Moderate-to-Severe Acne

Moderate-to-severe acne typically means having a lot of whiteheads, blackheads, papules or pustules that cover from one-quarter to three-quarters of the face and/or other parts of the body. This type of acne usually requires the help of a dermatologist and the use of one or more treatments including:

• Prescription medications
  • Retinoid creams or gels: Derived from vitamin A, retinoids prevent blackheads and other types of acne from forming. Retinoids can irritate the skin and increase sun sensitivity. It's very important to use a broad-spectrum sunscreen (protects against UVA and UVB rays) with a sun protection factor (SPF) of 30 or higher while using one of these treatments.
  • Antibiotic lotion or gels: Antibiotic lotions or gels stop the bacteria that cause acne.
  • Oral antibiotics: Like the antibiotic lotions, antibiotic pills help prevent the bacteria that cause acne.  The dermatologist may prescribe a stronger dose at first, and then decrease it as acne improves.
  • Oral contraceptives: If appropriate, "the pill" may be prescribed in some older teen girls and women to adjust the hormones to reduce oil production.
• Over-the-counter topical acne medications (See Mild Acne).
• Extraction: This procedure uses a sterile pen-sized tool to remove the blackheads or whiteheads.  While a dermatologist may remove acne, you or your child should not squeeze or pick pimples because it can cause an infection, make the acne worse, or lead to scars.
• Phototherapy: Laser and light sources can be used to remove acne, as well as lessen acne scars.  Only a dermatologist who has experience should perform phototherapy. Be sure to ask the dermatologist for experience and qualifications with this type of procedure.

If the treatment works, keep using it, even if the acne is gone. Stopping can allow the acne to come back.

Use only one treatment at a time unless a dermatologist recommends otherwise. If after six to eight weeks, one treatment isn't working, it's time to switch to another. If there is little or no improvement after 10 weeks, it may be time to see a dermatologist. In some cases, a dermatologist may prescribe two or more treatments.

 

Next: Severe Acne