Sunday, June 23, 2024

How to Choose the Best Acne Treatment

Updated March 2014

Buying Advice: Acne Treatments

Acne is one of the most common skin disorders and can afflict anyone from babies to adults. It is most common in teens going through puberty because the temporary surge of hormones causes an increase in sebum production. Sebum is a naturally occurring oil in hair follicles that keeps skin moisturized. If your skin produces too much sebum and it mixes with dead skin cells, it can clog pores and breed bacteria causing an inflammatory response commonly known as acne. Hair follicles on your face, upper neck, and chest produce the most sebum, which is why acne is most prevalent in those areas.

While it is now known what causes acne and how to treat it, it wasn't always so clear. In ancient times, people believed that acne was caused by telling lies or by eating spicy food. Ancient Romans actually pioneered the first fairly effective acne treatments by mixing sulfur in with mineral baths to dry pore-clogging oil and kill bacteria. While advances were made in the years that followed, it wasn't until the 1920s when it was discovered that benzoyl peroxide had the ability to fight acne-causing bacteria that significant treatment options became available. Inexpensive and effective, benzoyl peroxide quickly became the most popular treatment option and has remained so to this day. Since benzoyl peroxide, new and enhanced acne treatment options have consistently been introduced into the market ranging from more advanced cleansers all the way to high-intensity blue light therapy and beyond.

What to Know Before You Buy

Skin Care Do's

Mild to moderate acne can be controlled with proper self-care. Gently cleanse your skin, paying particular attention to problem areas. Use over-the-counter drying agents that remove excess oil and promote the exfoliation of dead skin cells. Products with benzoyl peroxide and/or salicylic acid (or BHA) as the active ingredient are best. Regularly washing your hair with a clarifying shampoo and keeping it off your face can help prevent breakouts along the hair line as well. Also, avoid resting your hands on your face or touching it with clothing or hats because sweat and dirt contribute to acne as well as oil.

Skin Care Don'ts

Don't use harsh facial scrubs, astringents, or masks because they can irritate your skin and make your acne even worse. Avoid using oil-based makeup or other skincare products and instead opt for products labeled water-based or noncomedogenic. Lastly, don't be tempted to pick or squeeze pimples because you can actually make acne worse by driving bacteria deeper into your pores, which can cause pockmarks. If you are having mild outbreaks, you should have a trained esthetician give you a facial with extractions. But, for moderate to severe acne, you should visit the dermatologist.

Non-Prescription Treatment Options

Topical lotions, creams, gels, and cleansers available over the counter are meant to treat mild acne while still being gentle on your skin. They help dry up excess oil, kill bacteria, and promote the shedding of dead skin cells. Active ingredients may include benzoyl peroxide, sulfur, resorcinol, and salicylic acid. Don't be alarmed if you experience side effects such as skin irritation, excessive drying, or flaking. These symptoms will improve after about a month of use.

Prescription-Strength Treatment Options

For moderate to severe acne, you may need a doctor to prescribe a stronger treatment regime. Commonly prescribed topical creams or gels have active ingredients derived from vitamin A (a retinoid), such as tretinoin, adapalene, and tazarotene, which promote skin health on the cellular level. Your doctor may also prescribe a topical antibiotic to kill excess bacteria, as some naturally occurring bacteria is normal. The side effects may be worse the stronger the treatment, so consult with your doctor if you experience increased sun sensitivity, burning, or redness. You may need to switch medications, alter your dose, or rinse medication from your skin following application. Oral antibiotics will work best on moderate to severe acne but are used in short courses of three to four months until symptoms improve to prevent users from developing antibiotic resistance. Side effects of antibiotics include increased sun sensitivity, reduced efficacy of other medications, and upset stomach.

Combination Treatment Options

Some newer acne treatments achieve optimal results by combining medications. For instance, some antibiotic treatments are also used in conjunction with benzoyl peroxide to help prevent antibiotic resistance.


Isotretinoin is a very powerful medication prescribed when other treatment options fail to work. It is very effective but requires close monitoring by a medical professional because of the high incidence of side effects. It can cause birth defects in pregnant women, high cholesterol, and may even cause depression. Most people will be familiar with this treatment through its brand name-Accutane.

Oral Contraceptives

Oral contraceptives may help treat acne in women by balancing out hormone levels but carry their own indications and side effects.

Laser and Light Therapies

Laser and light therapy treatments are new technologies that help treat acne without damaging the skin. Laser treatments reduce oil production while light treatments target bacteria. These treatments are used by people who cannot tolerate other forms of treatment. A common side effect is skin irritation similar to a sunburn.

Cosmetic Procedures

Chemical peels and microdermabrasion are more traditionally used to reduce the appearance of other forms of skin damage, such as aging and scars, but can also be used with other methods to treat acne. Skin can get discolored and blister, which takes time to heal properly.

Alternative Treatment Options

Alternative acne treatments can be used alone or in conjunction with more traditional, mainstream options. Natural acne treatments aren't generally scientifically proven but may be just the thing for those sensitive to other treatment options. Though certain foods aren't proven to cause acne, a healthy diet and drinking plenty of water is one way to keep your skin properly nourished and hydrated. Some people suggest staying away from foods high in simple sugars, complex carbohydrates, and dairy and instead opting for nutrient-rich grains, fruits, veggies, and those high in zinc. Going on a detox diet may also help rid your body of impurities, so avoid processed foods and stick with organic items. Tea tree oil is also a well-studied and popular treatment option because it is proven to be just as effective as benzoyl peroxide.


Topical and oral treatments all work to reduce oil, increase cell regeneration and exfoliation, and combat bacteria. When it comes to treating acne, some patience is required. Results may not be seen for one to two months and your skin may appear slightly worse before it gets better. This is contrary to a lot of treatments being marketed as showing instant improvements.

Non-prescription treatments used on a daily basis cost around $30 to $60 a month while prescription items generally cost $45 to $200 per month, including a visit to your doctor and the cost of the prescription. Other cosmetic treatments occur less frequently but are expensive at $75 to $200 per session. Because acne treatments must be continued long term, even after acne clears, it can be quite expensive to treat. This is especially true if you experience acne scarring.

More severe cases of acne can cause scarring in the form of pockmarks. Treatments for pockmarks are costly and can start around $2,000 depending on the treatment you choose. Less expensive but also slightly less effective is microdermabrasion, which polishes the skin's surface for more subtle results and can be done by an esthetician. Soft tissue fillers are also a less expensive but consequently temporary solution that calls for fat cells to be injected under the skin to fill it out and make scars appear less noticeable. Moderate acne will require more intense and costly solutions. Chemical peels, dermabrasion, and laser resurfacing help minimize moderate acne scars by removing the top layer of skin and promoting the growth of new skin cells. As a last resort, skin surgery is the most invasive and expensive treatment option that calls for cutting out scars and using skin grafts to repair the holes that are left. For your safety and best results, be sure to consult a dermatologist prior to starting any treatment options.