Acne treatment that you apply to the skin: Most acne treatments are applied to the skin. Your dermatologist may call this topical treatment. There are many topical acne treatments. Some topicals help kill the bacteria. Others work on reducing the oil. The topical medicine may contain a retinoid, prescription-strength benzoyl peroxide, antibiotic, or even salicylic acid. Your dermatologist will determine what you need.
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Temporary skin fillers have been used for years for acne scar treatment, but a permanent dermal filler was approved for use by the FDA only recently. Designed to remove moderate to severe acne scarring, Bellafill is made up of 80 percent collagen to replace lost volume and 20 percent polymethylmethacrylate, which helps your body heal by boosting protein production.
This article was medically reviewed by Hilary Baldwin, MD. Baldwin, medical director of the Acne Treatment Research Center, is a board-certified dermatologist with nearly 25 years of experience. Her area of expertise and interest are acne, rosacea and keloid scars. Baldwin received her BA and MA in biology from Boston University. She became a research assistant at Harvard University before attending Boston University School of Medicine. She then completed a medical internship at Yale New Haven Hospital before becoming a resident and chief resident in dermatology at New York University Medical Center.

Combined oral contraceptives. Four combined oral contraceptives are approved by the FDA for acne therapy in women who also wish to use them for contraception. They are products that combine estrogen and progestin (Ortho Tri-Cyclen, Yaz, others). You may not see the benefit of this treatment for a few months, so using other acne medications with it the first few weeks may help.
Topical treatments on their own may not be enough to give you clear skin, especially in those with complicated, inflammatory cystic acne. There are several acne medication options approved for use by the FDA, but which one is best for you is a question for your dermatologist and/or general practitioner. Baldwin says if you have insurance and you have acne, a prescription may be the best step because "it makes no sense to try to handle the condition yourself or to use over the counter products that are always less effective than prescriptions meds." Here are a few of the acne medications you'll want to ask about:
Flutamide, a pure antagonist of the androgen receptor, is effective in the treatment of acne in women.[100][107] It has generally been found to reduce symptoms of acne by 80 or 90% even at low doses, with several studies showing complete acne clearance.[100][108][109] In one study, flutamide decreased acne scores by 80% within 3 months, whereas spironolactone decreased symptoms by only 40% in the same time period.[109][110][111] In a large long-term study, 97% of women reported satisfaction with the control of their acne with flutamide.[112] Although effective, flutamide has a risk of serious liver toxicity, and cases of death in women taking even low doses of the medication to treat androgen-dependent skin and hair conditions have occurred.[113] As such, the use of flutamide for acne has become increasingly limited,[112][114][115] and it has been argued that continued use of flutamide for such purposes is unethical.[113] Bicalutamide, a pure androgen receptor antagonist with the same mechanism as flutamide and with comparable or superior antiandrogenic efficacy but without its risk of liver toxicity, is a potential alternative to flutamide in the treatment of androgen-dependent skin and hair conditions in women.[105][116][117][118]
Spironolactone is an androgen blocker. It can be used to treat hormonal acne in women (only) by reducing the production of androgens (male hormones) in a woman's body, which can then reduce oil production in the skin. If you're wondering how to get rid of acne overnight, keep in mind that aldactone can take up to three months to start taking effect.
Accutane is especially good for cystic acne in women and body acne in men. “Oral vitamin A basically shuts down your sebaceous glands. If you suppress [them] for a long enough period, you can cure someone of their acne, and about 50 percent do hit that cure rate,” says Linkner. A course of Accutane can take about six to nine months. Sometimes patients need to repeat the course at a higher dosage in order to truly eliminate acne.

In women, acne can be improved with the use of any combined birth control pill.[88] These medications contain an estrogen and a progestin.[89] They work by decreasing the production of androgen hormones by the ovaries and by decreasing the free and hence biologically active fractions of androgens, resulting in lowered skin production of sebum and consequently reduced acne severity.[10][90] First-generation progestins such as norethindrone and norgestrel have androgenic properties and can worsen acne.[15] Although oral estrogens can decrease IGF-1 levels in some situations and this might be expected to additionally contribute to improvement in acne symptoms,[91][92] combined birth control pills appear to have no effect on IGF-1 levels in fertile women.[89][93] However, cyproterone acetate-containing birth control pills have been reported to decrease total and free IGF-1 levels.[94] Combinations containing third- or fourth-generation progestins including desogestrel, dienogest, drospirenone, or norgestimate, as well as birth control pills containing cyproterone acetate or chlormadinone acetate, are preferred for women with acne due to their stronger antiandrogenic effects.[95][96][97] Studies have shown a 40 to 70% reduction in acne lesions with combined birth control pills.[90] A 2014 review found that antibiotics by mouth appear to be somewhat more effective than birth control pills at decreasing the number of inflammatory acne lesions at three months.[98] However, the two therapies are approximately equal in efficacy at six months for decreasing the number of inflammatory, non-inflammatory, and total acne lesions.[98] The authors of the analysis suggested that birth control pills may be a preferred first-line acne treatment, over oral antibiotics, in certain women due to similar efficacy at six months and a lack of associated antibiotic resistance.[98]

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Topical and oral preparations of nicotinamide (the amide form of vitamin B3) have been suggested as alternative medical treatments.[133] It is thought to improve acne due to its anti-inflammatory properties, its ability to suppress sebum production, and by promoting wound healing.[133] Topical and oral preparations of zinc have similarly been proposed as effective treatments for acne; evidence to support their use for this purpose is limited.[134] The purported efficacy of zinc is attributed to its capacity to reduce inflammation and sebum production, and inhibit C. acnes.[134] Antihistamines may improve symptoms among those already taking isotretinoin due to their anti-inflammatory properties and their ability to suppress sebum production.[135]
Baby acne is usually mild, and it’s limited to the face 99 percent of the time, says Teri Kahn, MD, clinical associate professor of dermatology and pediatrics at University of Maryland School of Medicine and Mt. Washington Pediatric Hospital in Baltimore. “Typically, baby acne appears in the form of little whiteheads and blackheads on the forehead, cheeks, and chin,” she says. Other skin conditions, like eczema, show up on other parts of the body.

In 2015, acne was estimated to affect 633 million people globally, making it the 8th most common disease worldwide.[9][18] Acne commonly occurs in adolescence and affects an estimated 80–90% of teenagers in the Western world.[19][20][21] Lower rates are reported in some rural societies.[21][22] Children and adults may also be affected before and after puberty.[23] Although acne becomes less common in adulthood, it persists in nearly half of affected people into their twenties and thirties and a smaller group continue to have difficulties into their forties.[2]


Microneedling is a procedure in which an instrument with multiple rows of tiny needles is rolled over the skin to elicit a wound healing response and stimulate collagen production to reduce the appearance of atrophic acne scars in people with darker skin color.[142] Notable adverse effects of microneedling include postinflammatory hyperpigmentation and tram track scarring (described as discrete slightly raised scars in a linear distribution similar to a tram track). The latter is thought to be primarily attributable to improper technique by the practitioner, including the use of excessive pressure or inappropriately large needles.[142][146]
^ Jump up to: a b GBD 2015 Disease and Injury Incidence and Prevalence, Collaborators. (8 October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-6736(16)31678-6. PMC 5055577. PMID 27733282.

The severity of acne vulgaris (Gr. ἀκµή, "point" + L. vulgaris, "common")[24] can be classified as mild, moderate, or severe as this helps to determine an appropriate treatment regimen.[20] There is no universally accepted scale for grading acne severity.[15] Mild acne is classically defined by the presence of clogged skin follicles (known as comedones) limited to the face with occasional inflammatory lesions.[20] Moderate severity acne is said to occur when a higher number of inflammatory papules and pustules occur on the face compared to mild cases of acne and are found on the trunk of the body.[20] Severe acne is said to occur when nodules (the painful 'bumps' lying under the skin) are the characteristic facial lesions and involvement of the trunk is extensive.[20][25]
People who escaped their teen years almost pimple-free may develop persistent adult-onset acne as they get older. Despite the normal increase in androgen levels during puberty, some doctors believe that flare-ups of acne have less to do with androgen levels than with how a person's skin responds to an increase in sebum production or to the bacteria that causes acne. The bacteria Propionibacterium acnes occurs naturally in healthy hair follicles. If too many of them accumulate in plugged follicles, they may secrete enzymes that break down sebum and cause inflammation. Some people are simply more sensitive than others to this reaction. Sebum levels that might cause a pimple or two in one person may result in widespread outbreaks -- or even acute cystic acne -- in another person.
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