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Facing Facts About Acne

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Every mark on the skin produced by acne is a type of lesion. The mildest cases of acne produce blackheads and whiteheads. (The color of these is determined by whether the plugged follicle remains open or closed. If it is closed, it is a whitehead.)

More troublesome acne lesions include

  • papules – inflamed lesions that usually appear as small, pink bumps on the skin and can be tender to the touch
  • pustules (pimples) – white or yellow pus-filled lesions that may be red at the base
  • nodules – large, painful, solid lesions lodged deep within the skin
  • cysts – deep, painful, pus-filled lesions that can cause scarring

Treatments

The type of treatment people with acne get depends on the severity of the outbreak. "There are OTC products for mild cases, while a visit to a health care professional such as a dermatologist may be in order for the more stubborn cases," says Liedtka.

Acne treatments are regulated by FDA under the same provisions of the Federal Food, Drug, and Cosmetic Act covering prescription and non-prescription (or OTC) products.

Topical OTC medicines are applied to the skin and come in many forms, including gels, lotions, creams, soaps, and pads. Typical OTC treatments for mild acne include benzoyl peroxide, resorcinol, salicylic acid, and sulfur.

"It is best to read the labels or talk to your health care professional before you use any of these products, so that you know which is right for you, what if any side effects may occur, and when you can expect to see results," says Liedtka.

Types of prescription topical medicines used to treat acne include antibiotics, benzoyl peroxide, azelaic acid, dapsone, and vitamin A derivatives known as retinoids.

People with moderate to severe inflammatory acne may be treated with prescription topical or oral medicines, alone or in combination. And people with nodules or cysts should be treated by a dermatologist.

Caution with Isotretinoin

Patients with severe nodular acne that does not improve with the use of other treatments may be prescribed isotretinoin, which is sold under the brand names Accutane, Sotret, Claravis, and Amnesteem.

Isotretinoin is a vitamin A derivative that is taken orally once or twice a day with food for 15 to 20 weeks. It reduces the size of the oil glands so that less oil is produced.

Although effective, isotretinoin is associated with serious side effects, especially for pregnant women. According to the medication guides for these products, isotretinoin can cause serious birth defects in the developing fetus of a pregnant woman. It is vital that women of childbearing age are not pregnant and do not get pregnant while they take isotretinoin, or for 30 days after completion of treatment.

Because isotretinoin can cause birth defects, it is only for patients who can understand and agree to carry out all of the instructions in iPLEDGE, a mandatory distribution program intended to prevent the use of the drug during pregnancy due to the high risk of birth defects.

WebMD Public Information from the FDA