Summary of acne treatments

We thought some of you might like a brief summary of the main types of acne treatment that are available in the UK at the present time. There is a bewildering choice ranging from cosmetic remedies to medicines and medical devices.    Some are available to buy on line or from a pharmacy or supermarket; some require a prescription and others are only available from private practitioners. There is very good scientific evidence that all of the over-the-counter and prescription medicines for acne work well for most people. The evidence for other types of treatment is variable, both in terms of quantity and quality. At the present time, there is very little evidence on the effectiveness and safety of complementary and alternative medicines (including acupuncture). There is a lot of ongoing research into the effects of diet on acne but it is too early to say for sure whether any kind of dietary manipulation reduces acne severity for most people. If you are going to try a new or experimental treatment, make sure you ask the treatment provider to show you some evidence that it works and is safe. 

If you want to know more, why not go to the main Acne Academy web pages?  There you will find lots of more detailed information about treating active acne and acne scars.  

Table 1.  Acne remedies to use on the skin or take by mouth

Category Examples of active ingredient(s) How to obtain Typical products
Cosmetic remedies Salicylic acid,
witch-hazel, fruit acids, plant extracts
Online, supermarket,  pharmacy Creams, gels, washes, cleansers, concealers, spot sticks, pads, wipes
Over-the-counter medicines Benzoyl peroxide, nicotinamide Online, pharmacy Creams, gels
Prescription medicines Antibiotics, topical retinoids, hormone based therapies, oral isotretinoin With a doctor’s prescription from a pharmacy Creams, lotions, gels, tablets, capsules
Complementary and alternative therapies (used with or instead of traditional medicines) Herbs, plant derivatives, essential oils, dietary supplements, Ayuvedic and Chinese medicines Health food shops, dieticians, specialist providers Creams, gels, tablets, botanical extracts

Table 2.  Other acne treatment options

Treatment What does it do? Available on the NHS? Notes
Comedo extractor Applies gentle even pressure to remove blackheads. A doctor may offer to remove blackheads if you have lots of them. Can be purchased for a few pounds.
Light based therapy The way it works depends on the type of light and how it is used.  A light based device  may kill acne-causing bacteria,  reduce inflammation and/or lower the amount of grease (sebum) the skin produces NO; from some beauty therapists and private health practitioners. There are a wide range of light base devices including narrow band light of different wavelengths, intense pulsed light and laser light.  Devices for home use are available from specialist providers and some pharmacies.
Photodynamic therapy Light therapy combined with topical application of a light sensitive compound; the idea is to make the light therapy more powerful. NO; from private practitioners only. The downside is that side effects are greater than with light alone.
Heat based therapy Applies focused heat below the skin surface to kill acne-causing bacteria. NO Devices for home use are available from specialist providers.
Acupuncture Alters the interaction between the brain and the skin. NO Key component of traditional Chinese medicine.
Psychotherapy May help you to cope with the impact of acne. NO Has no effect on the severity of acne.
Hyfrecation or cautery Uses heat to treat spots called macrocomedones (large whiteheads). YES Only used by dermatologists.