Reviewed by Dr. Jaggi Rao, MD, FRCPC, Double board-certified dermatologist
Nearly everyone has mild to moderate common acne at some time during life, most typically between the years of 8 and 18. There are many ways a doctor can help you keep your experience of acne to an absolute minimum. But there are no medical miracles that cure acne overnight1. Your doctor can only help you clear up your skin a little more completely, a little faster, without scars or brown spots.
It is important to seek medical attention if acne breaks out at the same time joint pain begins, when pimples seem to be “burrowing” under the skin, when pimples appear on the scalp after shaving the scalp, and when acne occurs with endocrine issues.
In the United States, European Union, and Canada, it is necessary to see a dermatologist to get antibiotics for acne.
Severe acne treatment has to be performed by a doctor.
Doctors sometimes fail to establish realistic expectations. Most medical treatments for acne only reduce the number of pimples and blemishes by 33% to 50% over a period of months.
Health insurance often does not pay for acne care.
Doctors often prescribe medications that are inappropriate for the patient’s skin type, especially for Asian skin.
The easiest way to do day-to-day skin maintenance is with a treatment kit like Exposed Skin Care.
Acne breakouts occur at the same time as joint pain you have not had before.
You are a woman, and you want to change brands of the Pill to fight acne.
Pimples seem to be burrowing under your skin to connect with each other.
You shaved your head, and nasty pink pimples broke out on your scalp.
You shaved another part of your body, and it now appears infected.
You have never had acne, and suddenly you have cysts under the skin.
You are a man, and acne broke out when you started testosterone replacement therapy.
You have unusually large pimples that have a yellow center.
You have deep, ice-pick scars left where acne healed.
You have raised, pink scars where acne healed.
These are symptoms of types of acne that only a doctor can treat. A doctor who understands your skin type4, or even better, has your skin type, can offer you insights into treatment and perform procedures that are simply not available over-the-counter or at a spa.
What Can You Get at the Dermatologist’s Office That You Can’t Get Anywhere Else?
There are also some treatments that you can’t do at home and you can’t get at a spa. Among the treatments you will only get at the doctor’s office5 are:
Oral retinoid drugs7. An “acne” pill such as Accutane is only available from a doctor. Since oral acne treatments can have serious side effects, medical monitoring is necessary to prevent lasting health problems.
Steroid injections8. Injected steroids are available from dermatologists for “acne emergencies,” when a pimple might ruin a photo for a once-in-a-lifetime occasion, such as a wedding, anniversary, or graduation. Repeated use of steroids can cause lightening and thinning of the skin.
Certain laser and external beam radiation treatments9. Resurfacing the skin after severe acne scarring usually requires multiple visits to a dermatologist or plastic surgeon. The most severe medical scars can be covered up with makeup, but can’t be healed without medical treatment.
What Doctors Won’t Tell You About Acne Treatment
Dermatologists usually provide potent acne treatment. For mild to moderate acne, prescription medical treatments are not always best. Here are some common problem issues:
Prescription-strength benzoyl peroxide usually causes redness, itching, inflammation, burning, and peeling of the skin. Many people who can’t continue prescription-strength benzoyl peroxide do just fine when they use an over-the-counter product.
Retinoid drugs prescribed for treating cysts and nodules often have an unexpected side effect10, such as a whitehead, a blackhead, a pimple, or all of the above. Your doctor may forget to tell you that if you take Accutane for severe acne, you need to be especially careful to keep your skin clean and exfoliated.
American doctors tend to overlook dental consequences of drugs. Minocycline, for example, is almost never given to anyone under the age of 22 in Canada because of the potential for staining the teeth black, especially along the gum line. American doctors may assume that this effect only occurs when children are treated with minocycline while they still have their “baby teeth” and prescribe minocycline to any acne patient over the age of 8.
Doctors sometimes prescribe drugs that are appropriate for fair skin but not for Asian skin. The use of hydroquinone to stop brown spots from forming as acne heals, for example, sometimes (but not always) causes black and blue spots on Asian skin.
Doctors tend to overlook natural products that help prescription medications work better. When Asian, brown, or black skin is treated with tretinoin topical, for example, use of a vitamin E cream at a different time of day can help prevent inflammation and discoloration of the skin.
Doctors often forget to discourage unrealistic expectations of acne treatment. Most medications, used by themselves, will only reduce the number of pimples by 33 to 50%. Laser resurfacing may require multiple office visits over a period of months. To get a better result from treatment for your acne at the doctor’s office, you have to be especially diligent about other aspects of skin care.
A dermatologist’s practice is not built by saving patients’ money. Moreover, many insurance plans do not pay for acne treatment, and claims may be denied only after several months of bills have accumulated. There are few procedures for acne care in the dermatologist’s office that will not cost US $1,000 or more, at least not in the United States.
See a doctor for acne treatment if and when you must. But for the basics of day-to-day acne treatment, consider a complete acne care system like Exposed Acne Care. Even if you receive a doctor’s treatment for specialized acne concerns, you will need a system like Exposed Skin Care to keep blemishes and pimples from coming back once medicine has removed them.
Rathi SK. Acne vulgaris treatment : the current scenario. Indian J Dermatol. 2011 Jan-Feb;56(1):7-13. doi: 10.4103/0019-5154.77543. PubMed PMID: 21572783; PubMed Central PMCID: PMC3088940.
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Tailored acne treatments help women address adult acne with the added benefit of improving aging skin | American Academy of Dermatology. Aad.org. 2019
Farrah G, Tan E. The use of oral antibiotics in treating acne vulgaris: a new approach. Dermatol Ther. 2016 Sep;29(5):377-384.
Costa CS, Bagatin E, Martimbianco ALC, da Silva EM, Lúcio MM, Magin P, Riera R.Oral isotretinoin for acne. Cochrane Database Syst Rev. 2018 Nov 24;11:CD009435.
Lee SJ, Hyun MY, Park KY3 Kim BJ. A tip for performing intralesional triamcinolone acetonide injections in acne patients. J Am Acad Dermatol. 2014 Oct;71(4):e127-8.
Wiznia LE1, Stevenson ML1, Nagler AR2. Laser treatments of active acne. Lasers Med Sci. 2017 Sep;32(7):1647-1658.
Khalil S, Bardawil T, Stephan C, Darwiche N, Abbas O, Kibbi AG, Nemer G, Kurban M. Retinoids: a journey from the molecular structures and mechanisms of action to clinical uses in dermatology and adverse effects. Dermatolog Treat. 2017 Dec;28(8):684-696.