Treating Acne

Acne affects most people at some point in life. This disease occurs in highly sebaceous (oily) parts of the skin, such as the face, chest, back, and upper arms. Acne starts as a disease of pore plugging. Pores are the shared openings of skin where sebum (oil) and hair emerge onto the surface. When skin cells at the top-most layer stick to each other around a pore, this creates a blockage, and then oil cannot get out.

Once oil becomes stagnant, it changes from a liquid to a solid. The solid oil blockage clinically appears as whiteheads and blackheads, also called comedones. After comedones are formed, a certain bacteria called Propionibacterium acnes (P. acnes) overgrows in the oil and generates an inflammatory response, leading to pimples and pustules. In severe cases, the inflammatory response can be extensive, leading to large pimples (nodules) and cysts, and eventually scars.

Acne treatment regimen

Depending on the symptoms, Dr. Saucier may recommend one or a combination of therapies for a customized acne treatment regimen. Read more about Dr. Saucier here.

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What are the treatments for acne?

It takes many weeks for the top layer of skin to turn over. Because of this, acne can be a very slow disease to treat. Most treatments take up to 12 weeks for maximal benefit to occur. Treatments for acne include:

• Salicylic acid

  Many over-the-counter acne products contain salicylic acid, which can help mild cases of acne. It promotes skin cell shedding and can release plugged pores (comedolysis).

• Benzoyl peroxide

  Benzoyl peroxide is also easy to find in over-the-counter acne products, and it has both comedolytic and antimicrobial benefit. Benzoyl peroxide is highly complementary to topical retinoids.

• Chemical peels

  Salicylic acid peels are particularly beneficial for acne and can "jump start" an acne program. Most insurance companies do not pay for chemical peels for acne.

• Retinoids

  Retinoids are the most effective of all topical medicines prescribed for acne. They are powerful chemical exfoliants and help prevent pore plugging in the first place. Available retinoids for acne include tretinoin, adapalene, and tazarotene.

• Oral and topical antibiotics

  Prescription antibiotics for acne come in topical and oral preparations. They are ideally used for short periods of time in cases of inflammatory acne.

• Hormonal options

  Oral estrogen / progesterone (birth control) can be helpful in many women with acne. Another safe option for women is spironolactone, a weak diuretic with anti-androgen (anti-male hormone) benefit.

• Extraction

  In treatment resistant cases, individual whiteheads and blackheads can be carefully removed with a comedone extractor.

• Isotretinoin

  Widely known by its former branded name Accutane, isotretinoin is still available for treatment recalcitrant and/or severe nodulocystic acne. This medication can only be prescribed with enrollment in the iPLEDGE program.