Treatment - Acne

Benzoyl peroxide works as an antiseptic. This means you will have less bacteria on your skin.

It helps you have less whiteheads and blackheads and has an anti-inflammatory effect.

Benzoyl peroxide is usually available as a cream or gel. It's used either once or twice a day.

Wait 20 minutes after washing to put it on. Put it on all the parts of your face affected by acne. Put it on a thin layer as it may irritate your skin.

Side effects

Put on sunscreen as benzoyl peroxide makes your face more sensitive to light.

Benzoyl peroxide can bleach things. Do not get it on your hair or clothes.

Common side effects of benzoyl peroxide include:

• dry and tense skin
• a burning, itching or stinging sensation
• some redness and peeling of skin

Side effects are usually mild. They should pass when your treatment stops.

Most people need treatment for at least 6 weeks to clear most or all of their acne.

Your GP may tell you to keep up some treatment to stop acne coming back.

Topical retinoids are creams and gels you can put on your skin. They work by taking away dead skin cells (exfoliating). This helps to stop them building up in hair follicles.

Tretinoin and adapalene are topical retinoids for acne. They come in a gel or cream and are usually put on once a day before you go to bed.

Wait 20 minutes after washing your face. Put it on all the parts of your face affected by acne.

Azelaic acid is often used if the side effects of benzoyl peroxide or topical retinoids are very irritating or painful.

Azelaic acid works by getting rid of dead skin and killing bacteria. It's available as a cream or gel. It's usually put on twice a day (or once a day if your skin is very sensitive).

Side effects

The side effects of azelaic acid are usually mild and include:

• burning or stinging skin
• itchiness
• dry skin
• redness of the skin

If your acne is bad, antibiotic tablets are usually used with a topical treatment.

Your GP will usually tell you to take antibiotics called tetracyclines.

Pregnant or breastfeeding women should take an antibiotic called erythromycin.

It usually takes about 6 weeks before you notice your acne is getting better.

How long you take antibiotic tablets for depends on how soon your acne changes after taking them. It could be 4 to 6 months.

Side effects

Tetracyclines can make your skin sensitive to sunlight and UV light.

They can also make the oral contraceptive pill less likely to work. This is for the first few weeks you are taking these antibiotics. You'll need to use a different type of contraception, such as condoms.

Hormonal therapies can often be good for women with acne. Especially if the acne flares up around periods or is to do with polycystic ovary syndrome.

But the progestogen-only pill or contraceptive implant can sometimes make acne worse.

Your GP may recommend the combined oral contraceptive pill. This is even if you are not sexually active.

This pill can often help acne in women. But it may take up to a year before you see your skin get better.

Co-cyprindiol is a hormonal treatment for bad acne that antibiotics do not work for. It helps your glands make less sebum.

You'll have to use co-cyprindiol for 2 to 6 months before you notice your acne getting much better.

Side effects

Risks and side effects of co-cyprindiol:

• there's a small risk that you may get breast cancer in later life
• there's very small chance you will get a blood clot - the risk is around 1 in 2,500 a year

Isotretinoin is for severe cases of acne that other treatments have not worked on.

You take isotretinoin as a tablet. Most people take it for 6 to 9 months.

Your acne may get worse during the first 7 to 10 days. But this is normal and soon settles.

Side effects

Common side effects of isotretinoin include:

• inflammation, dryness and cracking of the skin, lips and nostrils
• inflammation of your eyelids (blepharitis)
• inflammation and irritation of your eyes (conjunctivitis)

Rarer side effects of isotretinoin include:

• inflammation of the liver (hepatitis)
• inflammation of the pancreas (pancreatitis)
• kidney disease

Because of the risk of these rarer side effects, you'll need a blood test before and during treatment.

Isotretinoin and birth defects

Isotretinoin will damage an unborn baby. Your dermatologist will explain the risks of taking isotretinoin if you can become pregnant.

Do not use isotretinoin if you're pregnant or you think you're pregnant.

If you can get pregnant you will need to sign a form to say that you:

• understand the risk of birth defects
• will use contraceptives to prevent this risk - you will do this even if you're not currently sexually active

You must have a pregnancy test before, during and after treatment.

You must use 2 methods of contraception:

• during treatment
• for 1 month before treatment begins
• 1 month after treatment has finished

If you think you may have become pregnant when taking isotretinoin, contact your dermatologist immediately.

Isotretinoin is also not suitable if you're breastfeeding.

Isotretinoin and mood changes

There have been reports of people experiencing mood changes while taking isotretinoin.

There's no proof that these were because of the medicine.

Contact your GP immediately if you:

• feel depressed
• feel anxious
• feel aggressive
• have suicidal thoughts

This is a small pen-shaped instrument that can be used to clean out blackheads and whiteheads.

A chemical solution is put onto the face, causing the skin to peel off and new skin to replace it.

Dermabrasion removes your top layer of skin. There are 2 ways to do this:

• using lasers
• using a specially made wire brush

After the treatment, your skin will look red and sore for a few months. But as it heals you should see your scars starting to look better.

Laser treatment can be used to treat mild to moderate acne scarring.

There are two types of laser treatment:

Ablative laser treatment

Lasers remove a small patch of skin around the scar. This makes a new, smooth-looking area of skin.

Non-ablative laser treatment

Lasers helps the growth of new collagen (a type of protein found in skin).

This helps to fix some of the damage from scarring, and makes it look better.

Dermal fillers are used to fill scars that have left a dip in your skin.