Acne: Diagnosis, treatment, and outcome

How do dermatologists diagnose acne?

To diagnose acne, a dermatologist will first examine your skin to make sure you have acne. Other skin conditions can look like acne. If you have acne, the dermatologist will:

  • Grade the acne. Grade 1 is mild acne. Grade 4 is severe acne.
  • Note what type, or types, of acne appear on your skin.

How do dermatologists treat acne?

Today, there are many effective acne treatments. This does not mean that every acne treatment works for everyone who has acne. But it does mean that virtually every case of acne can be controlled.

People who have mild acne have a few blemishes. They may have whiteheads, blackheads, papules, and/or pustules (aka pimples). Many people can treat mild acne with products that you can buy without a prescription. A product containing benzoyl peroxide or salicylic acid often clears the skin. This does not mean that the acne will clear overnight.

Despite the claims, acne treatment does not work overnight. At-home treatment requires 4-8 weeks to see improvement. Once acne clears, you must continue to treat the skin to prevent breakouts.

When to see a dermatologist

If you have a lot of acne, cysts, or nodules, a medicine that you can buy without a prescription may not work. If you want to see clearer skin, you should see a dermatologist. Dermatologists offer the following types of treatment:

Acne treatment that you apply to the skin: Most acne treatments are applied to the skin. Your dermatologist may call this topical treatment. There are many topical acne treatments. Some topicals help kill the bacteria. Others work on reducing the oil. The topical medicine may contain a retinoid, prescription-strength benzoyl peroxide, antibiotic, or even salicylic acid. Your dermatologist will determine what you need.

Acne treatment that works throughout the body: Medicine that works throughout the body may be necessary when you have red, swollen types of acne. This type of treatment is usually necessary to treat acne cysts and nodules. Your dermatologist may prescribe one or more of these:

  • Antibiotics (helps to kill bacteria and reduce inflammation).
  • Birth control pills and other medicine that works on hormones (can be helpful for women).
  • Isotretinoin (the only treatment that works on all that causes acne).

Procedures that treat acne: Your dermatologist may treat your acne with a procedure that can be performed during an office visit. These treatments include:

  • Lasers and other light therapies: These devices reduce the p. acnes bacteria. Your dermatologist can determine whether this type of treatment can be helpful.
  • Chemical peels: You cannot buy the chemical peels that dermatologists use. Dermatologists use chemical peels to treat 2 types of acne — blackheads and papules.
  • Acne removal: Your dermatologist may perform a procedure called “drainage and extraction” to remove a large acne cyst. This procedure helps when the cyst does not respond to medicine. It also helps ease the pain and the chance that the cyst will leave a scar. If you absolutely have to get rid of a cyst quickly, your dermatologist may inject the cyst with medicine.

Outcome

Waiting for acne to clear on its own can be frustrating. Without treatment, acne can cause permanent scars, low self-esteem, depression, and anxiety.

To avoid these possible outcomes, dermatologists recommend that people treat acne. When the skin clears, treatment should continue. Treatment prevents new breakouts. Your dermatologist can tell you when you no longer need to treat acne to prevent breakouts.

Learn more about acne:

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