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What Is The Best Treatment For Severe Acne

Which Acne Medication Is Best For You

What is the BEST Treatment for SEVERE Acne

Acne can vary hugely in severity and difficulty of treatment, meaning that the right solution for you could be completely different to the right solution for another person.

Because of this, theres no best acne medication for everyone. If you have persistent or severe acne that doesnt seem to respond to over-the-counter acne medication, the best approach is to talk to your doctor or schedule an appointment with a qualified dermatologist.

The right doctor will be able to check your acne and recommend a suitable treatment based on your symptoms and previous experiences with acne medication. They may prescribe a topical or oral retinoid, an antibiotic, an over-the-counter cream or a combination of several products.

Topical Therapies: Over The Counter

Benzoyl peroxide is an over-the-counter bactericidal agent that comes in a wide array of concentrations and formulations. No particular form has been proven better than another.5 Benzoyl peroxide is unique as an antimicrobial because it is not known to increase bacterial resistance.11 It is most effective for the treatment of mild to moderate mixed acne when used in combination with topical retinoids.2 Benzoyl peroxide may also be added to regimens that include topical and oral antibiotics to decrease the risk of bacterial resistance.2 Salicylic acid is present in a variety of over-the-counter cleansing products. These products have anticomedonal properties and are less potent than topical retinoids, but there have been only limited high-quality studies examining their effectiveness.5

Learn More About Prescription Acne Medication

Would you like to learn more about the acne medications listed above? Our Tretinoin 101 guide covers everything you need to know about tretinoin, one of the most widely used topical retinoid medications for treating and preventing acne.

You can also learn more about how tretinoin is used in both acne and anti-aging treatment.

Recommended Reading: How To Wash Your Face To Get Rid Of Acne

What Are The Best Sunscreens To Prevent Hyperpigmentation And Dark Marks

Unprotected sun exposure increases the amount of pigment in the skin and can cause pigmented acne scars and post-acne dark marks. To prevent those dark marks from forming, one needs to control active acne with an effective topical or oral anti-acne treatment. In parallel, it is recommended to use an oil-free sunscreen with SPF 30. The best sunscreen for acne or post-acne dark spots is also water-resistant, which will stay on your skin when sweating. Some of the new sunscreens contain, in addition to SPF, plant extracts with anti-oxidants like green T and vitamin E and ingredients that help fade post-acne dark spots like licorice and vitamin C.

What Questions Should I Ask My Doctor


You may want to ask your healthcare provider:

  • What causes cystic acne?
  • What is the best cystic acne treatment?
  • What are the treatment side effects?
  • How can I lower my chances of getting acne cysts?
  • How can I prevent scarring or other complications?

A note from Cleveland Clinic

Its tempting to want to touch or pick at painful, swollen acne cysts. But cystic acne is more likely than other zits to scar or develop infections. A dermatologist can offer suggestions to prevent cystic acne. This doctor can also treat painful acne cysts, lowering the chances of scarring. Antibiotics and topical creams are effective cystic acne treatments.

Last reviewed by a Cleveland Clinic medical professional on 08/25/2021.


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What Are The Best Treatments For Hyperpigmentation

While the acne scar treatment list above can also help with dark spots and hyperpigmentation, they are usually unnecessarily invasive and costly for those most worried about dark spots and less about textured scars.

The gold standard prescription formula for the treatment of hyperpigmentation is the Kligman formula, which includes hydroquinone hydrocortisone, , and retinoid .

While this formula has been the #1 dark spot treatment for decades, it does have its drawbacks. Due to the high % of hydroquinone in the formula, it can result in the skin’s darkening. Also, due to the inclusion of hydrocortisone, it is not suitable for long-term use. Finally, as a prescription product, it requires a dermatologist visit, which can be cost-prohibitive and difficult.

That’s why we created the MDacne Dark Spot Remover, which contains both hydroquinone, retinoids, and hydroxy acids combined with plant-based botanicals making it an excellent treatment for post-acne hyperpigmentation. However, like most other topical treatments, it will not have much of an effect on true acne scars.

What Are The Best Treatment Creams For People With Scars

Retinoids, derivatives of vitamin A, are known to exfoliate and remove the dead skin cells from the top layer of the skin and increase the cell turnover in the epidermis. Using retinoids can also help slow the loss of collagen fiber and promote new collagen production in the dermis, increasing the skin’s strength and elasticity. Bonus, retinoids can also make your epidermis thicker, which improves skin texture.

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How And When To Use It

Benzoyl peroxide is for use on your skin only.

Always wash your hands before and after using this medicine.

If your skin becomes dry or starts peeling, try using benzoyl peroxide less often. Put it on once a day or once every 2 days, until your skin gets used to it.

Benzoyl peroxide can bleach or discolour your hair, as well as clothes, towels and bedding. Keep it away from hair and coloured fabrics.

How to use benzoyl peroxide 5% gel

  • Wash the affected area with a mild skin cleanser and water.
  • Gently pat your skin dry.
  • Put a thin layer of gel on all the affected areas. If your whole face has acne, use a strip of gel each time.
  • You’ll usually use the gel once or twice a day. If you have sensitive skin, use the gel once a day, before going to bed.

    Try to avoid strong sunlight while using benzoyl peroxide gel. Use an oil-free sunscreen, or a moisturiser or foundation with added SPF30. In stronger sunlight, use SPF30 or above. Ask a pharmacist to help you pick a sunscreen that’s right for your skin type.

    How to use benzoyl peroxide 5% wash

  • Wet the area you want to treat.
  • Place a small amount of the product onto your hands.
  • Smooth it onto the affected area.
  • Keep the wash on your skin for no more than 1 to 2 minutes.
  • Rinse your face thoroughly with water.
  • Gently pat your skin dry.
  • You’ll usually use the wash 1 or 2 times a day.

    Physical Treatments For Acne

    Acne, Pimples & Scars Permanent Treatment, Best Treatment for Severe ACNE SKIN,
    • Sunlight is anti-inflammatory and can help briefly. However, exposure to ultraviolet radiation results in skin ageing and can eventually lead to skin cancer.
    • Lasers and other light systems using visible light wavelengths appear safe and helpful for acne. Treatment is often delivered twice weekly for four weeks. The effect may be enhanced by the use of a photosensitising agent .
    • Cryotherapy may be useful to control new nodules.
    • Intralesional steroid injections can be used to shrink older nodules and pseudocysts.
    • Comedones can be expressed or removed by cautery or diathermy .
    • Microdermabrasion can help mild acne.
    • Note: X-ray treatment is no longer recommended for acne, as it may cause skin cancer.

    Recommended Reading: How To Clear Acne Around Mouth

    What Causes Cystic Acne

    Pores in the skin can clog with excess oil and dead skin cells, causing pimples. Bacteria can enter the skin pores and get trapped along with the oil and skin cells. The skin reaction causes swelling deep in the skins middle layer . This infected, red, swollen lump is an acne cyst.

    Cystic acne causes include:

    • Age .
    • Family history of cystic acne.
    • Hormone changes during the teenage years and sometimes during menopause, and stress.

    Who Is More At Risk Of Acne

    Unfortunately, some people suffer from acne worse than others. Bad acne tends to run in families – your mother, father, aunt or uncle probably had severe breakouts when they were a teenager.

    Some people also have naturally higher hormone levels and make more sebum, so their skin pores are always clogging up.

    If you live in an area that gets very humid or have a job which exposes you to moist heat or grease or tar then you are more likely to get acne.

    Chin straps, headbands, and even hair products applied too close to the skin can precipitate a break out as several different medicines – most notably prednisone, phenytoin, and certain hormonal contraceptives that are high in androgens .

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    What Is Hormonal Acne

    Acne is caused by a combination of changes in your skin and hormonal factors.

    If you’re dealing with hormonal acne, you should know that you’re not alone! Hormonal acne is very common, particularly for women in their 20s and 30s. Unlike your teenage acne, predominantly on the upper part of the face, hormonal acne usually appears mostly on the lower parts of the face and around the mouth and jawline.

    Hormonal acne is when your acne breakouts by hormonal fluctuations or an imbalance in your hormone levels. Genetics also plays a role in hormonal acne. One study found that 67% of women in the study group with hormonal adult acne had an acne family history. Hormonal acne is typical of women and can happen at any age. It can happen in teenagers but is very common in young adult women and even order peri-menopause and menopause menopausal women.

    Hormonal acne is common. It affects 50 percent of women between 20 to 29 and 25 percent of women between 40 to 49.

    Types Of Acne Spot Treatment

    Severe Acne Treatment

    Acne spot treatments typically fall into four categories:

    • Topical skincare products containing low doses of acne medication
    • Over-the-counter topical treatments containing stronger doses of acne medication
    • Prescription-strength topical treatments
    • Prescription tablets

    Other treatments include comedone extractors , chemical peels, and light therapy.

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    Chemical Peels For Acne Scars:

    Moderate and deep chemical peels improve acne scars’ appearance using a chemical solution to remove the old skin’s outer layer. The new skin that replaces it is usually smoother with improved, more even color and texture. The results: Superficial peels with glycolic acid, lactic acid, or other alpha and beta hydroxy acids can improve skin texture and fade dark spots but will not provide a significant effect on depressed acne scars.The side effects: Light, superficial chemical peel: After a light chemical peel, patients typically experience a reaction similar to sunburn in the treatment area with mild redness lasting from 3-7 days. Moderate to severe chemical peels: After moderate and severe peels, patients can expect significant swelling, blisters that will crust, turn brown and peel off within seven to 14 days.Additional risks: Temporary or permanent change in skin color is possible following a chemical peel. These treatments can also cause reactivation of cold sores and, in rare cases, cause more scarring

    Urgent Advice: Call Your Doctor Or Go To A& e Straight Away If You Take Too Much Isotretinoin

    If you need to go to your nearest A& E department, take the isotretinoin packet or leaflet inside it plus any remaining medicine with you.

    Will the dose I take go up or down?

    After a few weeks, your doctor may change your dose of capsules. You may need a higher dose if your acne isn’t getting better. You may need a lower dose if you have side effects that bother you.

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    What Causes Acne

    The cause of acne usually boils down to clogged pores when a mix of sebum, bacteria, and dead skin cells are trapped in a hair follicle.

    Each pore on the surface of skin is the opening to a hair follicle, which is made up of a hair and an oil gland. When working properly, the oil gland releases sebum that travels up the hair and out of the pore. The sebum reaches the skin, where its job is to keep skin lubricated.

    If part of this process goes awry, acne may occur.

    This can be due to excessive sebum produced by the oil gland, a buildup of dead skin cells, or the accumulation of bacteria all of which can lead to clogged pores that contribute to the formulation of acne.

    How To Use It

    Best Acne Treatment System In The World – Better Than Proactiv
  • Mix 1 part apple cider vinegar and 3 parts water .
  • After cleansing, gently apply the mixture to the skin using a cotton ball.
  • Let sit for 520 seconds, rinse with water and pat dry.
  • Repeat this process 12 times per day, as needed.
  • Its important to note that applying apple cider vinegar to your skin can cause burns and irritation. If you choose to try it, use it in small amounts and dilute it with water.


    The organic acids in apple cider vinegar may help kill acne-causing bacteria and reduce the appearance of scars. Applying it to the skin may cause burns or irritation, so it should be used carefully.

    Zinc is an essential nutrient thats important for cell growth, hormone production, metabolism, and immune function.

    Its relatively well studied compared with other natural treatments for acne.

    Research indicates that people with acne tend to have lower levels of zinc in their blood than those with clear skin .

    Several studies have also shown that taking zinc orally may help reduce acne.

    For example, a 2014 review found that zinc is more effective at treating severe and inflammatory acne than treating moderate acne .

    The optimal dosage of zinc for acne has not been established, but several older studies have observed a significant reduction in acne using 3045 mg of elemental zinc per day .

    Elemental zinc refers to the amount of zinc thats present in the compound. Zinc is available in many forms, and they contain varying amounts of elemental zinc.

    15 ).

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    Treatment Of Mild Acne

    Most patients with mild acne can be treated with topical treatment that can be obtained over-the-counter in New Zealand without prescription. Most people just use topical agents for facial skin as they can be difficult to apply to one’s back. Extra vitamins and minerals have not been proved to help.

    • Wash affected areas twice daily with a mild cleanser and water or an antiseptic wash.
    • Acne products should be applied to all areas affected by acne, rather than just put on individual spots.
    • A thin smear should only be applied to dry clean skin at nighttime.
    • Acne products may work better if applied in the morning as well.
    • They often cause dryness particularly in the first 24 weeks of use. This is partly how they work. The skin usually adjusts to this.
    • Apply an oil-free moisturiser only if the affected skin is obviously peeling.
    • Avoid applying oily cosmetics such as foundation or sunscreen.
    • It may take several weeks or even months to see convincing improvement.
    • Discontinue using a product if severe irritation results. See your doctor for advice.

    Suitable topical agents for mild acne that can be obtained without a prescription include:

    • Antiseptic washes with triclosan or benzoyl peroxide
    • Mild salicylic acid preparations to exfoliate and unplug the follicles
    • Tea tree oil, bee venom, polyphenols and other products for which evidence of efficacy is limited.

    Topical agents for mild acne which require a prescription include:

    Clindamycin Prescription Acne Medication

    This is a medication which is used to kill bacteria which causes acne. It is often prescribed in the most serious cases of acne, due to how strong this antibiotic is.

    There are, however, a few side-effects to the medication, which we will cover soon, which means it is quite often not the first choice for doctors when finding a medication to work on your skin. It will, quite often, be used as a last resort medication.


    • This is a very strong medication and should work on even the most serious cases of acne. If no other treatment that you have tried in the past works, there is a good chance that this one will end up doing so.


    • There are a few downsides to using Clindamycin. Perhaps the biggest is that it can cause diarrhea and other conditions, which, in some people, can be life threatening. As this is an antibiotic your body may also start to build up a resistance to it which may make it difficult to get it working if you use it for longer periods of time.

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    Tretinoin For Treating Acne

    Tretinoin is a topical retinoid. Nobody actually knows how retinoids actually have a benefit on the skin. All we know is that they are brilliant at ensuring a healthy skin cell turnover.

    We also know that they are even better at ensuring that dry and dead skin cells actually remove themselves from the skin properly. This stops them from blocking up the pores which, ultimately, will stop the acne from getting any worse.


    • This is an effective treatment. It is a topical treatment so it gets to work on the skin pretty fast. Not only will the tretinoin stop the pimples that have already developed from developing even further, it will stop new ones developing completely. This treatment will work for the vast majority of people.


    • During the first month of using this treatment, it is likely that you will suffer from some mild skin irritation. Whilst long-term side-effects are rare, if you are dealing with very painful skin irritation and itching, you may want to get in touch with your doctor as soon as possible who will be able to help ensure that your reaction to the tretinoin is not abnormal.

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    Moderate to severe acne scars

    The unfortunate reality with acne is that it can either regularly or randomly become extremely severe. Anything from stress to a change in lifestyle or diet can have a huge impact. And when things get bad, you should really not suffer in silence.

    If youve had those sudden breakouts that take over your face and cause a lot of discomfort and embarrassment, then you know that all you want is a quick and reliable solution. And if all your other go to products are failing then your next steps are a bit limited.

    But just because you have limited choices, doesnt mean there arent viable solutions.When everything else fails and you simply cannot keep your acne under control, then its probably time to talk to a doctor about prescription treatments. These products are not available over the counter, and should only be considered after a careful assessment by a medical doctor.

    The active ingredients in these products are highly regulated and often contain strong antibiotics. When you do find the right option though, then you should see a pretty quick improvement.

    On this page we will show you some of the most effective products available for different types of skin.

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