Every person is different. Some people can successfully manage their acne with over-the-counter creams and gels from the pharmacy.

Others may need stronger prescription-only creams and gels. These treatments work in a variety of ways, and depending on the type of acne spots you have, certain ones may be more effective. 

Non-inflammatory lesions:

• Whiteheads or “closed comedones”– these are closed, oil-plugged pores.
• Blackheads or “open comedones” -these are open plugged pores — the oil turns brown when it is exposed to air.

Inflammatory lesions:

• Papules- these are small, sore red bumps
• Pustules- these are also known as pimples, and are papules containing pus
• Nodules- these are large, solid, painful lumps under the skin
• Cysts- these are large, painful, pus-filled lumps under the surface of the skin

Benzoyl Peroxide and Salicylic Acid

The most commonly used over-the-counter cream is Benzoyl Peroxide-  a big advantage of this product is that bacteria don’t get resistant to it over time. It can help a variety of the lesions described above, particularly if used with a retinoid cream/gel (see below). It’s also often used with antibiotic creams or pills to stop bacterial resistance developing. Salicylic acid is also present in quite a few over the counter creams, cleansers and face-washes- it breaks down comedones, and may be of some benefit.

Retinoids and Topical Antibiotics

In terms of prescription-only topical treatments available from your doctor or online doctor, the “retinoids” are among the most effective. They are used in mild to moderate acne- they can prevent the formation of comedones (blackheads and whiteheads). They are also helpful against inflammatory lesions such as papules and pustules. They are recommended for use by themselves for non-inflammatory acne (comedones), but WITH antibiotics if there is inflammatory acne present (papules, pustules). They can be helpful also when oral treatments are being stopped, to try to maintain any improvements achieved.  Topical antibiotic preparations are used for mild to moderate inflammatory or mixed acne, but it’s usually recommended they are used along with Benzoyl Peroxide to prevent resistance.

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