How to get rid of acne
There are a lot of medications for the treatment of acne. But large advertising campaigns for non-prescription products can easily create unrealistic expectations. Some treatment approaches and medications have been proven to effectively reduce acne, and others have not.
Unfortunately there are only a few good trials comparing the various treatments with each other. So it is often not possible to know whether certain products are more effective than others. Most products have to be taken for a long time before there is a noticeable improvement. And some have considerable side effects.
The type of treatment that is considered for acne will depend on various things, including
- how severe the acne is,
- what type of skin you have (dry, oily or combination),
- how distressing the acne is for you,
- whether you are susceptible to acne scarring,
- whether you have other health problems,
- whether you are male or female,
- which treatments have already been tried out and how well they worked, and
- the likelihood of positive and adverse effects of the different products.
There are a variety of creams, lotions and gels that can be applied directly to the skin (topical application), with different drugs in them. All of these have to be used for several weeks or months before they start working. They are not only applied to the existing pimples, but to the surrounding skin as well, to prevent new pimples from forming.
Some medications can irritate the skin, leading to things like redness and itching. The likelihood of this happening can be reduced by starting off with a low dose and then gradually increasing the dose. If the skin becomes irritated, lowering the dose can help. If the skin stays irritated or if the medication has not worked after some time, a different medication can be tried out.
In Germany and other countries, benzoyl peroxide can be bought over the counter and has long been a standard treatment for acne. It is available in the form of gels, lotions and creams. Benzoyl peroxide helps remove the layer of dead cells on the outside surface of the skin. This helps prevent the sebaceous glands from clogging up, making it easier for sebum (oil) to leave the pore. It also has antibacterial properties and, unlike with antibiotics, there is no risk of bacteria getting used to it (becoming resistant) if it is used a lot.
Benzoyl peroxide helps in mild to moderate acne. It can lead to a visible improvement in people’s complexions within a few weeks. But it can also irritate the skin, causing things like redness and itching. If benzoyl peroxide comes into contact with clothes and hair it may bleach them, so it is advisable to take care when applying it. The form benzoyl peroxide is used in does not make a difference to how effective it is. It comes in various concentrations: 2.5%, 5% and 10%. Products with higher concentrations do not work better than those with lower concentrations, but adverse effects are more common with 10% benzoyl peroxide.
In inflammatory forms of acne the skin is infected with bacteria. Antibiotics that are applied to the skin have an anti-inflammatory effect and can reduce inflammatory forms of acne. They are not effective in the treatment of non-inflammatory acne.
Topical antibiotics need to be taken for quite some time before they can have an effect. In Germany, they are available on prescription only. It takes at least three weeks, and often even between three and six months, before an improvement can be seen. One problem with antibiotics is that there is always the danger that bacteria could become resistant. In other words, the bacteria may get used to the drug if it is used too often. As a result, the antibiotics do not work as well anymore, or not at all. So antibiotics are not suitable for repeated long-term use.
Retinoids are derivatives of vitamin A. The retinoids that can be applied topically in the treatment of acne include adapalene,isotretinoin and tretinoin. These medications are prescription-only in Germany and come as creams, gels or solutions. They can help in both inflammatory and non-inflammatory acne: an improvement in skin condition can be seen within several weeks.
Retinoids can have adverse effects such as redness, burning and itching. They have not been approved for use in women who are pregnant or breastfeeding.
Other products for topical use
Azelaic acid helps prevent oil glands from becoming blocked and can reduce acne. It has an antibacterial and anti-inflammatory effect. The possible adverse effects include skin irritations such as itching and burning.
A lot of acne products, such as cleansing toners and creams, contain salicylic acid. This ingredient is believed to work by removing dead skin cells from blocked pores. It is not clear whether products that have salicylic acid in them help against acne. Salicylic acid can also have adverse effects such as redness, dryness and peeling.
A wide range of “alternative medicine” products are available too. There is generally a lack of good scientific research in this area. It is not clear whether any of them can help against acne.
Oral medications are generally considered for the treatment of moderate to severe acne, or if topical treatment has not lead to a good enough improvement.
Antibiotic tablets can reduce inflammatory acne when taken for several weeks or months.
Oral antibiotics can have adverse effects, including dizziness, digestive problems and allergic reactions such as rashes. One type of antibiotic called tetracycline is not suitable for girls and women who are pregnant or breastfeeding. Like with topical antibiotics, there is a danger that bacteria could become resistant and oral antibiotics could stop working if they are used too much.
One of the main causes of acne is higher levels of, or an increased sensitivity to, the hormone androgen. Certain hormone products can reduce the production and effect of androgen, leading to better skin.
Some hormone products can be prescribed especially for the treatment of acne. These also have a contraceptive effect. Three combinations have been approved for the treatment of acne in girls and women in Germany:
These hormone products are often used together with a topical treatment in women with moderate to severe acne, to improve the effect.
Hormone products such as the contraceptive pill (“the pill”), on the other hand, are intended for contraceptive use and are usually not licensed for the treatment of acne. But if girls and women who have acne use the contraceptive pill as a form of contraception, then it might have a positive effect on their acne too. This is only true, though, if they take a pill that has the hormones estrogen andprogestin in it. Find out whether any of the contraceptive pills have a better effect on acne in our research summary “Acne: Do different types of contraceptive pill affect your skin differently?”
Hormone products can have adverse effects too, such as headaches and nausea. They also increase the risk of deep vein thrombosis – some more so than others.
Retinoid tablets are the most effective medications for the treatment of acne, but they also have the most adverse effects. Because of this, they are generally only used if other medications have not worked. Retinoid tablets can lead to a clear improvement in acne, or might even make acne clear up completely. But sometimes it comes back again after a while.
Because retinoids decrease the production of oil in the skin, people who take them might have dry lips, skin and eyes. Other side effects include headaches, achy joints and backache. The higher the dose of retinoids you take, the more likely you are to experience adverse effects. Pregnant and breastfeeding women should not take retinoids.
Retinoids will only be considered as a treatment option for sexually active women if they use at least one contraceptive method, or preferably two at the same time. For example, if they take the pill and use condoms as well, to be on the safe side. Retinoids can be harmful to unborn babies, so women must carry on using contraception at least four weeks after they stop taking retinoids.
A few years ago there were a number of reports that taking isotretinoin led to a higher risk of suicide. This has not been confirmed by scientific studies. Still, it is important to look out for any unusual changes in mood if you are taking retinoids, and inform your doctor if you have any. In any case, it always makes sense to seek medical and/or psychological support if acne is a big problem for someone or if it causes psychological problems.
Laser treatment and intense pulsed light therapy
There is some evidence that laser treatment and intense pulsed light therapy can lead to a short-term improvement in inflammatory acne. There is a lack of good research on the long-term benefits of these treatment approaches. So it is not clear whether they represent an alternative to other therapies that are known to be effective.
Somewhat more research has been done on phototherapy. This treatment approach involves shining UV light on the affected areas of skin under medical supervision. This is meant to help kill the bacteria in acne. Research suggests that it can improve acne, at least in the short term. Phototherapy is not the same as using a tanning bed.
Via. The Institute for Quality and Efficiency in Health Care (IQWiG)
The above is some of the common practices for how to get rid of acne but our main focus is to provide home remedies for acne. In our next post, we will guide you to the natural process home remedies to help you get rid of acne.