Get Rid of Bad Acne

Bad acne affects your physical appearance, but it also impacts your mood, self-esteem, and attitude, and it’s no fun. Additionally, moderate to severe acne can lead to permanent scarring. Dealing with your acne properly can start the process of healing your skin, improving your self-esteem, and helping you move on. Choosing the correct products can help you to avoid and treat common causes of acne.

Steps

Using Over-The-Counter Products

1. Use a gentle, pH balanced, soap-free cleanser. Wash your face twice a day, in the morning and in the evening, and again after exercising. Cleanse areas from under the jaw to the hairline, then rinse the areas thoroughly.
   • If you do not have sensitive skin and your skin tends to be oily, opt for an acne cleanser with either benzoyl peroxide or salicylic acid.
   • Strong soaps, scrub pads, or rubbing your skin harshly does not help, and may cause your skin to become irritated causing areas of acne to worsen.
   • Wash your hair regularly to control the release of oil from sebaceous glands located on the scalp.
2. Choose a product with an effective active ingredient. Four main ingredients are found in the topical products that can be purchased without a prescription. The two more popular ingredients, both of which have been studied and found to be effective, are benzoyl peroxide and salicylic acid.
   • Benzoyl peroxide works by controlling the bacteria, called Propionibacterium acnes, that normally lives on the skin. It also helps unclog pores. When pores get clogged with oil and dead skin cells, the bacteria can grow causing areas of acne to develop. Start with the lowest strength of benzoyl peroxide, which is 2.5%, if you have never used it before. Move up to stronger benzoyl peroxide products once you are tolerating the treatment. You may see some good results but feel you may get better results with a stronger product. Benzoyl peroxide products are made as strong as 10%, and come in many different forms, like gels, creams, lotions, and pads.
   • Salicylic acid products help to control the build-up of skin cells, and help to break down developing whiteheads and blackheads. Salicylic acid products also come in different forms, so you can choose the type of product that best suits your skin and your routine.
   • Additional topical products are available that contain either sulfur, usually combined with sodium sulfacetamide to help mask the unpleasant smell, or resorcinol. Both sulfur and resorcinol work by aiding the breakdown of blackheads and whiteheads and reducing acne-causing bacteria.
   • These products may not be appropriate for women who are pregnant or breastfeeding; consult a doctor or pharmacist if selecting an acne treatment under these conditions.
3. Wait long enough. Treatment with over-the-counter topical acne products sometimes take 8 weeks or even longer to see results. Some people even experience a worsening of acne symptoms prior to improvement. Be patient. Stay with your regimen of proper cleansing and using a topical product long enough to see results.
4. Understand what you are waiting for. The goals of treatment are to heal existing acne lesions, prevent the formation of new ones, avoid scarring, and improve self-esteem. The drugs contained in the topical products work in 4 primary ways, but no single over the counter product can do it all.
   • The targets for effective treatment include preventing cells in the follicle areas from clumping together, controlling oil production from the sebaceous glands, controlling the growth of bacteria, and helping to stop inflammation.
   • Whiteheads form when oil from the glands combines with dead skin cells to form a plug. The plug allows the bacteria underneath to grow beyond what is normal. The follicle wall may expand and become red. Blackheads form the same way, except the plug allows some of the bacteria to be exposed to air which causes it to darken. The darkened spot is not from dirt. Pimples result from inflamed or infected follicles that are blocked. This results in a raised, reddened area with a visible white spot in the center.
5. Take precautions to avoid serious allergic reactions. The FDA has identified a trend of serious, sometimes life-threatening, allergic reactions that may occur with over the counter topical acne products. The exact cause of the allergic reactions can be the active ingredients, the vehicles used, like creams or gels, or a combination of both.
   • To be safe, apply a small amount of product to a few small areas of acne for three days. If you should develop any signs of an allergic reaction stop using the product immediately and seek emergency medical attention.
   • The signs of a serious allergic reaction include tightness in the throat, difficulty breathing, feeling dizzy or faint, and swelling of the eyes, face, lips, or tongue. Hives, redness, rashes, and itching are also signs of an allergic reaction.
6. Use more aggressive at-home products. After consulting a doctor or an aesthetician, consider using home microdermabrasion treatments or home chemical peels.
   • Microdermabrasion is essentially an aggressive exfoliation that removes layers of skin and the bacteria that may be hiding there.
   • Light chemical peels can be done at home. These are usually not as effective as the deeper physician treatments, but they may be effective for some people. This process involves applying a solution to your face that strips away surface layers of skin.

Getting Medical Treatments

1. See a dermatologist to determine the severity of your acne. If you don’t have a dermatologist, then see your regular doctor first to get started with prescription treatment, or to get a referral to see a dermatologist.
   • You may want to consult your dermatologist about any existing scars from acne outbreaks as well.
2. Start using a prescription topical product. Your doctor can help you by prescribing treatments that are more effective than products that are available over the counter.
   • Some treatments, such as topical azelaic acid, are considered safe for pregnant women, although they may cause some temporary skin discoloration in pregnant women and women who use hormonal birth control. Other treatments may not be pregnancy-safe, so you should disclose any possible pregnancy to the doctor prescribing your medications.
   • Retinoids are topical treatments,usually available only by prescription, though you can now find a retinoid called adapalene gel (Differin gel) over-the-counter. They have been studied and shown to be effective in treating acne. Just like over the counter products, retinoids are made in different forms, such as creams, gels, and lotions, and also are available in different strengths. Retinoids are vitamin A derivatives. They work by helping the skin to get rid of dead cells and by preventing future development of clogged pores. Many retinoids can also help by treating areas that are reddened or inflamed. Retinoids also help keep your skin clear after it has cleared your existing acne.
   • Topical dapsone products have recently been approved in the United States for the treatment of acne. Dapsone has both antibiotic-like activity, and it acts as an anti-inflammatory. This form of therapy has been shown to work fairly quickly. In some cases, dapsone works best when combined with other forms of treatment, like the use of a topical retinoid product. Using dapsone with benzoyl peroxide could cause discoloration, so it is usually not recommended.
   • Your doctor may also prescribe a topical combination medication. Some medications such as Benzaclin and Ziana combine antibiotic with a retinoid or benzoyl peroxide.
3. Increase your use of the new product gradually. The most common problems with using prescription topical products are burning and stinging of the skin, dryness, and scaling. By using the product gradually at first, for example just three times weekly then build up to once or twice daily as prescribed, will help your skin to tolerate the new treatment without the discomforts.
4. Ask your dermatologist about oral medications if your acne persists. Your dermatologist will monitor your progress and may consider adding other types of treatments to your topical regimen.
   • Oral antibiotics have been prescribed to help treat acne for many years, but that practice is changing. Antibiotics work by controlling the growth of the bacteria that can cause acne to develop.
   • Antibiotics that are commonly used to treat acne include doxycycline, minocycline, and tetracycline. These are not generally recommended for pregnant or breastfeeding women or for children under the age of 12.
   • Due to the ability of that bacteria to become resistant to treatment, oral and topical antibiotics are now used less frequently than they were in the past. They are most often used to control inflammatory acne while other treatments take effect.
5. Consider taking birth control pills. In women, it is common for acne to worsen just before, and during, the menstrual cycle. Some studies suggest that as many as 63% of women who experience breakouts are particularly prone during their periods, usually about a week before your usual cycle.
   • In many cases, treatment options may include the use of oral contraceptives, or birth control pills, to help regulate the hormonal changes and thereby improve acne conditions. Birth control pills carry some risks and are not to be used in everyone. Talk to your dermatologist about this option.
   • Pay attention to washing and cleansing your face thoroughly when your period approaches, as your skin tends to produce more sebum, or oil, during this time.
   • In boys, acne can also be caused, or worsened, by hormonal changes. Some oral medications are available to help, but also carry risks and are not often prescribed.
6. Learn about Accutane. In some types of severe acne, called cystic or severe nodular acne, Accutane therapy is very effective. Accutane therapy requires a good understanding of the common side effects, as well as possibly serious ones.
   • This form of therapy also requires a serious commitment to therapy that includes 2 forms of birth control in females due to the high risk of birth defects. Other commitments are also required. The effectiveness of the drug is very good, but there are risks. Talk with your dermatologist to learn more about Accutane treatment.
7. Ask your doctor about alternative treatments. Some treatments that may be effective against moderate to severe acne include chemical peels, microdermabrasion, and laser or light treatments. These should be done under a physician’s care.
   • Chemical peels involve applying a chemical solution that peels away layers of skin. They can be effective in treating some types of acne, such as blackheads, whiteheads, and pustules.
     • Chemical peels should not be combined with oral retinoids, though it may be most effective when combined with other types of acne treatments.
   • Microdermabrasion or dermabrasion involves using abrasive brushes (sometimes in conjunction with small crystals) to remove layers of skin.
     • Microdermabrasion is appropriate for all skin tones and can help treat some types of acne. Dermabrasion is not usually recommended for people with darker skin, as it may cause scarring. It is also usually not recommended for acne, or for people who have used the acne medication isotretinoin in the past year.
   • Light therapy — which includes blue light, red light, or lasers — is a somewhat new treatment that has shown promise in treating a variety of skin conditions, including acne. Specific layers or areas of skin are targeted with a narrow spectrum of light, which can help eliminate bacteria in the skin or reduce oil production.

Protecting Your Skin During Treatment

1. Moisturize your skin. Talk with your dermatologist about the best product choices. While oil production is directly linked to acne, drying out your skin too much will eventually cause more oil to be produced. This can cause your acne to get worse. Some acne products dry out your skin, so it is important to keep your skin moisturized properly.
2. Protect your skin from the sun. Skin damage from the sun can make acne worse, plus lead to other serious skin diseases. Before going into the sun, always apply sunscreen to prevent sun damage. Your dermatologist can help you choose the best sunscreen product for your skin type.
3. Avoid picking. Squeezing, picking, or pinching areas of acne actually make things worse. This can also lead to scarring, or darkened areas on your skin.
4. Learn to relax. Stress does not directly cause acne, but it can make it worse. Develop new hobbies and discover relaxation tools to help you unwind and stay stress-free.

TIPS

• Benzoyl peroxide products can cause discoloration, or bleaching, of towels, sheets, and clothing.
• Introduce new products or treatments gradually to reduce side effects and to watch for possibly serious allergic reactions.
• Always use effective sunscreen products. Your dermatologist can help you choose the best products for your skin type.
• Choose cosmetics carefully, in order to avoid products that contain oils. Look for products that are “nonacnegenic” or “noncomedogenic.”
• Shave carefully to avoid irritating the skin, including existing areas of acne.
• Be aware of the cleanliness of things that touch your face, or other areas where your acne breakouts occur. Examples include cell phones, tight-fitting sports equipment such as helmets, and routine household items like sheets and pillow cases.
• Acne is not caused by dirt or oil-free make-up.
• Eat healthy. Some myths suggest food sources cause or worsen acne, such as chocolate. Evidence does support a possible link to some foods, like dairy products, but a generally healthy and balanced diet can only help. Talk to your dermatologist if you have specific questions about food choices.
• Try to avoid touching your face, and wash your hands before you do.

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Sources and Citations

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