Accutane (isotretinoin) has a mixed reputation, but among dermatologists it’s the finisher for patients with severe acne. “If you have an acne patient that doesn’t respond to anything, [Accutane] can really be a game changer,” board-certified dermatologist Adam Friedman tells SELF. Accutane is an oral retinoid, and it has all the same benefits of a topical retinol but is even more effective.
However, unlike the previously discussed treatment options, gender plays a role in how effective dapsone will be. Research has shown11 that female patients who use it get a much better response than male patients. It’s also a slow-working treatment. Studies among adolescents have shown that it is very effective, but it may take up to 12 weeks for improvements to show up, with more improvements taking place with continued use.
Accutane is especially good for cystic acne in women and body acne in men. “Oral vitamin A basically shuts down your sebaceous glands. If you suppress [them] for a long enough period, you can cure someone of their acne, and about 50 percent do hit that cure rate,” says Linkner. A course of Accutane can take about six to nine months. Sometimes patients need to repeat the course at a higher dosage in order to truly eliminate acne.
A complete skin care regimen to control acne usually starts with washing. The ideal face wash creates a soft creamy lather in warm water. It rinses off dirt, excess oil, and makeup, leaving the face ready for the next step in daily skin care, whether that is toner, moisturizer, exfoliant, sunblock, or more makeup. It is fragrance-free, and it does not create a foam, film, or tingly sensation on the face. Any product that foams and suds vigorously, like a detergent, is a strict no-no for acne treatment, especially on dry skin.
Considerations: Side effects are generally mild and short lived. Most common, in 1-5% of people are itching, burning, stinging, and tingling. Other side effects were reported in less than 1% of people. There have been a few reports from darker skinned people of lightening of the skin. Azelaic acid has not been well studied in people with dark complexions.1
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The other downside to Proactiv+ is that the bottles are small — like, half the size of Paula’s Choice small. Combine that with its recommended two or three-times daily application, and you’re going to be going through a lot of kits, which ultimately means spending more money on your treatment. If Proactiv is the only thing that works for you, it may very well be worth the investment, but we recommend starting with Paula’s Choice to see if you can get the same results at a cheaper price.
Thanks to its special MicroClear technology, Neutrogena Oil-Free Acne and Redness Facial Cleanser helps boost the delivery of active ingredient salicylic acid, in order to help reduce the appearance of acne. The inclusion of aloe and chamomile help to calm irritation while visibly reducing facial redness, a source of emotional stress for many acne sufferers.
Every expert we spoke with said the most critical part of combating acne is combating it every day. “The only way to make any medication work is to use it on a daily basis,” says Dr. Green. Fitz Patrick emphasizes that it really comes down to what you can maintain for the long term: “Kits are great because they take out all the guesswork -- you just follow the instructions. But if four steps is going to be too many for you to keep up week after week, you’ll be better off finding one that has fewer treatments.”
This ties back into what I was saying about your face being delicate. The way you clean your underarms, or upper torso, should most definitely not be the way you clean your face. The former body parts are washed by scrubbing, usually in a vigorous manner. Your face is far too delicate for this. Rough scrubbing on your face will only irritate it and cause problems.
Oral antibiotics are the standard of care in managing acne that is moderate to severe, resistant to topical therapy and covers large body surface areas. Oral antibiotics that may be prescribed to treat acne include tetracycline, doxycycline, minocycline, erythromycin, trimethoprim-sulfamethoxazole, trimethoprim and azithromycin. Combination therapy (the use of two or more therapies) including oral antibiotics and topical medication (often retinoids) may help treat acne.
The treatment regimen your doctor recommends depends on your age, the type and severity of your acne, and what you are willing to commit to. For example, you may need to wash and apply medications to the affected skin twice a day for several weeks. Often topical medications and drugs you take by mouth (oral medication) are used in combination. Pregnant women will not be able to use oral prescription medications for acne.
Properly selected face cleanser will help rid your skin of bacteria that clog pores and multiply in them. High-quality face cleaning also removes dead skin cells, making acne treatment more effective. It will take a strong but gentle remedy to remove dirt without new irritations. Therefore, you should avoid abrasive scrubs and soaps for the face, which can deprive the skin of its natural oils and may cause the painful irritation.
The Daily Skin Clearing Treatment is an all-over 2.5 percent benzoyl peroxide cream that also touts calming bisabolol and allantoin to alleviate the dryness and irritation that can crop up mid-treatment. Anyone frustrated with oil-slick skin will also love this part of the regimen — it creates a satin mattifying effect, instantly transforming shininess into a glow.
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