Medicines for Acne

What it is

Acne develops when the small oil glands attached to hair follicles become overactive and their openings become blocked. Trapped oil and dead skin form blackheads and whiteheads, and the bacteria that normally live on the skin can multiply, driving inflammation that produces red spots, pustules and, in more severe cases, deeper painful lumps. It is extremely common in the teenage years, when hormonal changes increase oil production, but it can persist into adulthood and also occurs in adults who never had it before. Acne ranges from a few comedones to widespread inflamed lesions, and even milder forms can leave marks or scars and have a real effect on confidence and mood. It is not caused by poor hygiene, and over-washing can make it worse rather than better.

How it is treated

Treatment is matched to the type and severity of acne and aims both to clear current spots and to prevent the lasting scarring that inflamed acne can cause — which is why effective treatment is started early rather than waiting. Mild acne is usually managed with topical preparations applied to the whole affected area, not just to individual spots, and these often work best in combination. Benzoyl peroxide, available over the counter from a pharmacy, is a useful first step and is frequently paired with a topical retinoid or a topical antibiotic. Because antibiotics applied or taken on their own encourage resistant bacteria, they are combined with benzoyl peroxide or a retinoid rather than used alone, and oral antibiotic courses are kept time-limited. For moderate acne not responding to topical treatment, an oral antibiotic may be added for a defined period. In women, a combined hormonal contraceptive can help where acne is influenced by hormones. Severe, widespread or scarring acne, or acne causing significant distress, is referred to a dermatologist for oral isotretinoin. Treatments take weeks to work, and improvement is gradual, so persistence matters.