Topicals are creams, lotions or gels you apply directly to your skin. Typical ingredients include benzoyl peroxide and salicylic acid, which help fight bacteria and reduce inflammation. Other common ingredients are adapalene, tretinoin, azelaic acid and alpha hydroxy acids which all help to normalize skin cell turnover, gently exfoliate the skin and prevent clogged pores. Topical retinoids such as Retin-Aâ are also used to improve the look of acne scars by gently exfoliating the skin and prevent breakouts and improve skin quality. A newer drug is Clascoteroneâ, an FDA approved cream for the topical treatment of acne that decreases inflammation with early improvements seen as early as two weeks.

For more severe acne, your doctor may prescribe oral antibiotics such as doxycycline or azithromycin, which help kill bacteria and reduce inflammation. Generally, these medications will be taken for a few months until the acne has cleared up and then gradually tapered off. Additionally, some women are prescribed hormonal treatments such as spironolactone, or oral contraceptives which helps to balance hormones and reduce the production of sebum. Studies have reported that spironolactone, an antiandrogen that prevents oil production, is effective to improve acne by 50% to 100% in women. In severe cases, Dr. Shagalov may recommend Isotretinoin (Accutane), which is an extremely effective treatment.

Accutane

Accutane is a brand name for the drug isotretinoin, which is a type of retinoid. It is primarily used to treat severe nodular acne that has not responded to other treatments. Accutane works by reducing the amount of oil produced by the skin’s sebaceous glands, which can help to prevent the formation of acne. Accutane is taken orally and is usually prescribed for a period of four to six months. It is known to have potential side effects, including dry skin and eyes, chapped lips, and increased sensitivity to the sun. It can also cause more serious side effects, such as depression, suicidal thoughts, and birth defects if taken during pregnancy. In practice, patients are usually thrilled with their results and are very happy with the course of Accutane treatment.

For those with milder forms of acne, Dr. Shagalov may recommend light therapy. This involves exposing the skin to certain wavelengths of light that help to kill bacteria on the surface and promote healing. It’s usually done in her office, but there are also at-home devices available as well.

Chemical peels can improve mild to moderate acne by exfoliating the skin to reduce or prevent clogged pores. Chemical peels also reduce pore size and can help improve the appearance of acne scars.

Steroid injections in painful swollen cystic acne can reduce inflammation to hasten resolution, and to help prevent scarring.