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Acne

Acne is a common skin problem. It occurs most often in people between ages 10 and 30, but it can affect persons of any age.

Acne is caused by a complex combination of factors. These include hormones, bacteria and an individual’s genetic tendency to have blocked pores. For the most part, having acne has very little to do with one’s hygiene or what they eat. Most of the time, a person gets acne due to factors out of their control (i.e. a genetic tendency), and without medications, the acne will often be difficult to control.

There are no proven associations between foods, beverages and acne. However, if you have found that certain foods or drinks (e.g. chocolate) definitely make your acne worsen, then you may choose to avoid those products.

It is a good idea to avoid leaning your face on your hands. It is also advisable to avoid rubbing, picking or squeezing lesions on your face, since they tend to get more inflamed and take a little longer to heal if you do this.

Treatment

This is some standard information regarding acne treatment. However, your doctor/provider will most likely individualize your therapy.

Wash your face gently (do NOT scrub or use anything harsh or “grainy”) twice a day with a mild over-the-counter soap such as White Dove, Neutrogena Transparent Bar, Purpose, Aveeno or Cetaphil. Your doctor/provider might recommend a specific medicated soap/cleanser such as Ovace, or Plexion.

You may be prescribed a Benzoyl Peroxide product (or a product combined with Benzoyl Peroxide) such as Duac, Benzaclin, Acanya or Benzamycin. If so, apply a thin coat of this (at the prescribed times…usually at bedtime or twice daily) after gently cleansing your face (see above). You should apply a thin coat of this to all of the areas of your face where you tend to get acne. That is, do not just put the product on individual bumps. Caution: Products containing Benzoyl Peroxide can bleach clothes/pillow cases etc., so be careful and wash your hands after use and you might even want to consider white pillow cases only.

You might be prescribed another class of topical acne product such as Metrogel, Aczone, Clindamycin, or Avar. Apply topically just as described in the paragraph above.

You may be prescribed a topical product that contains a Retinoid. This product could be a retinoid alone, or it could be a “combination product”. Examples of these include Differin, Fabior, Retin A Micro, Epiduo, or Veltin. These products are applied at bedtime. They are excellent products overall for acne. However, they can occasionally cause irritation/drying during the first month of use. The ideal way to use these products is as follows: First, wash your face and dry it. Then, apply a thin coat of the medicine to your entire face except for your eyelids (it doesn’t take much b/c it spreads very easily). In the beginning weeks of use, it is probably wise to apply these topical “retinoids” only 2-3 nights per week. If you realize that you are having no irritation issues, go ahead and use the medicine more frequently, gradually working up to every night application if you do not experience excessive irritation along the way. If you do experience excessive irritation at any point along the way, simply back off the medication and use it a little less frequently. It is not necessary for you to have skin irritation in order for these products to work for your acne.

Oftentimes, your doctor/provider prescribes oral antibiotics for acne (e.g. Septra, Minocycline (Solodyn), Doxycycline (Doryx), or Azithromycin). If you are given an antibiotic, use the product exactly as instructed. If you have any problems with the medication (such as rash, headache, nausea, dizziness, yeast infection, etc.), contact your doctor/provider or the office staff so that we know what is happening – many problems like this can be remedied over the phone. Also, if there is any chance you are pregnant or become pregnant while taking medicines, you should stop the antibiotic. If you are prescribed Doxycycline (e.g. Doryx) or Azithromycin, it is best to take these medications with food. If you are prescribed Minocycline (e.g. Solodyn), please note that a very small percentage of patients get dizziness (or headache) from this antibiotic. More importantly, a very small percentage of patients can get a bad Drug Reaction from this antibiotic that typically occurs 1-3 weeks after starting it. If you have any hint that something of this nature is occurring (e.g. fever, rash, redness, flu-like symptoms), stop the medication and let your doctor know. Some antibiotics MIGHT make you a little more sensitive to the sun (i.e. you might sunburn easier than usual). The most common offenders include Doxycycline (e.g. Doryx) and Septra. If you do notice more sun sensitivity with any antibiotic, just use good sense and be more careful to wear sun protection and limit your exposure accordingly. Sometimes, this problem can be prevented by taking your antibiotic with the evening meal rather than with breakfast during the sunnier times of the year. If this ever becomes a major problem for you, please let our office know.

Most people take at least 4-6 weeks to see a definite improvement in their acne once they begin medication. Occasionally, acne gets worse for a week or two after starting new medication, so don’t worry if this happens – it will reverse course soon. There are many approaches to treating acne, and it may take more than 1 visit or strategy to make your case significantly improve. Therefore, do NOT lose heart or get frustrated if you don’t get excellent results right away. Your doctor/provider will work with you over time to determine the ideal treatment for your acne.

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