Let's clear up a few things about acne

Whether you’re a teen going out with friends or you’re an adult facing a work presentation, acne can make it hard to put your best face forward. It takes only a couple of blemishes to throw off your mood and confidence.

Acne that’s more severe and persistent, if left untreated, can cause scarring – not only physically, but also emotionally. For teens, especially, it can upset emotional well-being far more than you might think, affecting their self esteem and social development.

The good news is that most of that pain can be avoided if effective treatment is started as soon as possible. Unfortunately, many people use over-the-counter products incorrectly, wait too long to see a doctor, or give up on treatments before they’ve had a chance to work. So let’s clear up a few things to give you or your child the best chance at getting acne under control.

What can you do at home?

Nonprescription acne treatments: Over-the-counter acne products can be very effective as first-line treatment for mild acne. Look for products with the active ingredient benzoyl peroxide or salicylic acid. Many expensive products have the same active ingredients as the less-costly ones, so there’s no need to spend a lot of money. Read the labels, compare ingredients and choose the equivalent with the best price.

Acne washes: Try washing your face gently once or twice a day with an acne wash containing benzoyl peroxide or salicylic acid. Don’t scrub – that can irritate your skin. If even gentle washing with an acne wash is too irritating, or if you’re using prescription acne medication, try a mild soap or a non-soap cleanser instead. Cetaphil, Neutrogena and Dove are good, gentle choices.

Makeup: Look for brands that say “noncomedogenic” on the label – these won’t clog pores or cause acne.

Sunscreen: Use brands that are formulated for acne-prone skin, such as Cetaphil and Neutrogena.

Headbands and helmets: If you’re prone to acne, be careful when wearing headbands, helmets or hats – the added friction can cause acne around your hairline.

Cautions: Don’t overuse acne products. More is not necessarily better. If you buy five different products and use them all, you’ll irritate your skin, which will not help your acne. The trick is to find the treatment and the wash that work best for your skin type, and to use them as directed. A dermatologist can advise you if you’re not sure. And whatever you do, don’t pop pimples yourself – that can cause scarring.

Should you change what you’re eating?

Greasy fries, chocolate, sugary foods, processed carbohydrates – a lot of foods have been blamed for causing acne. While the debate goes on, the most plausible connections may be with milk and high-glycemic-index foods, but no major studies have offered definitive proof.

When should you see a doctor?

Even people with mild cases of acne can benefit from professional advice. Your primary care provider may be able to get you started on a good skin-care regimen, or may refer you to a dermatologist for further care and advice.

Dermatologists see people at every end of the acne spectrum, from mild to severe. They can help you understand your skin type, recommend the most effective approaches for your skin, and often prescribe topical treatments or pills that are more effective than over-the-counter options.

In some cases, it’s especially important to be evaluated by a dermatologist. Make an appointment right away if:

  • Your skin is red and inflamed
  • You are starting to notice scarring
  • Your child develops acne at an unusually early age, such as 5 or 6 – this can be a sign of an internal disorder that is creating excess hormones and may require medical treatment
  • You are an adult woman with a sudden, unusual acne outbreak – this can be a sign of a hormonal imbalance called polycystic ovary syndrome
  • You suddenly have an acne outbreak that is more severe than ever before

After ruling out medical problems, your dermatologist will usually start you on the mildest acne medications first, and then move up the scale to stronger medications, and possibly antibiotics, as needed. For the most resistant cases, Isotretinoin (formerly sold under the brand name Accutane) is currently the most potent medication we have. It requires careful monitoring for side effects, but in cases of severe acne, nothing is more effective.

With all medications, it’s important to keep a few things in mind:

  • You’ll need to give them time to work. You may not see results for four to eight weeks, and in some cases, acne may even get a little worse before it gets better. Don’t give up on medications before they’ve had a chance to do their job.
  • Acne medications all have potential side effects. Be sure you understand yours, and talk to your doctor if you have any concerns or reactions.
  • Most acne medications dry out the skin, which can be hard if you have combination oily-dry skin. Usually your skin will adapt after a few days or weeks. If it continues to be a problem, ask your doctor to help you find a solution.

With early, appropriate treatment and proactive maintenance, the vast majority of people can get acne under control, before it leaves lasting scars. It’s a very individual condition, but we have many effective tools available – and the look on a person’s face, once everything is clear, is priceless.