The Best (and Worst) Dermatologist Acne Solutions

Jeff Hautala
By Jeff Hautala, Co-Founder of Exposed Skincare

If you feel like you’ve tried every over-the-counter solution available, you might start to consider dermatologist acne solutions. Dermatologists are skin experts and they can offer a variety of acne solutions that aren’t available from your local pharmacy, including antibiotics, birth control, prescription-strength medications, or chemical peels and other in-office procedures. However, just because they can offer these things, that doesn’t necessarily mean all of them are great options for your skin, or for anyone’s for that matter. Everyone’s acne is different and responds differently to various treatments, but there are some dermatologist acne solutions that are still popular despite research that suggests they’re not the best idea for anyone. This guide will walk you through your dermatologist acne solution options—the good, the bad, and the unusual.

dermatologist acne checking
Some dermatologist acne solutions can help significantly reduce acne, while others have little impact or contribute to other problems.

Acne Pills: What Are Your Options?

There are four main categories to choose from when it comes to acne pills: oral antibiotics, combined oral contraceptives, oral retinoids, and a few miscellaneous options. All of these can help in different ways, but first, what are they?

Oral Antibiotics for Acne

This medication, like most pills for acne, is not for acne specifically. Antibiotics came into popular use in the 1940s and are designed to kill bacteria. Oral antibiotics for acne became a popular dermatologist acne solution because a particular kind of bacteria known as p. acnes can create minor infections in the pores that cause pimples and cysts.

When antibiotics were first introduced, they were moderately effective in killing p. acnes, but that effectiveness has been steadily declining due to something called antibiotic resistance. This is when some bacteria develop a random mutation that allows them to survive the antibiotic, and then those bacteria reproduce, creating more bacteria that can’t be killed by the antibiotic, until there are enough of these antibiotic resistant bacteria that the antibiotics are no longer very effective.

Nearly everyone has some antibiotic resistant bacteria in their system, and some doctors worry that in the not-so-distant future, antibiotics could be ineffective for everything from strep throat to serious acute infections. This is already seen in things like MRSA, an infection that is immune to many forms of antibiotics. Because of this, most medical institutions recommend that doctors prescribe antibiotics only when absolutely necessary. However, many dermatologists still prescribe a large number of antibiotics, presumably because despite the risk, they’re the best acne medicine, right?

Well, not really. Out of all the acne pills out there, antibiotics are definitely not the best, and we generally don’t recommend them for acne for three reasons: the first is the antibiotic resistance issue, the second is that they are not more effective than many other, safer options, and the third is their inherently temporary nature.

The Drawbacks of Oral Antibiotics for Acne

Studies show that even when oral antibiotics for acne were first used, they only cleared about 60% of acne, and research suggests those numbers are lower now, and dropping, due to antibiotic resistance.

Of course, antibiotics can be a very effective dermatologist acne solution for some people, but even then, they aren’t a great idea because you can only take them for three months. This is also due to antibiotic resistance. The best way to prevent the growth of antibiotic resistant bacteria is to take your antibiotics for the length of time prescribed, even if your symptoms clear up, and to stop them after three months, at most. If you stop taking the antibiotics as soon as your symptoms disappear, you won’t have killed off the maximum amount of bacteria, and they could develop resistance by being exposed to the antibiotic without dying. If you keep taking antibiotics after three months, your system will start to get used to the antibiotic and naturally develop some antibiotic resistant bacteria.

Some dermatologists (and other doctors) continue to prescribe oral antibiotics for acne even after three months have gone by because of a seemingly obvious issue with antibiotics: they only continue to kill bacteria while they’re in your system, and once they aren’t, the bacteria typically come back. P. acnes are part of our skin’s natural biome of bacteria, meaning they always live on the surface of our skin and don’t necessarily cause any harm. This changes when the skin produces extra oil, which p. acnes feed on, so their numbers increase and infections increase, or when the skin becomes inflamed and p. acnes get trapped in a pore where they cause an infection. Because of this, treatments that address oil production and inflammation typically produce better, more long-lasting results.

Amoxicillin for Acne

Amoxicillin is one of the most famous antibiotics, and it’s one of many antibiotic dermatologist acne treatments. It is a penicillin-based drug, and its function for killing bacteria is breaking down the cell wall. The cell wall is a unique feature of bacterial cells, and it helps keep the contents of the cell contained in the cell membrane. Without a cell wall, the cell bursts and dies. Amoxicillin for acne is great because it’s been around a while and has proven to be safe for pregnant women. But its major drawback also comes from the fact that it’s been around a while. Because it has been in use for so long, most people have bacteria that are resistant to it and it may not do the best job actually clearing your acne.

Ampicillin for Acne

This sounds very similar to amoxicillin, because it is. Most doctors prescribe them interchangeably, as they are both penicillin-based drugs and they function almost exactly the same: by breaking down bacterial cell walls. They often have the same effectiveness and side effects as well. Amoxicillin absorbs into fat cells more quickly, so it may show more immediate results, but it could also be slightly more likely to cause gastrointestinal distress. Ampicillin for acne is also safe during pregnancy, but it has been around even longer than amoxicillin, so it may be even less effective.

Tetracycline for Acne

This is probably the antibiotic for acne you’ve heard of the most because it’s one of the most popular and comes in many synthetic forms that we’ll get to in a moment.  Tetracycline for acne works by preventing essential enzyme reactions within the bacterial cell, which doesn’t necessarily kill the bacterium, but it does stop it from reproducing to make more bacteria, which can be just as effective. Tetracycline acne treatments are popular dermatologist acne solutions because they prevent the growth of p. acnes, but they can also reduce inflammation, which also helps reduce acne. Like amoxicillin and ampicillin though, tetracycline has been around long enough to make it significantly less effective than it used to be. And unlike amoxicillin and ampicillin, it is not safe for pregnant women or children under the age of 8. Tetracycline can cause bone structure issues in fetuses, and it can cause permanent blueish-black tooth discoloration in fetuses and children up to age 8. It may cause temporary tooth discoloration in teenagers and adults, but it is not usually permanent as it is with kids and babies. Finally, one last drawback: tetracycline can reduce the effectiveness of most oral contraceptives.

man holding pills and a glass of water
Tetracycline for acne is one of the most popular acne treatment prescriptions, but due to antibiotic resistance, it may not be as effective as it once was.

Minocycline for Acne and Solodyn for Acne

We’ve combined these two because Solodyn is simply extended-release minocycline, meaning it releases into the bloodstream more steadily rather than all at once. Minocycline for acne is a popular synthetic tetracycline treatment. Like all tetracycline-like medications, minocycline for acne works because it prevents enzyme interactions between p. acnes that keep them from reproducing. It’s also similar to the other members of the tetracycline family because it can cause permanent blueish-black tooth discoloration when used in children under 8 years old. Because minocycline has been in commercial use since the early 70s, it is not the most effective oral antibiotic for acne.

Doxycycline for Acne

Another synthetic tetracycline, doxycycline is a somewhat effective treatment that functions by interrupting enzyme interactions and preventing the reproduction of bacteria. It has all the strengths of other tetracycline-like antibiotics, but it also falls prey to all the same pitfalls: it can discolor your teeth, and it’s been in use so long that it may no longer be all that effective.

Erythromycin for Acne

Erythromycin is a macrolide antibiotic, meaning it tampers with bacterial proteins. Like how tetracyclines prevent essential enzyme interactions, macrolide antibiotics prevent essential protein interactions in order to keep the bacteria from reproducing. Erythromycin acne treatments used to be one of the most popular prescriptions for acne, but because it’s been in use since the 50s, it’s effectiveness is declining and other antibiotic options are slowly replacing it among the top dermatologist acne treatments. However, some still prescribe it because it is a safe alternative for those who are allergic to penicillin, and it has proven to be safe to use during pregnancy and during breastfeeding after the first two weeks.

Azithromycin for Acne

Azithromycin is a macrolide like erythromycin, but it is a specific kind of macrolide called an azalide. Azalides work the same way as macrolides, by interfering with bacterial proteins, but they contain nitrogen, making them slightly more stable than typical macrolides. Like erythromycin, azithromycin for acne is safe during pregnancy and breastfeeding. Unlike all of these antibiotics for acne that we’ve discussed so far, azithromycin was developed relatively recently, in 1980, so it may not be as affected by antibiotic resistance yet. However, as doctors start to prescribe it more as other antibiotics become less effective, it will follow the same path of antibiotic resistance.

Cephalexin for Acne

Cephalexin belongs to a different class of antibiotics called cephalosporins. These antibiotics kill p. acnes by combining some of the other mechanisms used by other antibiotics. Like tetracyclines, cephalexin disrupts bacterial enzymes, but rather than using this to prevent normal functioning, it tampers with the enzymes involved in building the cell wall, like penicillin-based drugs like amoxicillin. Cephalexin for acne works because it breaks down bacterial cell walls by breaking down the enzymes that typically help form it. It is considered reasonably safe during pregnancy and breastfeeding, and people with mild to moderate penicillin allergies are safe to take it, but those with a severe allergy are recommended to seek different treatment. Cephalexin has been around since the 70s, so it may be significantly impacted by antibiotic resistance.

Clindamycin for Acne

Clindamycin is also a different type of antibiotic for acne called a lincosamide which functions by interfering with proteins to prevent p. acnes from reproducing, like macrolides. It is often prescribed for serious infections, like severe ear and sinus infections, certain types of pneumonia, and pelvic inflammatory disease, but because it has been around since 1970, studies show that its efficacy is on the decline. Still, clindamycin for acne can be a very useful antibiotic since it is considered safe during pregnancy and for those with a penicillin allergy. The research is unclear on whether or not it’s safe during breastfeeding, so make sure to discuss this with your doctor.

Bactrim for Acne

Unlike the other antibiotics in this list, Bactrim is a brand name rather than a generic. It is actually a combination of two generic antibiotics: sulfamethoxazole and trimethoprim. Each of these ingredients kill bacteria by preventing the formation of particular acids and proteins essential for life. Although Bactrim was introduced back in the 70s, combining these two ingredients rather than using them separately can prevent issues related to antibiotic resistance, making it a very popular dermatologist acne solution. However, Bactrim for acne is not safe for everyone. It is not recommended for use during pregnancy, since it can sometimes result in birth defects such as cleft lip or club foot, and it is excreted through breast milk, so it is not safe for use during breastfeeding as well.

How Do Combined Oral Contraceptives for Acne Work?

Of all the acne pills, combined oral contraceptives (a specific form of “the pill”) are one of the best options for oily skin or hormonal acne. This is because combined oral contraceptives (COCs) combine synthetic estrogen and synthetic progesterone to help balance out hormones that can increase oil production and lead to acne. When the skin is producing too much oil, it can feed p. acnes bacteria to create pimples and cysts, but excess oil can also create acne in its own right. When oil clogs the pores, it results in blackheads and whiteheads. So how can COCs help? First we need to take a look at how hormones can lead to a problem with acne in the first place.

Woman smiling while holding antibiotics
Combined oral contraceptives can help suppress some of the hormone fluctuations that lead to increased acne.

Everyone, regardless of sex, produces both testosterone and estrogen. Some women and intersex folks produce more estrogen, while some men and intersex folks produce more testosterone, and as long as your testosterone and estrogen levels are at a normal amount for you, acne will not usually result. These hormones can cause acne, however, when they start to move out of your personal “normal” range. Fluctuations in general can cause a slight increase in acne, but acne is especially likely to result from increases in testosterone. This can be a literal increase, but it can also be relative. If hormones that balance out testosterone, like estrogen, drop, the relationship between testosterone and estrogen will shift so it there is a relative increase in testosterone.

Whenever testosterone increases, literally or relatively, the body produces more oil, and this leads to increased acne. This happens during the week before menstruation, but testosterone levels have natural fluctuations regardless of menstruation, so anyone can experience hormonal acne. COCs are a popular dermatologist acne treatment because they contain estrogen which helps balance out the excess testosterone or raise estrogen levels back to normal to neutralize a relative increase in testosterone.

Using Yaz for Acne

Yaz is one of the only birth control pills with FDA approval for use in treating acne. It is a COC that combines drospirenone, a synthetic form of progesterone, and ethinyl estradiol, a synthetic form of estrogen. Both the synthetic progesterone and estrogen can help prevent pregnancy, but the estrogen is the only one that helps reduce acne. This is why we recommend COCs specifically rather than recommending birth control pills in general; some birth control pills contain only synthetic progesterone, and thus are not effective in reducing acne. Taking Yaz for acne can help balance out the drop in estrogen that typically takes place during the week before menstruation starts, which helps prevent a relative increase in testosterone that might lead to increased oil production and acne. As with all birth control, you can get a prescription for Yaz from a gynecologist, but Yaz is also prescribed by general physicians and it is a common dermatologist acne solution.

How is Sprintec for Acne Different?

Taking Sprintec for acne can help in much the same way that Yaz can, though the hormones used are slightly different. Like Yaz, Sprintec is made of a combination of synthetic progesterone and estrogen. Both use ethinyl estradiol, but Sprintec uses norgestimate as a synthetic progesterone rather than Yaz’s drospirenone. Some studies show that drospirenone is actually closer to natural progesterone and that norgestimate may cause a slight increase in oil production, which would be counterproductive if you are considering taking a COC to help reduce acne. Despite this, Sprintec still contains synthetic estrogen, so depending on the person, Sprintec for acne could be very effective.

Tri Sprintec for Acne May Not Decrease Acne as Much as Other COCs

Even though they sound incredibly similar, Sprintec and Tri Sprintec are actually different. They include the same ingredients, but they are delivered in different dosages. With Yaz and Sprintec, there are a certain number of “active” pills that contain the hormones (21 for Sprintec, 24 for Yaz), and then a few inactive pills that don’t contain any hormones, but are simply there to keep you in the habit of taking your pill at the same time every day. Tri Sprintec also has active and inactive pills, but it has more than one type of active pill. All active pills contain the same amount of synthetic estrogen, but the norgestimate dosage changes from week to week. The seven pills from week one contain the least norgestimate, week two contains a little more, and week three has a little more than that. This could have an effect on menstruation, but it could also increase oil production due to the increasing amounts of norgestimate. Because of this, Tri Sprintec for acne isn’t our top pick of COCs for treating acne.

Ortho Tri Cylcen for Acne: FDA Approved

Birth control can be tricky because everyone reacts to it differently, but luckily there are a wide variety of options that contain the same active ingredients. Ortho Tri Cyclen contains the exact same hormones and dosages of those hormones as Tri Sprintec, but the inactive ingredients in Ortho Tri Cyclen are different. This way, if you have a negative reaction to one, you can simply try the other and see if things improve. However, Ortho Tri Cyclen does have one major difference from Tri Sprintec: Ortho Try Cyclen is one of the three COCs approved by the FDA for acne treatment.

Lo Loestrin Fe Acne Solutions

Lo Loestrin Fe is like Tri Sprintec and Ortho Tri Cyclen in that it has more than one dosage in its active pills, but it uses slightly different synthetic hormones and dosages. For the first 24 days, the active pills contain the typical synthetic estrogen, ethinyl estradiol, but they also contain a different synthetic progesterone called norethindrone acetate. After the 24 days, there are two active pills that contain the same small amount of synthetic estrogen, but no norethindrone acetate, then there are two inactive pills that contain extra iron. This emphasis on synthetic estrogen rather than synthetic progesterone can help reduce acne more significantly. The synthetic progesterone in COCs is more meant to help prevent pregnancy rather than reduce acne, but synthetic estrogen can help prevent pregnancy and reduce acne at the same time.

What Are Oral Retinoids for Acne?

Retinoids for acne are some of the most popular dermatologist acne solutions out there because they treat the skin itself rather than just the bacteria or oil affecting it, and they come in a wide spectrum of concentrations. But if you’ve researched them, you may have found some conflicting information. Some sources claim that they prevent clogged pores by slowing the overproduction of skin cells, while other sources claim that they prevent clogged pores by doing the exact opposite: speeding up the production of sluggish skin cells. The truth is that retinoids can do both of these things because their main mechanism is to regulate skin cell production and skin cell death.

Retinoids are concentrated, derivative forms of vitamin A, and they help reduce acne by making sure skin cells don’t cause clogged pores. Think of retinoids as a pace car for your skin cells. Ideally, skin cells will be created relatively quickly and die relatively quickly, but sometimes this process goes awry. If skin cells are created quickly, but take too long to die, they cling to the sides of the pore and cause a clog. Similarly, if skin cells are dying at a good rate, but are being produced too slowly, the pore can get clogged with a bunch of dead skin cells because there aren’t enough new skin cells to push them out. Retinoids keep this process on track to help prevent clogged pores. Because of this mechanism, most retinoids for acne are topical gels that are best suited for blackheads and whiteheads rather than pimples or cysts. The biggest exception to this is Accutane for acne, the strongest oral retinoid available that is often prescribed for severe cystic acne.

Retinoids are concentrated derivative forms of vitamin A, and the most powerful retinoid is isotretinoin, or Accutane.

The Truth About Using Accutane for Acne

Long heralded as the strongest, best acne medicine, Accutane (also known as isotretinoin) is a powerful oral retinoid that is supposed to be reserved for use with only the most severe cystic acne that has not responded to any other treatment.

Although it is commonly called Accutane, isotretinoin is no longer sold under the name Accutane, and is now sold as Absorica, Claravis, Myorisan, and others. Accutane is taken in pill-form once daily for four to six months, and then acne clears up more or less permanently. In some cases, another four to six month round of treatment is necessary, but many people see a significant improvement in even the most severe acne after using Accutane. It is one of the most popular acne pills, but it’s also one of the most controversial.

The reason Accutane is meant to be reserved for the most severe cases of acne is because it comes with a wide variety of side effects and we don’t understand the long-term effects very well yet. Researchers aren’t yet sure exactly how isotretinoin keeps acne at bay long term, even after treatment is discontinued and the compounds should be gone from the body completely, and most doctors are hesitant to support something whole-heartedly if they don’t whole-heartedly understand how it works. It’s also proven to have serious teratogenic effects, meaning it can cause severe birth defects. If you are capable of getting pregnant, there are a lot of frustrating hoops to jump through in order to take Accutane for acne, and even if you can’t get pregnant, everyone has to come in for frequent blood work to make sure their liver enzymes and blood fats are at healthy levels. Some doctors question whether it is a good idea to expose patients to such a strong medication that is not completely understood.

Miscellaneous Acne Treatment Prescriptions

Beyond antibiotics, combined oral contraceptives, and Accutane, there are still a handful of medications that make the list for some of the most popular dermatologist acne solutions. We want to call attention to two of these pills for acne, one that helps acne by reducing oil production, and another that helps by reducing inflammation.

Aldactone for Acne: Birth Control Isn’t the Only Option for Dealing with Hormonal Acne

Originally created in 1985 to treat hypertension, Aldactone (also known as spironolactone) is often prescribed off-label to treat acne because it helps reduce excess oil production caused by fluctuating hormones. Aldactone for acne might be a good idea for you if your acne is primarily hormonal. This is because Aldactone suppresses the creation of androgens, like testosterone, which prevents the overproduction of oil that often occurs during hormonal shifts. However, it does come with a few important caveats.

The first and most important issue to address is the black box warning. This is the highest level of caution the FDA can assign a medication, and it has been assigned to Aldactone and other forms of spironolactone. The black box warning states that some research has shown that Aldactone can cause tumors and unnecessary use the drug should be avoided. This might make it seem like a terrible choice for acne, but it’s not as simple as it sounds. The studies that found Aldactone tumorigenic (tumor-producing) were conducted in the 80s using doses of the medication almost 500 times what we prescribe today. Recent research has found no evidence that Aldactone at these lower doses causes tumors, but there hasn’t been enough research yet to overturn the black box warning.

The other key concern when it comes to prescribing Aldactone for acne is about kidney function. Although Aldactone suppresses androgen creation, that is not the main mechanism it uses to help with hypertension and congestive heart failure. Aldactone helps these conditions because it is a diuretic that increases potassium retention, and these features can negatively impact someone without hypertension or congestive heart failure. If you have low blood pressure or a kidney condition, make sure you discuss it with your doctor before starting Aldactone for acne.

Prednisone for Acne That’s Seriously Inflamed

The other medication in the miscellaneous acne pills category is prednisone. Prednisone is an oral corticosteroid, and its main function is to suppress the immune system slightly in order to reduce inflammation. This can help with a wide variety of issues, but it can help with acne because inflammation is the root of all acne. Bacteria and oil production play a key role in acne, but if the skin never got inflamed, bacteria and oil would rarely get trapped in the pores and acne would occur much less frequently. Because of this, some dermatologists prescribe prednisone for acne, in hopes of reducing acne-causing inflammation.

Prednisone pills
Prednisone for acne isn’t a long-term solution, but it can provide relief for severely inflamed cysts.

Prednisone is far from the best dermatologist acne solution though. There are several potential issues, starting with the fact that it’s a very temporary solution to a long-term problem. Corticosteroids should only be taken for a short amount of time, anywhere from 5 days to 3 weeks because extended use has the potential for severe side effects, like high blood sugar, cataracts, osteoporosis. Most dermatologists recommend that prednisone be used to help control acute cases of severe inflammatory acne, like cystic acne. After a round of prednisone for acne, inflammation will be reduced and acne may respond better to long-term treatment options. Even when used for a short period of time, oral corticosteroids are likely to cause side effects, since they affect the body as a whole rather than one specific area, like the skin. Because of this, some dermatologists recommend using topical corticosteroid creams or cortisone shots for acne.

Beyond Acne Pills: Other Dermatologist Acne Solutions

Even though the first thing many of us think of when we hear “medicine,” “prescription,” or “antibiotics” is probably pills, that is not the only form these treatments can take. All of the medications we just discussed also come in other forms: topical antibiotics, other forms of hormonal birth control, topical retinoids, and cortisone shots. Some of these forms of prescription acne medicine can be just as effective as acne pills, and are especially helpful if you struggle to take pills or suffer uncomfortable side effects from systemic, oral medications.

The Power and Limitations of Topical Antibiotics for Acne

We’ve already learned all about oral antibiotics for acne, but topical antibiotics for acne can be just as effective, and they typically come with fewer side effects and a decreased risk for antibiotic resistance.

The biggest difference between oral and topical antibiotics is that oral antibiotics are taken as a pill, while topical antibiotics are applied as a gel or cream directly to the site of the infection. There are several big advantages to this, especially for acne. First, because the antibiotic doesn’t go through the whole body, fewer bacteria are exposed to it and have a chance to mutate and become resistant. Second, many topical antibiotics for acne are combined with other acne-fighting ingredients. Some dermatologists prescribe other acne treatment prescriptions along with oral antibiotics, but that means adding a step to your routine, and the more steps are involved, the more likely we are to skip one. Topical antibiotics, on the other hand, often come in gels or creams that already include other acne-fighting ingredients. There is a wide variety of combinations, but many involve clindamycin or erythromycin and benzoyl peroxide or tretinoin.

Although topical antibiotics combined with other treatments are a popular dermatologist acne treatment, and they may not be quite as bad for antibiotic resistance, they should still be used sparingly.

The IUD and Acne: Can It Help?

Combined oral contraceptives can sometimes be used to reduce acne, but what about the IUD and acne? If some forms of birth control can help reduce acne, it makes sense to wonder if other forms can do the same.

Although being on any consistent form of birth control can significantly reduce stress and thus reduce stress-induced acne, it’s the hormones in combined oral contraceptives that really make a difference. When it comes to other forms of birth control, like the IUD, or intrauterine device, only the hormonal kind has a chance at helping reduce acne. Some IUDs are copper-based, meaning they use copper to damage sperm cells to prevent them from fertilizing an egg, but others are hormone-based, meaning they release a synthetic form of progesterone called levonorgestrel to make it more difficult for a fertilized egg to implant into the uterine wall. While the copper-based IUDs are effective at preventing pregnancy, they have no effect on acne. Hormonal IUDS, like Mirena, on the other hand, could have an effect on acne, but dermatologists aren’t sure it’s a good one.

Mirena and Acne

Mirena is one of the most popular hormonal IUDs, and it prevents pregnancy by steadily releasing small amounts of levonorgestrel, a synthetic form of progesterone, to prevent ovulation. It is very effective and lasts up to five years, but it is far less effective when it comes to treating acne.

Unlike combined oral contraceptives, Mirena and acne do not go well together because Mirena is missing one very important feature: estrogen. As we mentioned when we were discussing oral birth control, combined oral contraceptives are better for acne than other forms of the pill because they contain synthetic estrogen and progesterone, and it is believed that estrogen is the primary acne-fighting factor in birth control. Mirena, therefore, is not overly helpful when it comes to treating acne, because it contains no estrogen. In fact, some researchers believe progesterone could increase acne, though the evidence is inconclusive. If you’re looking for an effective form of birth control, Mirena is an excellent choice, but if you’re looking for an effective acne treatment, Mirena is unlikely to offer much help.

Is There Any Connection Between Nexplanon and Acne?

Nexplanon is a small rod that is inserted into the upper arm and steadily releases a synthetic form of progesterone called etonogestrel over the course of three years. Unlike Mirena and other hormonal IUDs, Nexplanon releases the synthetic hormone into the bloodstream rather than directly into the uterine lining, which results in increased side effects for some women. But Nexplanon and acne have the same relationship as Mirena and acne: the lack of estrogen means that Nexplanon can’t offer much of a solution for acne. We recommend trying combined oral contraceptives if you’re looking for a birth control that can pull double duty and protect you from pregnancy and acne at the same time.

Topical Retinoids: Epiduo Acne Treatment Prescription

There are several prescription topical retinoids you can get from a dermatologist’s office, from Tazorac to Retin-A, and there’s even an over-the-counter topical retinoid called Differin. Epiduo is a topical retinoid, but much like topical antibiotics, it is combined with benzoyl peroxide, making it even more effective.

One of the biggest reasons people seek dermatologist acne solutions rather than over-the-counter options is because they have cystic acne that nothing seems to be able to handle. Even prescription acne medicines sometimes fail to completely clear cystic acne. Epiduo, on the other hand, has research showing that it can significantly improve cystic acne. It is more effective than retinoids or benzoyl peroxide used separately, and more effective than retinoids and benzoyl peroxide used simultaneously but as separate products. Something about how Epiduo is combined makes it incredibly effective in treating one of the most difficult types of acne.

If you’ve tried an Epiduo acne treatment prescription and found that it just wasn’t strong enough for your acne, you may want to try their more recent product, Epiduo Forte. Similar to regular Epiduo, it includes benzoyl peroxide and a particular kind of retinoid called adapalene, but Epiduo Forte contains a 0.3% concentration of adapalene, whereas regular Epiduo uses only 0.1%. These percentages may seem small, but they are very effective. For many people, 0.3% is too strong and can cause redness, itchiness, and peeling, so we recommend starting with 0.1%, even if you’re sure you need the strongest product available. You can always work your way up to the 0.3% Epiduo Forte.

Cortisone Shot Acne Treatments

Cortisone shot acne treatments are a dermatologist acne solution that can help get rid of cysts almost overnight, but despite these amazing results, they need to be used sparingly. If your acne is made up mostly of blackheads and whiteheads, then cortisone shots are definitely not for you, but if you have severe cystic acne, cortisone shots can be used to reduce inflammation and make it possible for other treatments to help.

doctor holding injection
Cortisone shot acne treatments can reduce swelling quickly and allow acne medication to work.

Cysts form when the infection started by a pimple doesn’t go away. Instead, it burrows deeper into the skin, breaking down pore walls and growing inward. This is why cysts are large, painful, and don’t have a pimple-like head. Pimples come to a head as the immune system kills p. acnes bacteria and pushes them out, but with cysts, the infection continues to grow inward, unimpeded by the immune system. Because the infection isn’t being pushed out, the skin cell layer continues to grow over the infection, making it a very bad idea to pop a cyst on your own, since you’re all but guaranteed to cause scarring, but this also makes it difficult for acne treatment products to get to the actual infection. This is where cortisone shots can come in.

A cortisone shot acne treatment reduces the swelling and allows your acne treatment products to actually work and get rid of the infection causing the cyst, which is great. The trouble is, too much cortisone, or too many cortisone shots, can cause scarring and other side effects. Like prednisone, the oral corticosteroid we discussed earlier, cortisone shots are not meant to be a long-term solution, but rather a short-term treatment for a particularly bad cystic breakout that has persisted for weeks despite excellent skin care.

Dermatologist Acne Procedures

Dermatologists have a lot of different ways they can help reduce acne. The most common dermatologist acne solutions are various prescriptions, whether that means pills or creams and gels, but dermatologists can also perform various skin care procedures that can help reduce acne. The cortisone shots mentioned above are a popular procedure at many dermatology practices, but they also offer procedures like chemical peels, microdermabrasion, and microneedling.

What is a Chemical Peel for Acne?

A chemical peel for acne is a procedure where a dermatologist applies an acidic solution to your skin, allows it to set, then removes it. The process exfoliates your skin, so excess oil and dead skin cells are stripped away, and stimulates the skin so it produces more collagen and reduces the size of your pores and reduces wrinkles.

woman undergoing chemical peeling procedure
The chemical peel process is fairly simple, and in most cases, painless.

Many chemical peel before and after acne results have shown that acne, especially acne scars, can improve greatly with a chemical peel. But not all chemical peels are the same, and not all dermatologists who apply them are the same. Chemical peels are safe for all skin types and skin colors, but if you are a person of color, make sure your dermatologist has experience performing chemical peels on skin of color. Although it would make sense for skin experts to be experts in all skin types, many dermatologists only have experience with fair skin. Chemical peels are safe for all skin types, but different skin tones need different types of chemicals, so it’s important that your dermatologist knows what they’re doing before you get a chemical peel for acne. You also want to make sure you’re getting the chemical peel that meets your needs and expectations, as some are more extreme than others. The main categories are refreshing, medium, and deep peels.

The Refreshing Peel

A refreshing peel uses relatively gentle acids to exfoliate the very top layer of your skin. It is not painful and very few people report even moderate discomfort. Afterwards, your skin might be a little red and itchy, and you’ll need to wear sunscreen every day for the next few weeks, but other than that there should be little to no side effects. However, it’s also the least effective of all the types of chemical peels. You will probably notice a reduced number of blackheads and whiteheads, and your skin tone may become more even.

The Medium Peel

A medium peel exfoliates beyond the top layer of the skin and provides more obvious results, and is still considered to be essentially painless. Harsher chemicals are used for a longer period of time, so if you have dry or sensitive skin, we recommend checking with your dermatologist that this procedure is right for you. Even if you have tough or oily skin, this procedure often requires a longer recovery time than a refreshing peel. Your skin will likely be slightly swollen, and blisters may form. Like with a refreshing peel, you should wear sunscreen every day until your skin is fully healed, but you will also likely have to do a few other things, like take certain medications or apply special medicated lotion.

The Deep Peel

A deep peel is a bit of a misnomer because it makes it seem like it’s just a bit more extreme than a refreshing or medium peel, when in reality, it is a serious procedure that requires sedation and a week of recovery at home. Deep peels use carbolic acid, an intense acid that exfoliates the top two layers of skin completely, resulting in severe crusting, swelling, and blistering for several days. Recovery may take several weeks and include medications, medicated lotions, and unlike the other peels, this one is reported to be moderately uncomfortable to mildly painful. Although this procedure is more extreme, it also produces more extreme results. Most patients notice a huge difference as soon as the skin starts to heal, and the improvements last for several years.

Dermabrasion vs. Microdermabrasion for Acne

Microdermabrasion for acne works in much the same way as a refreshing chemical peel for acne does. The goal is to exfoliate the skin of all the excess oil and dead skin cells to make room for new, healthy skin cells. Chemical peels do this through chemical treatments, and microdermabrasion does this through tiny crystals sprayed onto the skin. This is a popular dermatologist acne solution, but it can also be performed by aestheticians at spas, though if you’re nervous about the results, we always recommend seeing a dermatologist.

It’s a quick, gentle procedure that may help reduce blackheads and whiteheads, but is not a great option for inflamed acne, like pimples or cysts. The crystals will likely only irritate inflamed acne, which can be painful but also might make the acne worse. You should also avoid microdermabrasion for acne if you’re taking Accutane or any other oral retinoid, and you should check with your dermatologist if you’re using a topical retinoid. Retinoids increase skin sensitivity and fragility, so microdermabrasion may end up doing more harm than good.

It’s also important to note that microdermabrasion is not the same as dermabrasion. Dermabrasion involves a dermatological tool that more or less sands down the skin, which can be much harsher than microdermabrasion, and is unsafe for skin of color. While microdermabrasion will not leave any hyperpigmentation or light spots in any skin color, dermabrasion has been known to cause discoloration.

What Is Microneedling for Acne?

Microneedling for acne is exactly what it sounds like: tiny needles being applied to the skin. This is meant to stimulate the skin cells’ healing response so that they produce more collagen and reduce wrinkles, scarring, and provide an overall more even skin tone. There are at-home microneedling devices, but dermatologists warn against using these. They say that the needles on these devices are too short, too dull, and too hard to clean. At best they will simply draw more blood to the skin and make it appear brighter, and at worst it could actually cause infection or scarring. Dermatologists say that when done properly in a dermatologist’s office, it can help reduce the appearance of acne scars significantly, but it’s not the best choice for acne itself. If you have a breakout, you actually aren’t even supposed to receive the treatment, as the needles could puncture the acne, come into contact with the infection, then spread that infection as the needles continue to puncture the skin.

The Best Acne Medicine is Consistent Treatment

Believe it or not, the best acne medicine doesn’t come from the dermatologist, though dermatologist acne solutions are sometimes the only way to clear acne completely. The first and most important step toward clear skin is a gentle, consistent skin care routine.

This doesn’t have to be a prescription, it can simply be a good over-the-counter treatment system, like the Basic Kit from Exposed Skin Care. It contains our Facial Cleanser, Clearing Tonic, Acne Treatment Serum, and Clear Pore Serum, which work together to treat your skin as gently as possible while still fighting acne. You may be wondering why we keep using the word “gentle,” and that’s a fair question. Most content about acne insists that you need to “be tough on acne” or use any and all means to get rid of it, but that’s not really the best way to treat acne. We understand that harsh acne treatments only serve to irritate the skin, which often leads to inflammation, and since inflammation is at the heart of all acne, we do everything we can to avoid it while still fighting acne.

Exposed Skincare products
The Exposed Skin Care Basic Kit is the best place to start when it comes to acne treatment.

We do this through our unique combination of ingredients. We include both scientific and natural ingredients in each and every one of our products. Some contain benzoyl peroxide and peppermint oil, others utilize salicylic acid and green tea extract, but no matter what the combination, we make sure our ingredients balance out to a gentle and effective formula for decreased acne. Dermatologist acne solutions are excellent resources for moderate to severe acne, but you might be surprised at how much your acne can improve just by using a consistent skin care routine, like Exposed.