The Best Way to Get Rid of Acne

Acne is an incredibly common skin problem. It affects around 85% of people in adolescence and early adulthood. While acne is less common as people age, up to 25% of women and 12% of men in their 40s still report trouble with acne. Acne is associated with poor self-image, depression, anxiety, permanent, and scarring, among other things. Treating acne is estimated to cost $3 billion per year.

Types of acne

Acne comes in several forms:

• Blackheads are open bumps that fill with oil and skin.
• Whiteheads are closed bumps filled with oil and skin
• Papules are small red or pink bumps
• Pustules are whiteheads with red around the base.
• Nodules are deep, large, painful solid pimples
• Cysts are large pus-filled pimples
• Fungal acne is usually itchy and inflamed and is caused by yeast.

Some forms of acne are prone to scarring. Nodules, pustules, and cysts are especially prone to scarring if popped.

Causes of acne

Acne is usually a hormone-related condition. Hormone surges, especially androgen hormones like testosterone, can cause acne. Some people produce excessive skin oils or skin cells. Other things that can make acne worse include:

• Tight clothing, especially clothing that doesn’t breathe
• Picking at acne sores
• High humidity
• Certain times in a woman’s menstrual cycle
• Using products that are greasy or oily
• Cortisol, the hormone associated with stress, can make acne worse but doesn’t cause it
• Certain types of skin bacteria, specifically Propionibacterium acnes

Studies have not shown any association between chocolate or greasy food and acne. Acne is not caused by poor hygiene, and over-washing or scrubbing too much can actually make acne worse.

Diagnosing acne

Many people with acne self-diagnose and don’t seek medical treatment unless home treatments fail. Acne is diagnosed based on a physical exam. Some other conditions can be mistaken for acne such as folliculitis (bacterial infection of the hair follicles) and hidradenitis suppurativa (an autoimmune skin condition).

Treating acne

There are many treatment options for acne, both over-the-counter and prescription. No one method works for everyone, but most people with acne need some type of treatment because this condition rarely resolves on its own. Untreated, acne can cause scarring.

The don’ts of treating acne

Before we talk about how we do treat acne, let’s talk about the things to avoid when treating acne:

• Don’t overwash your skin. While too much oil in the skin can increase acne, overwashing your skin can strip away the natural oils and make your skin over dry. This can lead to inflammation and overproduction of oil. Most people should wash their face twice a day and after sweating. Being over-vigorous with scrubbing can also dry and irritate the skin.
• Don’t pick or pop your pimples. This can increase inflammation and cause scarring.
• Don’t use heavy makeup to cover acne. This can block pores and make acne worse.
• Don’t use harsh skin products like exfoliants and astringents.

The dos of treating acne

In general, a good skincare routine is important for skin health and controlling acne. Your skin is the largest organ in your body and serves as a barrier to protect against toxins and other potentially harmful things:

• Do use sun protection. Sunscreen is very important for protecting your skin from damage in general. Use a product that isn’t overly oily preferably one that is made for the face.
• Do wash your hair regularly and keep it out of your face. Some hair products may also make acne worse.
• Do eat a healthy diet. While there aren’t studies that show that foods can cause acne, a healthy diet containing fewer sugars and carbohydrates may decrease breakouts.
• Do clean your technology. If you use a headset for work, make sure you are washing it regularly. Your cell phone is also guilty of harboring bacteria.
• Do clean your makeup brushes. If you wear makeup, make sure that you’re washing them regularly to avoid the buildup of harmful bacteria.
• Do drink plenty of water. Your body is 75% water, and your skin may be more prone to blemishes and breakouts if you aren’t properly hydrated.

Over-the-counter acne products

There are many products available over-the-counter for the treatment of acne. Some of these are stand-alone products, and some are available in skin care systems. They can vary in price from inexpensive products you can find at most pharmacies and grocery stores, to expensive subscription products. The most common products contain salicylic acid and benzoyl peroxide.

Benzoyl peroxide

Benzoyl peroxide is a topical medication for acne that comes in many forms. It is available in soaps, gels, lotions, liquids, foams, creams, pads, and some bars. Lower doses of benzoyl peroxide are available over the counter, but prescription forms are also available. It works by lowering facial oils, breaking down excess skin cells, and also has properties against the C. acnes bacteria associated with acne. This medication is not to be used around the nose, mouth, or eyes as it can irritate. In high concentrations, it can cause dryness and irritation. It can also have bleaching properties and affect fabrics and hair.

Salicylic acid

Salicylic acid is another common product for treating acne. Like Benzoyl peroxide, it’s available in both over-the-counter and prescription strengths. Salicylic acid works by dissolving dead skin cells. It can take a few weeks to see improvement. It comes in a variety of products such as gels, lotions, ointments, pads, soaps, and solutions. In higher concentrations, salicylic acid is sometimes used as a peeling agent. Salicylic acid can cause peeling and irritation of the skin. It should only be used for short periods and on small areas of the body.

Glycolic acid

Another ingredient in many over-the-counter products is glycolic acid. Glycolic acid works to break down the bonds between skin cells and causes a peeling effect. This means less “stuff” to clog the pores. It also helps the skin retain moisture. Like many over-the-counter treatments, prescription forms are available. Glycolic acid comes in wash, lotion, peel, serum, and pad form. Glycolic acid is a chemical peeling agent, so reactions include swelling, burning, and itching.

Retinoids

Retinoids are also offered in both over-the-counter and prescription options. They cause more irritation than some products, so they may not be an option for people with more sensitive skin. Retinoids also make the skin more sensitive to the sun so using sun protection is imperative. Retinoids should not be used in women who are pregnant. There are many products out there, so talking to your doctor or dermatologist may be the best option before considering one of these products. Side effects associated with retinoids include skin sensitivity, irritation including dark spots in people with darker skin, sun sensitivity, and dryness.

Complementary and alternative therapies

Many people with health conditions are interested in complementary therapies. Some treatments have some evidence supporting their use. Tea tree oil can be used to treat acne. It is considered comparable to benzoyl peroxide but better tolerated. Other potential therapies with reported benefits include topical and oral ayurvedic compounds, oral barberry extract, and gluconolactone solution.

Prescription medications for acne

As mentioned previously, many of the over-the-counter acne treatments also have prescription formulations that can be used under the supervision of a medical provider. Medical professionals will use several other prescription options for the treatment of acne.

Oral birth control

Oral birth control pills are frequently used for women with acne. They are generally an estrogen-progesterone pill and are used to try to control some of the hormone fluctuations associated with acne. These medications can’t be used in women who are pregnant and are also not recommended for women with certain medical conditions such as blood clots. In addition, birth control is not recommended in women over the age of 35 who smoke.

Anti-androgen medications

Anti-androgen medications, such as Spironolactone, are sometimes used to treat acne. These medications work to decrease the number of androgen hormones present (such as testosterone) to try to control the development of acne.

Antibiotics

Both oral and topical antibiotics can be used on their own or in combination with other therapies for acne. Frequently, benzoyl peroxide is used in combination with antibiotics such as clindamycin in a topical form.

Oral retinoids

The retinoids also come in oral forms. These are strong medications and are used more often when other medications have failed. These medications are extremely dangerous in pregnancy and patients prescribed this medication usually have to be on medications to prevent pregnancy and have to sign a pledge not to get pregnant while on these medications.

Physical modalities

In severe cases of acne, a dermatologist may choose to do chemical peels or inject steroids directly into the lesion. Some laser and light devices may be used, but additional studies are needed to determine the benefits of some of these therapies.

So, what is the best way to get rid of acne? No one treatment works for every person. Check with a pharmacy near you for over-the-counter options or consider talking to your healthcare provider or dermatologist. Around $3 billion a year is spent directly treating acne because this condition is so common. For ways to stretch your healthcare dollar, you can frequently find copay cards or prescription savings cards for discounts on prescription medications. At ScriptSave WellRx, we strive to get you the best price on your medication and can save you up to 80% on some medications.

Dr. Foglesong Stabile is a board-certified Family Physician who enjoys full scope Family Medicine including obstetrics, women’s health, and endoscopy as well as caring for children and adults of all ages. She also teaches the family medicine clerkship for Pacific Northwest University of Health Sciences.

Resources:

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