Combined oral contraceptives. Four combined oral contraceptives are approved by the FDA for acne therapy in women who also wish to use them for contraception. They are products that combine estrogen and progestin (Ortho Tri-Cyclen, Yaz, others). You may not see the benefit of this treatment for a few months, so using other acne medications with it the first few weeks may help.
Lastly, one of the best preventative steps is to drink water everything all day. When you play properly hydrated, your body is able to process all the toxins that go in it a lot more efficiently. It is no surprise that one of the main ways your body gets rid of toxins is through the pores in your skin. If you don't regularly flush out your system, then you are paving the way to allowing a backup of gunk to clog your pores. Once your pores are clogged, you are one step closer to getting an acne breakout. Of course, you can help to avoid all this by staying properly hydrated.
Stronger cases may call for prescription retinoids (such as Retin-A or Tazorac), which “are really the standard of care for most acne therapy,” says Joshua Zeichner, MD, director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City. Certain drugs, such as Epiduo and Ziana, combine retinoids with antibacterials and may be more effective than separate products. Because retinoids also have anti-wrinkle properties (they help stimulate collagen production), they are especially beneficial for adult acne sufferers.
Everyone's skin is different, so the routine and facial cleanser that works for your best friend probably won't work for you. "It is always best to see a dermatologist to determine a best skin routine as often times prescription products are needed as well," says board certified dermatologist and medical director and founder of California Dermatology Specialists, Dr. Eric Meinhardt.
Any acne treatment is a weeks-long experiment that you’re conducting with your skin. Acne is slow to heal, and in some cases, it can get worse before it gets better (nearly every benzoyl peroxide product we looked at emphasized the likeliness of irritating acne further, and starting off with a lighter application). April W. Armstrong, a doctor at the University of California Davis Health System, recommends waiting at least one month before you deem a product ineffective.
Retinoids: Retin-A (tretinoin) has been in use for years, and preparations have become milder and gentler while still maintaining its effectiveness. Newer retinoids include adapalene (Differin) and tazarotene (Tazorac). These medications are especially helpful for unclogging pores. Side effects may include irritation and a mild increase in sensitivity to the sun. Adapalene 0.1% is now available without a prescription. With proper sun protection, however, they can be used even during sunny periods. The combination medication known as Epiduo gel -- which contains the retinoid, adapalene, along with the antibacterial, benzoyl peroxide -- is applied once a day.
Dermatologists aren’t sure why azelaic acid is so effective at clearing up inflammation, but it’s often used as an option for sensitive skin or pregnant patients. The ingredient is good at treating malasma, acne, and rosacea, Dr. Linkner says. Your dermatologist can prescribe products with high concentrations of azelaic acid, and you can also find over-the-counter options with lower concentrations of this active ingredient.
The only medication that can make an argument that it cures acne is isotretinoin, because research shows it permanently reduces skin oil production and provides "remission" of acne in 66% of people. However, even in the case of isotretinoin, relapse rates may be higher than we think. Also, isotretinoin is recommended only for severe acne that does not respond to other treatments because it comes with a litany of side effects, and leaves the skin and the entire body permanently altered.
Drink plenty of water: Our body gets dehydrated very quickly. Water is one of the important things our body organs require to function properly and it also helps in maintaining the skin soft and supple. Without enough water, our skin gets very dry and we use a heavy duty moisturize to maintain it supple. But moisturizers can clog the pores, so it is important to drink plenty of water.
But the side effects of targeted breakout cream treatments aren’t always worth it. “So many products instruct consumers to use benzoyl peroxide spot treat red bumps and pustules. I don’t recommend it,” says Dr. Lawrence Green, board-certified dermatologist and assistant clinical professor of dermatology at George Washington University. Such high concentrations of benzoyl peroxide cause added irritation and inflammation to already sensitive skin, so with this in mind, we cut kits that included spot treatments.
While you can certainly benefit from a great skin-care regimen, "in cystic acne, usually you need internal treatment," he says. "Topical medications usually don't work. Accutane is a great miracle cure for really bad cystic acne, but most people with cystic acne will improve with oral antibiotics — sometimes for two weeks, sometimes for three weeks."
A 2013 study on acne vulgaris in The Nurse Practitioner concurred that a multidimensional approach to acne is usually necessary because most people have a combination of symptoms. Based on the advice of dermatologists and aestheticians, we turned our focus to regimen sets, analyzing the ingredients of more than 40 kits before finding our top picks.
Natural treatments are usually free of the side effects sometimes caused by prescription options. But they may not be as effective. Research on natural options is lacking, and at this time nothing has been proven to produce results. Talk with your doctor about potential risks and to ensure the treatment won’t interact with any medications you’re taking.
'There is a high risk of birth defects, so women must take careful steps to prevent pregnancy during treatment,' she explains. 'Dry, cracked lips are common, blood tests must be done to monitor cholesterol and liver function, alcohol intake should be restricted and prolonged sun exposure must be avoided as there is a higher risk of getting a sunburn. Close supervision by a dermatologist experienced in prescribing the drug is mandatory.'