There are so many forms and severity of acne, and for this reason we have many options of treatment to achieve the best results.
Topical treatment is mainly recommended for mild acne. Patients with moderate or severe acne need both oral and topical therapy. The oral therapy should be given for 4-6 months, but topical therapy will be required throughout the duration of the disorder.
Topical therapies include many versions of creams, lotions, peels and even compresses. Recently we have also seen many versions of light and laser therapies. Creams are with different concentrations of antibiotics such as: tetracycline, chloramphenicol, erythromycin, clindamycin. Other cream ingredients such as: benzoyl peroxide, sulphur, adapalene, retinoic acid, salicylic acid are also beneficial. Sometimes, when we are dealing with acne post inflammatory pigmentation, we have to use creams with kojic acid, hydroquinone and vitamins.
There are so many cream formulations of different ingredients, but in general topical therapy only appears less effective than adequate combination of few methods at the same time – i.e. peels, creams, light or laser therapy. However, they are very useful as a maintenance therapy for weeks or months.
For treatment of comedo acne peelings are the best. There are various strengths of peels for different types of comedones (whiteheads/blackheads). Generally we can divide peels as a:
Superficial Skin Peels – done mainly with glycolic acid, salicylic acid and should be done once a week for very mild acne. This will cause redness and minimal flaking. It is not always absolutely essential to take time off work.
Medium Skin Peels – are done mainly with TCA (trichloroacetic acid) done once every month or two for multiple whiteheads to open blocked openings of the sebaceous glands. The peel will result in a temporary darkening of the treated area followed by a tightening of the skin and scaling. You need 5-7 days for recovery.
Deep Skin Peels are very successful for acne scarring but require longer recovery times (about 10-14 days). It will cause some oozing at the beginning and some redness later, but is done once every year or two