration to treat nodular cystic acne and acne resistant to other medications, isotretinoin demands careful monitoring from a dermatologist and typically about 20 weeks of treatment. Before starting treatment, all users must register in a program designed to prevent pregnancy because isotretinoin can cause severe birth defects, even following brief usage. Other possible side effects include aching muscles, depression, dry skin and sun sensitivity.
Acne scars require treatment based on specific characteristics of patients due to the complexity and uniqueness of scarring patterns. Options that dermatologists recommend include chemical peels, dermabrasion, laser resurfacing, microdermabrasion and skin fillers to reduce the prominence of blemishes; light and laser therapy to damage oil glands and inhibit their ability to produce oil, which contributes to acne; and surgery to remove scars and repair resulting holes with skin grafts or stitches.
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