Your doctor may put you on a two to greater than six-month course of oral antibiotics, such as doxycycline, minocycline, tetracycline, or erythromycin. Antibiotics in the tetracycline class are frequently used because they have both antibacterial and anti-inflammatory properties. The use of benzoyl peroxide with topical or oral antibiotics decreases the emergence of antibiotic-resistant bacteria.
Topical retinoids may be used to supplement this treatment. You can see an initial flare-up at the two to three-week mark, says D'Anne Kleinsmith, MD, a dermatologist in private practice in West Bloomfield, Mich., and a spokeswoman for the American Academy of Dermatology. This flare-up is generally attributed to the opening up of pores and drainage of sebaceous contents.
It's important that you follow instructions for prescribed medications carefully. For example, tetracycline should be taken before meals and without milk for full efficacy. Tell your doctor about other medications you are taking because certain medications can aggravate acne and interact with prescribed drugs.
Explore Your Options
Some birth control pills are helpful with acne, says Kleinsmith. Talk to your doctor to find out if you're a good candidate.
Some people turn to light sources, lasers, and photodynamic therapy (PDT) to treat acne and reduce scars. These procedures vary in cost but offer an alternative to daily creams and pills.
Line Up Your Expectations
Often, people give up on the treatment before it can successfully take effect. If you are experiencing side effects you can't tolerate, talk to your doctor and you can adjust your treatment together.
"Acne can be a very individual disease," says Wolf. "No two people are going to respond to the same treatment."
Treatment should typically be assessed after six weeks and, if it's working, it should usually be continued for at least four to six months.
"Getting the doctor and the patient on the same page is very important," says Wolf. "The patient's expectations may be that they're going to be cured in one month, whereas my expectation may be to get them under good control in six months.”
"There's no easy, quick fix for acne," says Wolf. "If you don't adhere to the therapy, follow the advice and schedule follow-up visits, you're not going to succeed. No therapy will work if you don't comply with the treatment."