What's the best acne treatment?

As you can see from the many different answers, there is no best treatment for acne. There is no one treatment that works best for every patient. A partnership between an experienced dermatologist and an experienced cosmetic surgeon is often necessary to arrest the acne process and treat the scarring associated with previous outbreaks.

The first step in the process is to stop acne outbreaks. This is best treated by consultation with a dermatologist. The next step is to erase the painful marks left behind. While no acne treatment can recreate unblemished skin, treatments can improve the texture of the skin.

It can take several treatments over years to get optimal results. In patients with darker skin, the options are more limited and more troublesome. Consultation with an experienced cosmetic surgeon is key to obtaining optimal results.

The face, chest, and back have the highest amount of oil glands, so we normally get acne in these areas. The oil glands are regulated by hormones in the body, so when hormone levels fluctuate, the oil glands produce more oil, thus clogging skin pores, leading to inflammation, and eventually resulting in pus-filled acne lesions. Fast, effective acne treatment requires a series of prescriptions (Rx), as listed below.

Rx 1: Effective treatment of acne requires a thorough evaluation by a Dermatologist who practices scientifically. Success with acne requires the use of a combination of individually-tailored treatments within a holistic framework or regimen.

Rx 2: Prescription-based treatment is extremely important. Most patients find that “over-the-counter” acne medications are not very effective – this makes sense, because treatments sold on television, the internet, or in magazines are often missing key ingredients that are needed to successfully treat acne.

Rx 3: Cosmetic peels, such as the salicylic peel, are a very helpful adjunctive therapy and are often overlooked by most Dermatologists in favor of more expensive treatments. Laser light therapies such as the IPL laser (intense pulsed light) can also be employed as well, as IPL treatments shrink the sebaceous glands and decrease oil production. In short, each acne program must be tailored to each individual patient and the proper combination of therapies must be employed.

Rx 4: For treatment of acne flare-ups, a short course of prescriptive oral antibiotics may be utilized. I use antibiotics only for short periods of time, since patients will eventually become resistant to oral antibiotics. My main approach is to combine all of the best treatments into one effective program.

Rx 5: Some patients find that topical acne treatments irritate their skin – this can be avoided if the right medications are chosen and if your doctor takes the time to educate you on how to use the medications in a way that won’t cause irritation.

Rx 6: Certain contraceptives may worsen acne, and others may improve acne. In short, some contraceptives are far more helpful than others, and the patient who uses contraceptives should consult with a Dermatologist for information on which contraceptives actually improve acne.

Rx 7: Natural supplements can help too. I recommend a multivitamin and a high-potency B complex vitamin to boost the immune system, promote health, and reduce stress levels. Also, it is equally important to exercise regularly and maintain a balanced diet. Foods that are high in fat and sugar may set off a cascade of reactions in the body which promote acne. Environmental factors such as stress, lack of sleep, lack of exercise, nutritional deficiencies, alcohol, and smoking must all be considered. Finally, the astute dermatologist will assess the skin-care products that you are currently using, since many products such as certain cleansers, moisturizers, and make-up may be contributing to your break-outs. It is also important to assess the home and work environment for other exposures that may be aggravating factors. Seeing a Dermatologist who specializes in acne treatment and takes a “big picture” approach is the key. A multi-modal approach will bring about the best results.

Blue light therapy is a treatment that uses light to kill the acne causing bacteria. Perfect for those allergic to topical and oral antibiotics.

Acne needs to be treated two ways:

- Unclog the pores

- Kill the bacteria that causes the inflammation.

Ideally it should be treated with both modalities. Blue light is just half the answer. Cooltouch is a laser light source that shrinks the oil gland and results in decreased bacteria counts as well.

Patients do best when also using a retinoid ( Retin-A, Differin, Tazorac) because these products act to prevent the clogs in the pores, as well as are anti-inflammatory.

The most complete product to treat acne is still Accutane. If properly prescribed, it decreases bacteria because of its action on the sebaceous glad, unclogs the pores and is anti-inflammatory as well.

1. Utilize atopical antibiotic in the morning and alternate a retinoid with a benzoyl peroxide derived at night.
2. Blue light/red light combination LEDs are helpful to diminish acne causing bacteria and diminishing inflammation.