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How is acne treated?

Dr. Nancy Shannon

Medically reviewed by Dr. Nancy Shannon, MD, PhD on May 25, 2021

As hard as you may try, some acne simply cannot be prevented. Whether it’s a one-time thing or a series of chronic breakouts, acne can almost always be treated — but understanding the available treatment options can feel overwhelming. Here’s an overview of some of the most common acne treatments and how they work:

  1. Benzoyl Peroxide

It’s common knowledge that acne comes from clogged pores, but it’s what happens after the pore gets clogged that really matters. A clogged pore is full of dead skin cells, oil, and bacteria; the last of which can grow rapidly in clogged pores and cause pustules. The bacteria in question, Cutibacterium acnes (Previously known as Propionibacterium acnes), thrives in environments depleted of oxygen. Benzoyl peroxide is a topical antibiotic that works by flooding the pores with oxygen, killing the bacteria. One study showed that a benzoyl peroxide cleanser applied twice daily killed 97.5% of C. acnes after 15 days, making it one of the most effective acne treatments out there. 

  1. Salicylic Acid

Instead of combatting what’s inside the pore, salicylic acid works to unclog the pores by exfoliating the superficial layer of skin cells. This allows sebum, produced by oil glands, to flow out freely from the pores rather than getting trapped and leading to acne.

  1. Topical Retinoids

Similar to salicylic acid, topical retinoids work on the surface level of the skin in order to combat acne by helping the superficial layer of skin cells to exfoliate off. Because topical retinoids help exfoliate superficial layers of the skin, this can cause people to develop skin flaking and irritation. For this reason, some dermatologists prefer starting their patients on a milder formula retinoid (or even milder retinol) before moving up in strength.

  1. Antibiotics

One of the primary purposes of antibiotics is to kill bacteria, so it makes sense that they have a role to play in the fight against acne. Antibiotics, whether used in creams or taken orally, can reduce the amount of C. acnes on the skin and decrease the incidence of acne breakouts as a result. Other than benzoyl peroxide (which is over-the-counter), other topical or oral antibiotics for acne are prescription-strength.

  1. Azelaic Acid

Azelaic acid works in many of the same ways that the products listed above do: it reduces skin inflammation, is antibacterial, and promotes high levels of cell turnover to prevent the buildup of dead skin cells in and around the pores. Though azelaic acid is perfectly safe for typical use, it can cause some skin to redden and peel. 

  1. Birth Control

It may sound strange, but birth control can make all the difference for women suffering from hormonal acne. The natural fluctuations caused by menstruation can cause acne breakouts in some women, and birth control can help regulate this. Combined birth control pills (those that contain estrogen and progesterone) help to lessen hormonal fluctuations and reduce androgen levels, which can lead to decreased sebum production and in turn reduce acne break-outs.

  1. Spironolactone

This oral medication is a diuretic that also reduces excess androgens (including testosterone) in the body, and it can be used to treat hormonal acne in women.

  1. Isotretinoin 

Generally reserved for more severe, chronic cases of acne, isotretinoin is better known by one of its most popular brand names: Accutane. Technically a member of the retinoid family, isotretinoin causes the pore’s sebaceous glands to become less active, meaning that your skin will produce less sebum over time. This decreases the likelihood of bacterial growth as well, as C. acnes feed on excess sebum. Though it has a high rate of efficacy, isotretinoin also comes with some potentially serious side effects. A dermatologist can discuss these risks and determine if you are a candidate for isotretinoin treatment.

  1. Dermatological Procedures 

There are a number of procedures such as light therapy, chemical peels, and steroid injections that dermatologists can administer in the office, though they are generally only used after some of the more traditional treatments listed above are tested. 

If you’re wondering what treatments may be right for you, we’re here to help. Get in touch with a member of our medical team today — we can help you figure out what your path towards clear skin should look like.

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