Prescription Medications. Medications that affect hormones, like birth control pills, can help control acne. You might also discuss antibiotic pills and prescription retinoids with your dermatologist. There are also antibiotics that are effective. Doctors may prescribe Aldactone (spironolactone), which was first made to treat high blood pressure, to treat acne. "That works miracles but it can take three months to kick in," Day says. Isotretinoin is another prescription drug for acne, but you can't take it if you're pregnant or planning to get pregnant.
To get rid of acne scars fast, apply diluted lemon juice to your scars so they lighten up and aren't as noticeable. You can also make a paste with 1 part baking soda and 2 parts water and use it to exfoliate your face, which can reduce the appearance of acne scars. For more stubborn acne scars, apply an over-the-counter cortisone cream to the scars to help them heal faster.
Diet. Studies indicate that certain dietary factors, including skim milk and carbohydrate-rich foods — such as bread, bagels and chips — may worsen acne. Chocolate has long been suspected of making acne worse. A small study of 14 men with acne showed that eating chocolate was related to a worsening of symptoms. Further study is needed to examine why this happens and whether people with acne would benefit from following specific dietary restrictions.
A U.K. survey found that on average single men only change their sheets four times a year. And while we certainly hope you are swapping out your linens much more frequently, dirty pillowcases can lead to clogged pores. Nasty as is sounds, bacteria can build up on your bed and your face rubs around on it for a good eight hours a night. Well, that just can’t be good. If your skin is oily, change those sheets (or at least your pillowcases) twice a week. It might be a pain, but isn’t a clear complexion worth it?
Old marks still sticking around take patience and consistency to treat. One way to even out skin tone over time is with regular exfoliating. "[Exfoliating] is important in treating acne scars at home as it lifts dead skin and allows new skin to grow and proliferate," Dr. Moy explains. This exfoliator contains papaya enzymes to break down dead skin cells and microderm crystals to buff away acne scars. Aloe vera, coconut, and vitamins E and B nourish the skin simultaneously.
Other concerns include inflammatory bowel disease and the risk of depression and suicide in patients taking isotretinoin. Recent evidence seems to indicate that these problems are exceedingly rare. Government oversight has resulted in a highly publicized and very burdensome national registration system for those taking the drug. This has reinforced concerns in many patients and their families have that isotretinoin is dangerous. In fact, large-scale studies so far have shown no convincing evidence of increased risk for those taking isotretinoin compared with the general population. It is important for those taking this drug to report changes in mood or bowel habits (or any other symptoms) to their doctors. Even patients who are being treated for depression are not barred from taking isotretinoin, whose striking success often improves the mood and outlook of patients with severe disease.
If you’ve made a concerted effort with over-the-counter regimens and/or diet and still aren’t seeing results, a dermatologist is absolutely worth it. There are many levels of care: Prescription retinoids (Retin A, Tazorac, Differin et al) and/or topical antibiotics are the mildest, along with blue-light treatments like Isolaze, which kill bacteria and clear pores, with virtually no downtime. Light lasers like Clear and Brilliant can clear pores and treat the red and brown tones left by old acne lesions. “Some patients think they’ve got a severe problem, when they really only have a few pimples, surrounded by red and brown marks from old breakouts,” notes Anolik. Oral antibiotics represent a more aggressive (and unsustainable long-term) solution; birth control pills and hormone-mitigating medications like Spironalactone and Deldactone can get many more-severe patients’ acne under control. Most aggressive is Accutane; while it can be severely drying and can cause birth defects if taken during pregnancy, it represents a cure for truly-severe acne cases, says Anolik. “Used correctly, it is something of a miracle for people who’ve tried everything and failed,” he says.
Drugs: Some medications may cause or worsen acne, such as those containing iodides, bromides, or oral or injected steroids (either the medically prescribed prednisone [Deltasone, Orasone, Prednicen-M, Liquid Pred] or the steroids that bodybuilders or athletes sometimes take). Other drugs that can cause or aggravate acne are anticonvulsant medications and lithium (Eskalith, Lithobid). Most cases of acne, however, are not drug related.