Acne: how to manage this age-old problem.


Acne:  how to manage this age-old problem.  The American Academy of Dermatology updated their acne care guidelines.  Here is a synopsis…


  • 40 million Americans have acne.
  • 74% of adolescents experience acne
  • Nearly 20% of adult women have acne.

What to do first?  Topical over-the-counter preparations like benzoyl peroxde and salicylic acid are recommended for intial control and maintenance of acne.  These are both inexpensive and available in a variety of preparations and strengths.  Beyond that clindamycin 1% solution or gel is the preferred topical antibiotic (as it is more effective than erythromycin and acne bacteria is less resistant to clindamycin).

If you need more help, then consider systemic (oral) antibiotics.  Doxycycline and minocycline are more effective than tetracycline.  Erythromycin should be restricted because of increased risk of bacterial resistance to this antibiotic.  Systemic antibiotic use should only be used for 3-4 months to decrease the risk of antibiotic resistance.

Do birth control pills work?  For females, there are four combination oral contraceptive pills that have been approved by the Food and Drug Administration (FDA) for management of acne.

Is there a pill to help women with acne and polycystic ovary syndrome?  Yes!  Spironolactone which is a “water-pill” also greatly helps with acne.

What about Accutane?  Yes.  This is still available.  This is usually prescribed by dermatologists as there is an”iPLEDGE risk management program”that is stringent and needs for extra testing and contraception usage to use Accutane.  Accutane is an oral isotretinoin that is known to cause fetal anomalies/malformations and so extra strict programs need to be in place to help decrease this risk.

Do diet changes help decrease acne? No.

I hope this helps.

About drlesliegreenberg

I have been practicing as a family physician for over 20 years--as both an educator of physicians and clinician. From infancy to the elderly, I perform obstetrics and general medicine. I love my career and am passionate about my field of knowledge and my patients. Follow me on Facebook at Leslie Md Greenberg Medical Disclaimer The content of this website is provided for general informational purposes only and is not intended as, nor should it be considered a substitute for, professional medical advice. Do not use the information on this website for diagnosing or treating any medical or health condition. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.
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