For some people, the following therapies might be helpful, either alone or in combination with medications.
- Light therapy. A variety of light-based therapies have been tried with some success. Most will require multiple visits to your doctor's office. Further study is needed to determine the ideal method, light source and dose.
- Chemical peel. This procedure uses repeated applications of a chemical solution, such as salicylic acid, glycolic acid or retinoic acid. This treatment is for mild acne. It might improve the appearance of the skin, though the change is not long lasting and repeat treatments are usually needed.
- Drainage and extraction. Your doctor may use special tools to gently remove whiteheads and blackheads (comedos) or cysts that haven't cleared up with topical medications. This technique temporarily improves the appearance of your skin, but it might also cause scarring.
- Steroid injection. Nodular and cystic lesions can be treated by injecting a steroid drug into them. This therapy has resulted in rapid improvement and decreased pain. Side effects may include skin thinning and discoloration in the treated area.
Treating children
Most studies of acne drugs have involved people 12 years of age or older. Increasingly, younger children are getting acne as well. The FDA has expanded the number of topical products approved for use in children. And guidelines from the American Academy of Dermatology indicate that topical benzoyl peroxide, adapalene and tretinoin in preadolescent children are effective and don't cause increased risk of side effects.
If your child has acne, consider consulting a pediatric dermatologist. Ask about drugs to avoid in children, appropriate doses, drug interactions, side effects, and how treatment may affect a child's growth and development.
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Alternative medicine
Some alternative and integrative medicine approaches might be helpful in reducing acne:
- Tea tree oil. Gels containing at least 5% tea tree oil may be as effective as lotions containing 5% benzoyl peroxide, although tea tree oil might work more slowly. Possible side effects include minor itching, burning, redness and dryness, which make it a poor choice for people with rosacea.
- Brewer's yeast. A strain of brewer's yeast called Hansen CBS seems to help decrease acne when taken orally. It may cause gas (flatulence).
More research is needed to establish the potential effectiveness and long-term safety of these and other integrative approaches, such as biofeedback and ayurvedic compounds. Talk with your doctor about the pros and cons of specific treatments before you try them.
Lifestyle and home remedies
You can try to avoid or control mild or moderate acne with nonprescription products, good basic skin care and other self-care techniques:
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Wash problem areas with a gentle cleanser. Twice a day, use your hands to wash your face with mild soap or a gentle cleanser (Cetaphil, Vanicream, others) and warm water. And be gentle if you're shaving affected skin.
Avoid certain products, such as facial scrubs, astringents and masks. They tend to irritate the skin, which can worsen acne. Too much washing and scrubbing also can irritate the skin.
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Try over-the-counter acne products to dry excess oil and promote peeling. Look for products containing benzoyl peroxide and adapalene as the active ingredients. You might also try products containing salicylic acid, glycolic acid or alpha hydroxy acids. It may take a few weeks of using a product before you see any improvement.
Creams are less irritating than gels or ointments. Nonprescription acne medications may cause initial side effects — such as redness, dryness and scaling — that often improve after the first month of using them.
- Avoid irritants. Oily or greasy cosmetics, sunscreens, hairstyling products or acne concealers can worsen acne. Instead, use products labeled water-based or noncomedogenic, which means they are less likely to cause acne.
- Protect your skin from the sun. For some people, the sun worsens the discoloration that sometimes lingers after the acne has cleared. And some acne medications make you more susceptible to sunburn. Check with your doctor to see if your medication is one of these. If it is, stay out of the sun as much as possible. Regularly use a nonoily (noncomedogenic) moisturizer that includes a sunscreen.
- Avoid friction or pressure on your skin. Protect your acne-prone skin from contact with items such as phones, helmets, tight collars or straps, and backpacks.
- Avoid touching or picking acne-prone areas. Doing so can trigger more acne or lead to infection or scarring.
- Shower after strenuous activities. Oil and sweat on your skin can lead to breakouts.
Coping and support
Acne and acne scars can cause anxiety and may affect your social relationships and self-image. Sometimes it can help to talk with your family, a support group or a counselor.
Stress can worsen acne. Try to manage stress by getting enough sleep and practicing relaxation techniques.
Preparing for your appointment
If you have acne that's not responding to self-care and over-the-counter treatments, make an appointment with your doctor. Early, effective treatment of acne reduces the risk of scarring and of lasting damage to your self-esteem. After an initial examination, your doctor may refer you to a specialist in the diagnosis and treatment of skin conditions (dermatologist).
Here's some information to help you get ready for your appointment.
What you can do
- List your key medical information, such as other conditions you're dealing with and any prescription or over-the-counter products you're using, including vitamins and supplements.
- List key personal information, including any major stresses or recent life changes.
- List questions to ask your doctor. Creating your list of questions in advance can help you make the most of your time with your doctor.
Below are some basic questions to ask your doctor about acne. If any additional questions occur to you during your visit, don't hesitate to ask.
- What treatment approach do you recommend for me?
- If the first treatment doesn't work, what will you recommend next?
- What are the possible side effects of the medications you're prescribing?
- How long can I safely use the medications you're prescribing?
- How soon after beginning treatment might my symptoms start to improve?
- When will you see me again to evaluate whether my treatment is working?
- Is it safe to stop my medications if they don't seem to be working?
- What self-care steps might improve my symptoms?
- Do you recommend any changes to my diet?
- Do you recommend any changes to the over-the-counter products I'm using on my skin, including soaps, lotions, sunscreens and cosmetics?
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to talk about in-depth. Your doctor may ask:
- When did you first develop this problem?
- Does anything in particular seem to trigger an acne flare, such as stress or — in girls and women — your menstrual cycle?
- What medications are you taking, including over-the-counter and prescription drugs as well as vitamins and supplements?
- In girls and women: Do you use oral contraceptives?
- In girls and women: Do you have regular menstrual periods?
- In girls and women: Are you pregnant, or do you plan to become pregnant soon?
- What types of soaps, lotions, sunscreens, hair products or cosmetics do you use?
- How is acne affecting your self-esteem and your confidence in social situations?
- Do you have a family history of acne?
- What treatments and self-care steps have you tried so far? Have any been effective?
- Have other family members had isotretinoin treatment or hormone therapy to treat their acne? Has it been effective?
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