For many acne sufferers, over-the-counter treatments are simply not effective enough. These people often suffer from the most severe forms of acne, from papulopustular or conglobate acne. The good news is that effective medical treatments are available on prescription and the sooner treatment is started, the lower the risk of physical and emotional damage.

Understand the four factors of acne and medical treatment options

Treatments for mild to moderate acne tend to treat one or more of the four problems attributed to the condition. Therefore, before opting for a treatment it is
important to identify the symptoms that are causing your concern. They work to:

  • reduce sebum production by controlling seborrhea.
  • accelerate the release of superficial skin cells (peeling) and thus help to deal with hyperkeratosis.
  • fight bacterial infection caused by microbial colonization.
  • reduce inflammation and, in turn, soothe blackheads, papules and pustules.

Acne Graphic

What are the medical treatments for acne?

Effective medications used to treat acne include:

  • topical retinoids
  • benzoyl peroxide
  • topical antimicrobials
  • azelaic acid
  • oral antibiotics
  • oral isotretinoin
  • oral antiandrogens

They can be used alone or in combination and, depending on the severity of the symptoms, the dermatologist will prescribe the appropriate medication.

Medical treatment of acne follows a strict international standard to ensure that dermatologists and doctors are consistent in their treatment. This evidence-based guidance * gives doctors information about which treatments, or combination of treatments, to use, depending on the severity of acne and individual symptoms. It offers appropriate alternatives for different skin types, options and for women.

Certain prescription acne medications should not be used during pregnancy, especially during the first trimester, so dermatologists and doctors can suggest alternatives.

It is important to emphasize that the treatment of acne, whether medicinal or non-medicinal, takes time to work.

As a general rule it takes between 4 to 8 weeks, although it can take up to three months and the symptoms may get worse before it gets better. It is easy for patients to become discouraged and give up, so it is important to preserve and maintain the routine, even if there is no immediate change for the better.

The medication can have some side effects. For example, dry skin or sensitivity to light. These symptoms can be combated with the use of adjuvant moisturizing products for acne-prone skin, such as Eucerin DermoPURIFYER Moisturizing Care. It can be used with standard medical acne treatment to intensely moisturize and soothe dry skin.

* Nast, A .; Dreno, B .; Degitz, K. et al. (2012), European Basic Indications (S3) for Acne Treatment, Journal of the European Academy of Dermatology and Venereology, 26, p. 1-29.


Main causes and factors of acne

Hormones . Most cases of acne are triggered by a reaction of the sebaceous glands to androgen hormones . The sebaceous glands respond to hormones through excessive sebum production.

The combination of excess sebum (seborrhea) and disturbed skin cells results in the enlargement of the sebaceous glands, pimples appearing. These can become colonized by bacteria and the skin can become red and inflamed.

This process is more common in adolescents, as it is in this age group that an increase in androgens is experienced during puberty. Up to 90% of teenagers can get some form of acne, although it usually goes away as they get older.
It is possible for people of all ages to have acne. Up to 80% of adult acne cases occur in women who are experiencing hormonal changes.
It may occur during pregnancy, menstruation or a hormone-related condition, such as polycystic ovary syndrome

Seborreia Chart Seborrhea

Microbial Colonization Chart. Microbial colonization.

Bacteria . People with acne tend to have oily skin and a shiny complexion which provides an ideal environment for acne bacteria, usually harmless, (Propionibacterium acnes) to multiply and cause irritation and inflammation of the glands.

Genetics . Another theory about the fact that some people are more prone to acne than others is related to genetics. Although it is not a hereditary condition, there is some connection between the parents’ acne and the increased likelihood of their child, or children, being affected. Likewise the children of adults who suffer from acne are more likely to develop adult acne.

Medication. Finally, it is thought that some medications, such as steroids and lithium, can cause acne in people prone to the condition.

Close-up to the skin Oily skin is more likely to have acne than other skin types.

Acne Myths

As well as the causes, there are many myths about acne, many of which unfairly blame the patient. For example, it is not true that people prone to acne are unhygienic .
In fact, the skin is more likely to be harmed by over-cleansing than by little.
It is also not true that a poor diet leads to acne. Of course, a healthy diet is preferable, but fatty foods and chocolate have little influence on acne.

People with acne-prone skin not only have a physical condition to contend with, they can also be affected psychologically. The presence of blackheads and pustules on the face is difficult to hide, so it is common for acne sufferers to lose self-confidence and self-esteem.

Likewise, some of the strategies adopted to try to hide the disease, such as the use of heavy makeup or covering the face with hair, can make the situation worse. Also, beard growth can complicate the application of topical medications.

The good news is that treatments exist and the sooner the treatment is applied, the lower the risk of the duration of physical and emotional damage.

Read more about acne medications in general .
Read more about acne-free treatments .

Man washing his face Over-cleaning can make acne symptoms worse.

Woman applying makeup with a brush Any make-up for acne-prone skin must be non-comedogenic to prevent clogged pores.


The main factors that contribute to acne

Symptoms vary from person to person and some people react differently to food or the environment.

Some of the most common factors known to aggravate acne-prone skin are :

  • eating excess monosaccharide carbohydrates (sugar and white flour)
  • high consumption of milk and other dairy products (Cheese, however there is no factor to prove it)
  • smoke
  • comedogenic skin care products and makeup

Woman drinking milk Excessive consumption of milk can aggravate the symptoms of acne.

It is important to seek dermotological advice, even if the symptoms are mild or in the initial state. Effective medical treatment can prevent the disease from getting worse and minimize the risk of scarring.

There are also a number of general rules that must be followed:

  • use warm water , neither hot nor cold
  • use non-comedogenic skin care
  • use makeup that does not clog pores
  • use an appropriate cleanser before bed to remove dirt and prepare the skin for drug resorption
  • letting the blackheads  heal naturally – squeezing only makes it worse

Read more about non-medical acne treatments .

Woman applying makeup with a sponge For hygiene reasons, sponges and make-up brushes should be changed regularly.


Medical treatments for acne symptoms

Although there is no “cure” for acne, symptoms can be treated with medical and non-medical therapies. Medical intervention is advised for the most severe forms of acne or when non-medical alternatives have been tried, but are not effective.

The first treatment option for severe acne will be the use of a  topical gel, cream or lotion .

Man touching left cheek apple For all skin concerns it is essential to follow a daily skin care routine with suitable products.

Medical treatments include:

  • Topical retinoids such as Tretinoin and Adapalene. Topical retinoids act on abnormal keratinization and are also anti-inflammatory, working on both comedonal and inflammatory acne.
  • Benzoyl peroxide helps prevent dead skin from clogging hair follicles and also kills the bacteria that cause infection.
  • Topical antimicrobials (topical antibiotics) help to kill bacteria on the skin that can infect clogged hair follicles. It must always be combined with benzoyl peroxide, to prevent the development of bacterial resistance.
  • Azelaic acid is often used as an alternative treatment to remove dead skin cells and kill bacteria. It is usually prescribed if the patient has side effects with benzoyl peroxide or topical retinoids.

Topical treatments can be combined with antibiotic pills (mainly tetracyclines or erythromycin).

If these don’t work, a drug called isotretinoin can be prescribed. Hormonal therapies can also be effective in women who have acne, as estrogen suppresses the activity of the sebaceous glands and decreases the formation of ovarian and kidney androgens.

Like all medications, side effects of acne medication are known. These can include dry skin and sensitivity to the sun. However these effects can often be offset by the use of adjuvant moisturizing care for acne-prone skin, such as Eucerin DermoPURIFYER Moisturizing Care.