Topical treatments on their own may not be enough to give you clear skin, especially in those with complicated, inflammatory cystic acne. There are several acne medication options approved for use by the FDA, but which one is best for you is a question for your dermatologist and/or general practitioner. Baldwin says if you have insurance and you have acne, a prescription may be the best step because “it makes no sense to try to handle the condition yourself or to use over the counter products that are always less effective than prescriptions meds.” Here are a few of the acne medications you’ll want to ask about:
Fresh aloe vera gel contains a significant amount of nutrients and vitamins
- Salicylic Acid
can be used in the process of healing and recovery from acne, and in removing the scars that subsequently develop. It is also an excellent natural moisturizer that leaves the skin glowing and feeling healthier and softer.
This is the most important reason for pimple formation in today’s generation. Eating a lot of fried and processed food triggers your oil glands and produces sebum, which leads to pimples, blackheads, and breakouts.
“Eating chocolate or a lot of junk food doesn’t by itself seem to cause acne, but not having a balanced diet and eating too many refined carbs can cause problems,” says Albert Lefkovits, MD, director of the Park Avenue Center for Advanced Medical and Cosmetic Dermatology in New York City. In a 2007 study, Australian researchers found that people who followed a low-glycemic index (GI) diet (which is low in refined carbohydrates like those found in white bread) had a 22% decrease in acne lesions, compared with a control group that ate more high-GI foods. Scientists suspect that raised insulin levels from the carbs may trigger a release of hormones that inflame follicles and increase oil production. (Check out this handy list of low glycemic foods.)
Shari Marchbein, board-certified dermatologist and clinical assistant professor at New York University School of Medicine, explains that there are currently four FDA-approved birth control bills for acne, as well as a drug she suggests called Spironolactone, which helps to block hormones from stimulating the oil glands. Day adds that it’s one of the most reliable medications she uses, though if you’re thinking about starting a family, definitely opt for a different treatment, as it’s been known to cause birth defects in women of child-bearing age that aren’t also on birth control.
Topical skin care products containing such ingredients as salicylic acid, benzoyl peroxide and nicatinamide (also called niacinamide) can be effective for people with mild acne and are widely available without a prescription. Examples include Benzac and Papulex products.
Comedonal acne: This type of acne is also caused by oil and debris clogging pores, but is characterized by skin-colored bumps called papules. These are typically found on the forehead or chin and are called “comodones,” but are more commonly known as blackheads. They may either be closed, where the follicle is completely clogged, or open.
Castor oil cleanses the skin and pulls out all the dirt, impurities, and even the bacteria (19). The ricinoleic acid present in it conditions the skin and makes it softer and healthier (20). Cystic acne can also be effectively treated with this oil.
Isotretinoin is a teratogen, so pregnancy must be avoided. Contraception counseling is mandatory, and two negative pregnancy test results are required prior to the initiation of therapy in women of childbearing potential. The baseline laboratory examination should also include cholesterol and triglyceride assessment, hepatic transaminase levels, and a CBC count. Pregnancy tests and a lipid panel and liver enzyme examination should be repeated monthly during treatment while dosing is changing. Once a level dose is used and the lipids, liver enzymes, and CBC count are normal, these tests may be discontinued.  Other adverse effects include dry skin, lips, and eyes; muscle aches; and headaches. Patients experiencing severe headaches, decreased night vision, or adverse psychiatric events should stop taking isotretinoin immediately. 
Retinoids: Retin-A (tretinoin) has been in use for years, and preparations have become milder and gentler while still maintaining its effectiveness. Newer retinoids include adapalene (Differin) and tazarotene (Tazorac). These medications are especially helpful for unclogging pores. Side effects may include irritation and a mild increase in sensitivity to the sun. With proper sun protection, however, they can be used even during sunny periods. The combination medication known as Epiduo gel — which contains the retinoid, adapalene, along with the antibacterial, benzoyl peroxide — is applied once a day.
Dr. Jennifer MacGregor, a dermatologist at Union Square Laser Dermatology in New York City, recommends getting your acne under control from the start. That may seem obvious, but Dr. MacGregor believes it’s important to take the time to go into a doctor’s office and get prescribed the best and safest products for your skin type.
Laser resurfacing involves directing concentrated pulsating beams of light at irregular skin. This procedure may be used to reduce wrinkles, blemished, or acne scars. There are two types of lasers commonly used in laser resurfacing: carbon dioxide and erbium. Treated areas heal in 10-21 days. Possible complications include milia, hyperpigmentation, and swelling.