8 Options for Treating Acne, As Recommended By Dermatologists

<p>Liz DeSousa/ Byrdie</p>

Liz DeSousa/ Byrdie

Medically reviewed by Julia A. Siegel, MD

Acne is one of the most common skin conditions, occurring when hair follicles beneath the skin's surface get clogged with oil and dead skin cells. But just because acne is common doesn't mean you have to grin and bear it. You have plenty of options for treatment, available both over-the-counter (OTC) and by prescription.

Keep reading to learn more about the different types of acne and the most effective acne treatments available, straight from board-certified dermatologists Melanie Palm, MD, Sonia Batra, MD, and Brendan Camp, MD.



Meet the Experts

  • Melanie Palm, MD, is a board-certified dermatologist and cosmetic surgeon at Art of Skin MD.

  • Sonia Batra, MD, is a board-certified dermatologist and founder of Batra Dermatology.

  • Brendan Camp, MD, is double board-certified in dermatology and dermatopathology.

  • Blair Murphy-Rose, MD, FAAD, is a board-certified cosmetic, medical, and surgical dermatologist.



Types of Acne

Before you jump into treatments, it's good to get familiar with the different types of acne—and discern which one you're dealing with.

  • Comedonal acne, including whiteheads and blackheads, is the mildest form of acne, caused by clogged pores and manifesting as small bumps under the skin. "This can happen if the skin is not turning over well or can be caused by using products or makeup that are too heavy and clog the pores," Batra says.

  • Inflammatory acne can occur when pores clog due to an overgrowth of bacteria on the skin. This type of acne usually appears as red bumps, pustules, papules, or cysts. "Sometimes, if too much oil builds up within a clogged pore, it can rupture or break under the skin's surface, and then the body mounts an inflammatory reaction," Batra says.

  • Cystic acne is a more severe type of inflammatory acne that causes painful breakouts deep beneath the skin's surface. It can also cause scarring. "It can be due to genetic predisposition, hormonal fluctuation, and perhaps more aggressive bacteria living in the pores," Batra says.

  • Hormonal acne is a type of acne that occurs due to hormonal fluctuations that occur at various times, like during menstruation, menopause, or pregnancy. Hormonal acne is most common in people between the ages of 20 and 50. It often appears as inflamed bumps or cysts on the chin, jawline, or other areas on the lower part of the face.

Here's how dermatologists recommend treating acne:

Gentle Cleanser

  • Format: Topical OTC

  • Types of Acne It Treats: Most forms of acne

  • What the Derms Say: Washing your face with a gentle cleanser is one of the most common first steps in treating acne. "This removes excess oil, dirt, and products that can clog pores," Batra says.

Benzoyl Peroxide

  • Format: Topical OTC and topical prescription

  • Types of Acne It Treats: Inflammatory and non-inflammatory acne

  • What the Derms Say: Often used in cleansers and spot treatments, benzoyl peroxide has antibacterial, anti-inflammatory, and keratolytic properties. "It can address bacteria on the skin that contribute to acne formation and prevent the formation of clogged pores," Camp says. Palm notes that it can irritate some people, especially when applied to wet skin.

Salicylic Acid

  • Format: Topical OTC and topical prescription

  • Types of Acne It Treats: Best for comedonal acne

  • What the Derms Say: "Salicylic acid is found in cleansers, toners, spot treatments, acne stickers, and even makeup," Camp says. "As a beta-hydroxy acid, salicylic acid penetrates deeply into pores to remove excess oil." According to Palm, salicylic acid is a great alternative for people who find benzoyl peroxide too irritating.

Retinoids

  • Format: Topical OTC and topical prescription

  • Types of Acne It Treats: All types of acne, including inflammatory, cystic, or hormonal acne

  • What the Derms Say: "Retinoids are vitamin A derivatives that help shrink oil glands, unclog pores, and speed cell turnover," Batra says. "Topical products that contain retinoids are sold over-the-counter, and higher strengths are available by prescription." Prescription-strength topical retinoids can decrease inflammation, block the effects of androgen hormones, and kill bacteria, she adds.

    Retinoids can easily cause skin irritation, which might lead to symptoms like dry, red, or flaking skin. "It's wise to gradually increase the use of retinoids slowly over time to allow your skin to [tolerate] them," Camp says. "Retinoids can also increase sun sensitivity, so they are best applied at night. An SPF moisturizer should be applied in the morning."

Chemical Peels

  • Format: Prescription or OTC peel

  • Types of Acne It Treats: Many different types of acne

  • What the Derms Say: "Chemical peels come in over-the-counter and prescription strengths to promote cell turnover and fade discoloration from prior breakouts," Batra says. "These are often concentrated exfoliants that cause the skin to slough." Chemical peels often contain ingredients like glycolic acid, salicylic acid, and lactic acid.

    When done in your dermatologist's office, chemical peels are highly effective at treating acne and minimizing scarring and discoloration caused by acne, Palm says. Depending on the chemical peel you get, you should expect to experience flaking and peeling skin somewhere between five and seven days after the treatment. Keep in mind that chemical peels are generally not safe during pregnancy, Palm adds.

Oral Antibiotics

  • Format: Oral prescription

  • Types of Acne It Treats: Inflammatory acne, cystic acne

  • What the Derms Say: "Oral antibiotics, like doxycycline, minocycline, and sarecycline, target bacteria on the skin that contribute to acne formation," Camp says. "Some, such as doxycycline, also possess anti-inflammatory properties." Oral antibiotics are usually prescribed for moderate to severe acne, and you'll need to take them for somewhere between one and three months. They're often prescribed with a topical medication that you can continue to use after finishing the antibiotic.

Isotretinoin

  • Format: Oral prescription

  • Types of Acne It Treats: Cystic acne

  • What the Derms Say: Isotretinoin, known more commonly as Accutane, is an oral prescription medication prescribed for severe acne that hasn't responded to other treatments. It works by shrinking the oil glands to reduce oil production and limit inflammation and scarring. Isotretinoin is typically prescribed for four to six months, and you'll need to see your doctor regularly during that time. "Though use of isotretinoin requires careful monitoring and can have side effects, it is an effective medication for severe cystic or scarring acne," Batra says.

Spironolactone

  • Format: Oral prescription

  • Types of Acne It Treats: Hormonal acne

  • What the Derms Say: Murphy-Rose says spironolactone is an oral medication typically used to treat hypertension, heart failure, polycystic ovarian syndrome (PCOS), and other endocrine disorders. However, it also can be used to address hormonal acne. "It helps to treat hormonal breakouts, reduce hair loss, and prevent hormonal hair growth in areas like the face," Murphy-Rose says.

    Here's how it works: "Spironolactone is an androgen hormone receptor blocker," Murphy-Rose explains. "Androgen hormones circulate in the blood and exert their effect after linking with a hormone receptor. Spironolactone blocks that receptor, preventing the hormone from being able to link and, therefore, blocking the 'activation.'" She says most of her patients don't experience side effects while taking spironolactone, but they can include symptoms like lightheadedness, dizziness, dehydration, and menstrual irregularities.

The Final Takeaway

No matter the type of acne you're dealing with, you have plenty of options for treatment, from over-the-counter cleansers to prescription retinoids. Rather than trying to take the matter into your own hands, consider seeing a dermatologist who can help you pave the way to clearer skin. This is especially important if over-the-counter options aren't working, you experience acne scarring, or your acne is impacting your quality of life.

Up Next: A Dermatologist-Approved Skincare Routine for Adult Acne

Read the original article on Byrdie.