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Treatment of Acne

The type of treatment depends on how severe the acne is, and whether it is inflammatory (whether the spots are red swollen bumps).

Mild non-inflammatory acne (whiteheads and blackheads) may be treated with gels, creams or lotions that are applied directly to the skin (topical). These include:

  • Retinoids, which contain vitamin A and loosen skin cells that are sealing the hair follicles;
  • Adapalene, which affects the growth of skin cells; or 
  • Benzoyl peroxide, which has anti-bacterial properties.

Mild to moderate inflammatory acne (with some pustules and nodules) is often treated with gels, creams or lotions containing: 

  • Benzoyl peroxide;
  • Azelaic acid, which stops the growth of skin bacteria keeping skin pores clear; or
  • Topical antibiotics such as clindamycin, which fight bacteria and reduce inflammation.

Moderate acne is often successfully treated with a low-dose oral antibiotic, such as tetracycline or erythromycin. These reduce the number of bacteria, inflammation and sebum production. It sometimes takes up to 8 weeks for any noticeable improvement and the treatment is usually needed for at least six months.

For women, taking a high oestrogen contraceptive pill may also help acne, by regulating the hormones that cause excess sebum production.

If the acne is severe, a dermatologist (skin specialist) may prescribe isotretinoin, a retinoid taken by mouth that acts to loosen excess skin cells and reduce sebum secretion.

If acne has already left noticeable scars, a cosmetic surgeon may discuss techniques such as dermabrasion or laser treatment. In these procedures, the top layer of skin is removed under a general anaesthetic, leaving a more even layer of skin. There is limited clinical evidence about the effectiveness of these treatments.

Treatment should also help address some of the psychological issues associated with acne, for example by reassuring the person that some of the myths are not true. Acne is not caused by poor hygiene, poor diet or lack of exercise, and is not infectious.