Acne breakouts are commonly associated with teenagers — but those troublesome pimples don’t always go away when we enter our 20s. The reality is that many adults continue to have acne on occasion throughout their 20s and 30s, and may even live with the skin condition well into middle age.
Thankfully, there are several ways to treat an existing breakout and prevent new pimples from developing. “The medications one uses for acne depend on type and severity,” says Adelaide A. Hebert, MD, a professor in the dermatology department at the University of Texas-Houston Medical School.
Some treatments are directed toward removing the dead skin and oils that clog pores and create acne, while others target the cystic formation typical of severe acne. Additional acne treatment options work by attacking overgrowths of Propionibacterium acnes, a type of bacteria that occurs naturally on the skin but can cause acne when its growth is uncontrolled.
Acne Treatment Options
Retinoids. These are chemical derivatives of vitamin A. They are effective against blackheads and whiteheads as well as severe, or inflammatory, acne.
“Retinoids work by exfoliating the clogged pores,” says dermatologist Heather Woolery-Lloyd, MD, of the University of Miami Cosmetic Center. “This class includes adapalene (Differin), which is good for sensitive skin; tretinoin ( Retin-A), which is good for most patients; and tazarotene ( Tazorac), which is good for severe disease.”
All are available by prescription. Dr. Woolery-Lloyd warns that all of these acne treatments can cause skin irritation, but this should clear up within two weeks.
Common acne such as whiteheads, blackheads, and inflammatory acne can be treated with retinoids, says Dr. Hebert, whereas cystic acne requires stronger medication, such as isotretinoin (Accutane). Despite the serious side effects associated with Accutane, including birth defects, seizures, psychiatric problems, and stroke, Hebert says, “If you have true, severe, scarring acne and no other risk factors, it’s still the best choice.” Nevertheless, because of Accutane’s risks, it is important that you remain under the close supervision of a doctor while taking it.
Benzoyl peroxide. “Benzoyl peroxide works as an antibacterial,” Woolery-Lloyd says. That means that this acne treatment fights germs that could be contributing to your acne. It is available over the counter and by prescription.
“It also can be drying, but is well tolerated by most people,” she says. One significant drawback: benzoyl peroxide bleaches any hair or fabric it comes into contact with.
Antibiotics. Topical antibiotics are creams rubbed on your skin. They fight bacteria that could be contributing to the formation of acne. Occasionally, your dermatologist might prescribe an antibiotic to be taken by mouth. In this case, remember that they often increase sensitivity to sun, Woolery-Lloyd says.
Oral antibiotics you might be prescribed include:
- Tetracycline, doxycycline, or minocycline
Topical antibiotics include:
- Azelaic acid
- Sodium sulfacetamide
Topical sulfur products. Many over-the-counter soaps and anti-acne creams contain sulfur, which has been in use as an acne treatment for half a century. Although the exact mechanism by which sulfur fights acne is not known, these products are recommended by dermatologists, says Hebert. Due to its odor, sulfur is usually combined with another treatment.
Many dermatologists recommend combinations of medications, such as using a topical antibiotic with a retinoid. Combinations are very effective, Hebert says. Another medication that may be useful in women is an oral contraceptive (birth control pill), which can help regulate hormones that may be contributing to acne breakouts.
No matter what acne treatment is used, if it is not working and you continue to suffer from bouts of acne, talk to your doctor. You may need to step up your program, or change it around a little, for best results.