Acne can’t be cured, but it can be controlled with treatment.
The goal of acne treatment is to reduce or clear up the spots through skin care or treatments to inhibit sebum production, limit bacterial growth, encourage shedding of skin cells and unclogging pores.
Some acne treatments are available over the counter from pharmacies, while others are prescribed by doctors or dermatologists.
What causes acne?
Acne develops when hormonal shifts (like the kind that occur during puberty, and in women, before a menstrual period and sometimes prior to menopause) cause an overproduction of oil and cells inside a skin follicle. Together, they form a kind of biological bottleneck that plugs the opening of the pore and causes the follicle beneath to swell.
This allows for the overgrowth of bacteria normally found on skin - Propionibacterium acnes (P. acnes) - which produce irritating chemical substances that further fuel the inflammation. The end result is acne.
What are the treatments for acne?
The occasional spot needs no treatment. Over-the-counter cover-up creams and cosmetics, if used at all, should be water-based. Even if outbreaks of acne cannot be eliminated, conventional treatment can provide relief.
The best treatments inhibit sebum production, limit bacterial growth or encourage shedding of skin cells to unclog pores. Because many therapies can have side effects, any patient with acne should proceed with caution when trying a new treatment. People with severe, persistent cases of acne may need the care of a dermatologist (a skin specialist).
'Gold standard' vs new treatments
For decades, doctors have said the "gold standard" for treating mild to moderate acne has been a combination of a deep pore cleanser such as benzoyl peroxide (it prevents the clogging of pores) and a topical antibiotic or sulphur medication to combat the bacteria. For some patients, treatment also included the topical prescription medication retinoic acid to help speed clearing. This is a combination that is still in use today.
Non-prescription treatment for acne
Soap and water. Gentle cleansing of the face with soap and water no more than twice a day can remove the excess oils and help the "oily skin" often associated with acne. However, this does not clear up acne that is already present. Avoid aggressive scrubbing, which can injure the skin and cause other skin problems.
Cleansers. There are many cleansers and soaps advertised for treating acne. However, these are unnecessary if the acne is being properly treated and can in fact aggravate acne.
Benzoyl peroxide. For mild acne, you may try, or your doctor may recommend, treatment with a non-prescription medication that contains benzoyl peroxide. It's believed that this compound works by killing the bacteria associated with acne and by preventing dead skin cells clogging pores. It usually takes at least four weeks to work and it may need to be continued once the acne has cleared to help keep acne at bay until you outgrow getting acne. It is available in a wide range of forms: creams, lotions, washes and gels. Benzoyl peroxide can cause dry skin and can bleach fabrics, so take care when applying it. Consider wearing an old T-shirt to bed if you are applying it to your back or chest overnight and using old or white bedclothes if applying to your face.