Acne is a chronic skin condition characterized by a classic three things, sebum overproduction, bacterial overgrowth (having nothing to do with cleanliness) and keratin hyper proliferation. It presents as white heads, black heads or cysts and can be painful, debilitating, socially distracting and awful for many of my patients. Complications include scarring and infection as well as mental health symptoms.
1. Get the right diagnosis
See your primary care practitioner or dermatologist to make sure you don\’t have rosacea, or folliculitis, two common conditions associated with similar appearances to acne.
2. Use the right over the counter products
I recommend using a gentle non-abrasive cleanser, like Cerave or Cetaphil or Dove sensitive soap, then a mild moisturizer, and avoid anything labelled as \”for acne prone skin\” if you are also using prescription topical products. These will end up over drying your skin, leading to irritation and peeling.
3. Get prescriptions
Treatment is focused on reducing the three conditions associated with acne, and we often combine these to get best results. Prescription treatments include: topical antibiotics (clindamycin, erythromycin, minocycline), topical retinoids (tretinoin, adapalene), and topical acne treatment combos (clindamycin-benzoyl peroxide). For moderate or persistent acne, I also include options of oral antibiotics and/or combined hormonal birth control pills (which have anti androgen properties).
4. Be patient
All these options take minimum 1-2 months to begin working, so be PATIENT. See a cosmetic dermatologist to consider corticosteroid injections if you are needing something faster and immediate.
5. Follow up
Severe acne can be treated with oral medications like Accutane (tretinoin) which is ideally started before scarring occurs, as this is difficult to treat once scarring has taken place. If one option isn\’t working, follow up with your medical team so we can escalate the treatment or start combining treatments.
References:
Medscape: Acne Vulgaris https://emedicine.medscape.com/article/1069804-overview
Dr. Lorraine Sharp 