Acne can be effectively treated nowadays, and there are numerous treatment options. The choice of the treatment depends on the severity of the acne – mild, moderate or severe, and your GP or dermatologist have quite a lot of options available.
Most patients with mild acne can be treated with topical products (gels, creams, solutions and lotions) that can be obought over-the-counter (without prescription). The management of moderate or severe acne should include prescribed topical or oral medication (pills) in addition to over-the-counter topical products.
The following is an overview of what your GP or dermatologist may prescribe if you have moderate and severe acne:
Topical prescription medication (gels, creams and lotions containing medication) include:
Antibiotics, such as clindamycin or erythromycin
Retinoids (vitamin A derivatives) such as tretinoin, isotretinoin or adapalene gel.
- Combination prescription topicals include isotretinoin+erythromycin (Isotrex), clindamycin+benzoyl peroxide (Duac) and adapalene+benzoyl peroxide (Epiduo).
Combination products of topical antibiotic plus benzoyl peroxide or retinoids are preferred in order to reduce the risk of antibiotic resistance.
Oral prescription medications (pills) include:
Oral antibiotics such as tetracycline, doxycycline, azithromycin or trimethoprim. Oral antibiotics are useful in inflammatory acne (with pimples), and improvement is usually seen after several weeks of use. Treatment can be continued for up to 3-4 months. When oral antibiotics are discontinued, control should be maintained long term by continuing topical therapy.
Combined oral contraceptive pill and oral antiandrogens (hormones) such as cyproterone in combination with oestrogen (these are options for female patients only)
- Oral isotretinoin is the treatment of choice for severe acne and also for persistent moderate acne not responding to other prescription medications. This is the last choice for dermatologists (or if the acne is severe). Treatment is weight-based, have some side effects (dry and itchy skin and lips, affection of the lever, joint pain e.g.) and continued usually for 15-20 weeks.
As you see, there are many options available to your GP depending on the severity of your acne. If you have moderate to severe acne and may not respond to one kind of medication, there might be other solutions for you!
See your doctor or dermatologist for advice if your acne is severe or if it is mild to moderate but fails to improve within 2 months of starting treatment with over-the-counter products.