What Can I Do To Get Rid Of Acne?

I have a fairly bad case of acne, and I cannot seem to get rid of it. I have tried over-the-counter treatments, but they make it worse. What can I do to to get clearer skin?

Acne vulgaris, the medical name for common acne, is a frequent problem in adolescence and young adulthood. Acne is associated with androgens, which are male sex hormones (yes, girls have them too, though less than boys), and therefore acne tends to be more severe in boys. It usually clears by itself by the time a person is in their late twenties, but of course considerable damage both in terms of scarring of the face and poor self-image may have taken place by then. Fortunately, there are now many options for the treatment of acne.

Acne develops in adolescence when the amount and type of sebum, the fatty material produced by glands in the skin, changes. Sebum production is increased, and may lead to small light colored bumps called comedones, which can be closed or open. When a comedone is open the sebum takes on a dark color, and it is called a blackhead. This is not dirt, and no amount of washing will prevent the development of blackheads.

Comedones can become inflamed, and may be infected, causing the red bumps — often with a white top — which we call pimples. Occasionally, the pimples can actually become cysts or boils with drainage and scarring. Some people, particularly if darker-skinned to begin with, may have dark spots develop wherever they have a pimple.

Most of the over-the-counter acne preparations contain salicylic acid, which dries the skin and reduces the comedones, and/or a low concentration of benzoyl peroxide, which is also drying and antibacterial. They are fine for someone with mild acne, but if they don’t work, as both of today’s writers report, then treatment with prescribed medication must be used. Combatting acne is an ongoing process; it doesn’t simply go away and never return. Therefore, the teenager must develop a relationship with a doctor who knows about the acne treatments, and can modify the treatment schedule as necessary.

Retinoids such as tretinoin (Retin-A) are a mainstay of treatment. They tend to unplug the comedones and allow antibiotics or antibacterial agents, like benzoyl peroxide, to penetrate. Tretinoin comes in different strengths and forms. It can be irritating to the skin, and may make the acne worse for four to six weeks before it really kicks in. If it is irritating, it can be applied less often, but once at night is a typical schedule. An antibiotic cream or benzoyl peroxide can then be applied in the morning.

For more serious cases, many doctors will give antibiotics by mouth; these can be very effective either with or without the topical treatments. Various tetracyclines or erythromycin are commonly used.

For the most serious cases, such as someone who is forming cysts and scars from their acne, isotretinoin can be given by mouth. This can be very effective, and often stops the acne for many months, even when the drug is no longer being taken. It does, however, have some disturbing side effects, and causes birth defects. Therefore, it can never be taken by someone who is or might become pregnant. Many doctors will only give it to women who agree to take birth control pills at the same time.

Finally, birth control pills themselves will often help with acne. Most of them contain an estrogen, which counteracts the androgen causing the comedones. Several of the newer birth control pills also contain a progestin (the other active component) which also reduces the formation of comedones. Even young women who are not sexually active and don’t need them for contraception can be given the birth control pills for their anti-acne effects.

The information provided on Health Search Online is for educational purposes only and is not a substitute for medical advice, diagnosis or treatment.