Control of acne is an ongoing process. All acne treatments work by preventing new acne, but existing blemishes must heal on their own and improvement takes time. If your acne has not improved after 6 to 8 weeks, you may need a change in your treatment.
The treatment your dermatologist recommends will vary according to your type of acne. Occasionally, an acne-like rash can be due to another cause such as makeup, lotions or oral medication. Rarely, acne can be due to a hormone imbalance. It’s important to help your dermatologist by providing a history of what you are using on your skin or taking internally. Women will want to discuss changes in the menstrual pattern.
Many non-prescription acne lotions and creams help milder cases of acne. However, many will also make your skin dry if used too often. If you use these products, follow instructions carefully. Your dermatologist may prescribe topical creams or lotions such as vitamin A acid or benzoyl peroxide to help unblock the pores and reduce the bacteria. These may cause some drying and peeling. Your dermatologist will advise you on the correct use and how to handle side effects. There are also antibiotics that are applied to the skin. These are used in less severe cases of acne.
When large red bumps are present, the dermatologist may inject cortisone directly into the bumps to help them go away. Your physician may open pimples or remove blackheads and whiteheads. Don’t pick, scratch, pop or squeeze pimples yourself; when the pimples are squeezed, more redness, swelling, inflammation and scarring may result.
Antibiotics taken by mouth such as tetracycline, minocycline or erythromycin are often prescribed for moderate or severe cases, especially when there is a lot of acne on the back or chest. The antibiotics reduce the bacteria in the follicle and may also decrease the redness directly. When taking oral antibiotics, some women develop a yeast infection in the vaginal area. If this occurs, continue your medicine and contact your dermatologist immediately for treatment of the yeast.
Women who are taking birth control pills may notice a significant improvement in their acne, and occasionally birth control pills are used specifically for the treatment of acne. It is also important to know that oral antibiotics may decrease the effectiveness of birth control pills. This is uncommon but possible, especially if you notice break-through bleeding. As with most medicines, check with your doctor about taking antibiotics if you are pregnant or nursing.
In cases of severe acne, other drugs may be used orally. These may include female hormones or medications that decrease the effects of male hormones. Another oral medication, isotretinoin, is sometimes used for severe acne that has not responded to other treatments. Patients using isotretinoin must thoroughly understand the side effects of this drug. Frequent follow-up visits are necessary to monitor side effects. Prevention of pregnancy is a must, since the drug causes severe birth defects if taken during pregnancy.