There are a number of acne medications available through your doctor or pharmacist that can help treat and prevent acne. It can take several weeks of treatment to see noticeable improvements, but you should seek further advice from your doctor or pharmacist if the acne has not improved within 4 to 8 weeks.
Salicylic acid preparations (e.g. DermaVeen Acne Cleansing Bar) and sulphur-based treatments (e.g. Clearasil Acne Treatment Cream) can help improve acne. These preparations are keratolytics (peeling agents) that can unblock pores by removing keratin plugs. Sulphur can also help suppress bacteria that may make the acne worse, but if you have a sulphur allergy, do not use these products.
Antibiotics and antibacterials
Benzoyl peroxide, which increases the rate of removal of skin cells and suppresses the bacteria that contribute to acne, is very effective if used regularly. Benzoyl peroxide treatments include such products as Benzac AC Gel and Wash, Brevoxyl, Oxy and PanOxyl. These products come in varying strengths (2.5 to 10 per cent) but, if too strong (greater than 5 per cent), the skin may become dry or rough. For this reason it is better to start with a lower strength, as stinging and skin redness may occur initially. If applied at night, much of the redness caused by the treatment will have gone by morning.
Azelaic acid (e.g. Acnederm medicated lotion, Finacea) is another acne preparation that has antibacterial and keratolytic properties. Like benzoyl peroxide, it can cause skin dryness and redness at first.
Topical antibiotic preparations that can be used to control acne include clindamycin (Dalacin T Topical Lotion and ClindaTech solution) and erythromycin (Eryacne 2% gel). These medications have antibacterial and anti-inflammatory effects, and are the least irritating topical agents commonly used for acne. They are often used in combination with benzoyl peroxide. In more severe cases, your doctor may recommend you take a course of antibiotics by mouth (e.g. erythromycin, doxycycline, tetracycline or minocycline).
Topical antiseptic washes
Topical antiseptic washes such as Acnederm Foaming Wash, Oxy Skin Wash and Sapoderm may also be helpful.
Oral contraceptives — ‘the pill’ (e.g. Diane-35 ED and Juliet-35 ED) can be an effective treatment for women with acne.
Retinoids are the most effective treatment for acne, but they can also irritate the skin more than other acne treatments. They are available in topical skin preparations, such as tretinoin (Retin-A), adapalene (Differin Topical Cream or Gel) and isotretinoin (Isotrex Gel), or as oral medicine (isotretinoin – brand name Roaccutane).
People taking retinoids may need non-oily moisturisers for their lips and face, as well as eye lubricant drops, as they can cause dry skin and eyes. Retinoids can cause severe birth defects, so cannot be taken by pregnant women, those planning pregnancy or women who are not using appropriate contraceptive measures.
Skin care while using acne treatments
Many treatments for acne, both topical (surface) and oral medicines, can cause dryness, redness and irritation. This is because your doctor has deliberately selected active ingredients to reduce oiliness and build-up of dead skin cells in the pores, which are known to be factors that contribute to acne lesions.
It is important to know that dryness is expected, and usually means that the treatments are working.
Your skin care regimen should include:
- active treatment; and
- sun protection.
- Choose a soap-free cleanser for sensitive skin types (not one for acne, unless specifically advised by your doctor).
- Cleanse your face twice a day, using your cleanser to also remove make-up.
- Don’t wash your face directly under the shower head (this can lead to excessive dryness and redness).
- Avoid cleansers with added herbs, fragrances, vitamins, fruity acids, etc.
- Don’t use exfoliants, Buf-Pufs, alcohol or acne wipes, toners, scrubs, granules, masks, peels, steams or have facials (check with your doctor first if in doubt).
- Don't squeeze or pick at acne pimples.
- It is important to moisturise whenever necessary, even if you have acne, because otherwise your skin may not be able to cope with the treatments that have been suggested to you.
- Try to moisturise twice a day, with extra ‘top ups’ during the day if necessary.
- It’s best to moisturise immediately after washing your face, before any treatments or sunscreens are applied.
- Use oil-free, non-comedogenic lotions i.e. those less likely to clog the pores of the skin.
- Again, try to avoid products with additives.
3. Active treatment
Your doctor will recommend active treatment for your acne, depending on your individual needs.
4. Sun protection
- Many acne treatments will leave your skin sensitive to the sun (this is temporary).
- Wear a broad-brimmed hat, stay out of the full sun, especially between 10am and 2pm (11am and 3pm summer time) and use a sunscreen.
- Sunscreens should ideally be SPF 30+ or higher, broad spectrum and applied every 2 hours when outdoors.
- Some sunscreens can aggravate acne, so trial and error may be required.
- It’s best to choose oil-free formulations.