Topical medications tend to be the most frequently chosen form for initial acne treatment. There are many topical solutions offered over the counter in pharmacies and it is not necessary to have a prescription. These over the counter options contain different medicinal agents in low concentration. These can include antibacterial soaps, salicylic acid, or creams or gels containing benzoyl peroxide.

In the case of mild or more punctual acne it is possible to start with these products. In moderate to severe cases of acne it is very likely that these treatments have little effect, or act only in the very short term. It is strongly recommended to seek a professional dermatologist to assess the situation and offer you a more targeted solution.

If the dermatologist suggests a topical treatment, there are several combinations that can be prescribed by prescription depending on the severity of acne, previous treatments, age, etc. Here are some examples:

Topical antibiotics

The topical treatments most commonly prescribed by dermatologists are antibiotics such as clindamycin and erythromycin.

With the formation of comedones, the environment for the growth of bacteria inside the hair follicle is very favorable, therefore, Propionbacterium acnes bacteria (eg Acne) can then cause an inflammatory process, which leads to formation of pimples.

Antibiotics help target bacteria that can cause acne and prevent it from growing on the skin. Benzoyl Peroxide is a dermabrasion agent, which for example acts as an antibacterial but has drying effects that help reduce excess sebum.

These antibiotics can be combined with other topical products such as retinoids, which are described below.

How long does it take until acne improves?

Depending on the treatment prescribed by the dermatologist and the severity of the acne, it may take several weeks to see an improvement.

What are the most common side effects?

Most side effects with topical antibiotics are mild irritation at the beginning of treatment, which usually goes away, such as erythema (redness), tingling sensation, dryness and peeling skin. It is very important that the skin is nourished with a good moisturizer. The topical medication prescribed by the doctor should usually be applied in very small amounts.

Topical Retinoids

Another type of topical treatment used for acne are retinoids. Derivatives of vitamin A, the most frequently used are tretinoin, adapalene and tazarotene.

How do topical retinoids work?

Retinoids are effective in the treatment of comedonal acne. When applied to the skin, they help unblock the pores and reduce inflammatory lesions by normalizing the growth cycle of the epithelial cells (the skin cells), thus promoting the elimination of the microcomedon from the follicle. They help to reduce the amount of blackheads, whiteheads and pimples, and greatly contribute to the uniformity of the complexion.

Increasing the permeability of the follicular wall, retinoids also contribute to increase the effectiveness of other topical medications. With antibiotics, they are the best combination to treat acne.

Note that there may be a period of 4 to 6 weeks of treatment before observing a real improvement.

Are there contraindications or side effects?

The most important contraindication is certainly pregnancy. The use of this kind of products is strongly discouraged for pregnant or breastfeeding women.

Retinoids increase sensitivity to the sun. It is therefore essential to avoid exposure to the sun as much as possible during treatment.

A slight irritation at the beginning of treatment as well as tingling can be felt. This is usually only temporary and by following certain application tips these effects can be greatly diminished and the treatment better tolerated.

Benzoyl Peroxide

Benzoyl Peroxide is a drug that has antibacterial and anti-inflammatory effects and promotes skinpeeling. It is available as a cream or gel to apply to the affected area. It is by reducing the production of sebum and stopping the bacterium responsible for acne, that it can treat acne.

Benzoyl peroxide can be served in different concentrations, usually between 2.5% and 10%. Its use may vary depending on the areas to be treated. For an application on the face for example, we suggest a concentration of 2.5% but for the back we will often choose a stronger prescription ranging from 5 to 10%.

Note that you will need to be diligent in the monitoring and application of the product to ensure good efficiency, and it can be between 4 to 6 weeks to see an improvement.

Are there contraindications or side effects?

Contraindications are similar to other topical medications. There is an ncreased sensitivity to sunlight. Therefore it is essential to avoid exposure during treatment.