Treatment of moderately severe acne
Treatment for moderately severe acne usually includes topical agents. In addition, a doctor or dermatologist may prescribe an oral medication, usually for at least six months.
Suitable oral medications include:
Antibiotics such as tetracycline, minocycline, doxycycline or erythromycin
In females, oestrogens and antiandrogens such as Diane 35™/Estelle 35™ or spironolactone
Some patients are helped by nonsteroidal anti-inflammatory agents such as ibuprofen or naproxen
For resistant or persistent acne, oral isotretinoin may be more suitable
See your doctor or dermatologist for advice if your skin problem fails to improve within three months or you have severe acne.
Treatment of mild acne
Most patients with mild acne can be treated with topical treatment (gels, solutions and lotions) that can be obtained over-the-counter in New Zealand without prescription. Most people just use topical agents for facial skin as they can be difficult to apply to one’s back. Extra vitamins and minerals have not been proved to help.
Wash affected areas twice daily with a mild cleanser and water or an antiseptic wash.
Acne products should be applied to all areas affected by acne, rather than just put on individual spots.
A thin smear should only be applied to dry clean skin at nighttime.
Acne products may work better if applied in the morning as well.
They often cause dryness particularly in the first 2-4 weeks of use. This is partly how they work. The skin usually adjusts to this.
Apply an oil-free moisturizer only if the affected skin is obviously peeling.
Avoid applying oily cosmetics such as foundation or sunscreen.
It may take several weeks or even months to see convincing improvement.
Discontinue using product if severe irritation results. See your doctor for advice.
Suitable topical agents for mild acne that can be obtained without prescription include:
Antiseptic washes (Acnederm wash™, Benzac™ AC Wash, Dalacin™ T Prewash, Oxy™ Daily Skin Wash)
Mild salicylic acid preparations to exfoliate and unplug the follicles (Neutrogena® Oil-free Acne Wash and many others)
Benzoyl peroxide cream / lotion / gel (PanOxyl™ Acne Gel, Brevoxyl™ Cream, Oxy-10™, Clearasil™ Ultra Acne Cream, Benzac AC Gel)
Azelaic acid (Skinoren™ cream, Acnederm™ medicated lotion)
Hydrogen peroxide in stabilised cream (Crystacide®)
Tea tree oil products
Topical agents for mild acne which require prescription include:
Antibiotics, such as clindamycin solution (Topicil™) or erythromycin solution (Stiemycin™) and gel (Eryacne™) are best used with benzoyl peroxide or azelaic acid to reduce the chance of antibiotic resistance.
Retinoids i.e. tretinoin (Retin-A™), isotretinoin (Isotrex™), adapalene (Differin™).
Blue light acne treatment is a new procedure recently found to be safe and helpful for mild to moderate acne.
See your doctor or dermatologist for advice if your pimples fail to clear up within six weeks or you have severe acne.
