Acne is caused by the effects of hormones on the pilosebaceous unit, consisting of a hair follicle, sebaceous gland, and a hair. The follicle becomes obstructed and an overgrowth of a normal skin bacteria, Propionibacterium acnes, causes destruction of the lining of the follicle. This process allows follicular material to enter the dermis, causing an inflammatory response. For a more detailed description of this process, see What Causes Acne?
This category contains medications that work to improve acne in various ways. Some are available over-the-counter and others are available only by prescription.
Acne Treatment With Benzoyl Peroxide
- Works by killing bacteria and reducing inflammation in the follicle
- A good choice for people with mild acne
- Available as a liquid (2.5% - 10%), bar (5% - 10%), mask (5%), lotion (5% - 10%), cream (5% - 10%), gel (2.5% - 20%), and cleanser (10%)
- All strengths are available without a prescription
- Using the 10% or 20% strengths does not necessarily improve the therapeutic benefit, but increases the risk of skin irritation.
- Used once or twice a day
- May cause skin irritation and bleaching of hair or fabrics
- Cannot be used at the same time as tretinoin because it inactivates tretinoin
Acne Treatment With Salicylic Acid
- Works by reducing the formation of comedones - blackheads and whiteheads
- Available in 0.5% - 2.0% strengths
- All strengths are available over-the-counter
- Not as effective as tretinoin
- Not as irritating as tretinoin
- Applied at night and washed of in the morning
Acne Treatment With Azelaic Acid
- Works by killing bacteria and reducing the formation of comedones - blackheads and whiteheads
- Marketed as Azelex®
- Available as a cream at 20% strength
- Must be prescribed by a health care provider
- Applied twice a day
- As effective as tretinoin and may have even more beneficial effects when used with tretinoin
- Not as irritating as tretinoin
Acne Treatment With Sulfacetamide-Sulfur
- Sulfur has been used to treat acne for over a thousand years
- Works by helping clean out pores
- Marketed as Novacet® or Sulfacet-R®
- Available over-the-counter
- Can cause skin discoloration and have an unpleasant odor
Acne Treatment With Benzoyl peroxide and Erythromycin
- This combination is available as a gel that contains 5% benzoyl peroxide and 3% erythromycin
- Marketed as Benzamycin®
- Must be prescribed by a health care provider
- The mixture must be refrigerated
- Applied twice a day
- The combination of the two drugs reduces bacterial resistance to erythromycin
- May cause skin irritation
