What acne treatments are best for me?

That depends on many factors: how severe your acne is, and what type of acne you have: is it whiteheads, blackheads, pustules, does it leave hyperpigmentation, do you have acne scars? Our doctors can provide several options that work much better than anything you can get over the counter.

For mild to moderate acne, most doctors will start with a  topical cream or gel containing a retinoid and add benzoyl peroxide. If there is inflammation (redness) then they will add a topical antibiotic (clindamycin, usually). For more severe (bacne/chest acne) and inflammatory acne, an oral antibiotic (usually doxycycline) may be added. For acne associated with your periods or time of month, women may choose birth control pills or vaginal ring to keep their hormone levels smooth and to decrease the circulating testosterone. The birth control pill or vaginal ring has a hormone which results in another hormone going up (SHBG = Sex Hormone Binding Globulin) which causes the Testosterone level that’s circulating around to go down, which results in less acne).  If the hormonal component is really severe, then the doctor might consider prescribing drug spironolactone, a “water pill” a.k.a a diuretic (which makes some people pee a lot) which also blocks male hormones. 

The most severe cases of acne may be treated with the drug isotretinoin, which is very effective. However, side effects and blood abnormalities must be monitored monthly and requires registration with the FDA to obtain a prescription. There are also various types of light, laser, or photodynamic therapies available for those with scars.