Oral antibiotics are recommended for no longer than three months as antibiotic courses exceeding this duration are associated with the development of antibiotic resistance and show no clear benefit over shorter courses.[87] Furthermore, if long-term oral antibiotics beyond three months are thought to be necessary, it is recommended that benzoyl peroxide and/or a retinoid be used at the same time to limit the risk of C. acnes developing antibiotic resistance.[87]
Dear acne, you suck. Seriously, we thought the breakouts would be over soon after AP Calculus. But it’s actually something that affects women and men in their 20s and 30s, and even well past their 50s. It’s just not fair (throws childlike temper tantrum). And if you thought blackheads and whiteheads were annoying, the deep painful pimples that often pop up in adult acne are much more aggravating—and harder to get rid of. So, we talked to dermatologists to find out which acne treatments are the most effective on all types of pimples.
Globally, acne affects approximately 650 million people, or about 9.4% of the population, as of 2010.[158] It affects nearly 90% of people in Western societies during their teenage years, but can occur before adolescence and may persist into adulthood.[19][20][23] While acne that first develops between the ages of 21 and 25 is uncommon, it affects 54% of women and 40% of men older than 25 years of age,[47][159] and has a lifetime prevalence of 85%.[47] About 20% of those affected have moderate or severe cases.[2] It is slightly more common in females than males (9.8% versus 9.0%).[158] In those over 40 years old, 1% of males and 5% of females still have problems.[20]
1. Topical Treatment: This refers to acne medications which are applied directly onto the skin, such as creams, gels, serums and ointments. Topical treatments can be found over-the-counter (OTC) or at a pharmacy when prescribed by a doctor. If you’re shopping for topical treatment solutions, look for products that contain acne-fighting ingredients such as salicylic acid, benzoyl peroxide, and glycolic acid that can penetrate pores to loosen and dissolve debris. Topical solutions are generally best suited to treat mild to moderate acne. 2. Systematic Treatment: Systemic acne medications are consumed orally, such as antibiotics or hormone pills, and work from the inside out to help clear your complexion. Antibiotics can help kill the bacteria lodged within infected pores to reduce inflammation, redness and swelling. Hormones pills such as birth control are frequently used to regulate androgen levels and treat hormonal acne. You won’t be able to purchase systemic treatments OTC and will need a doctor’s recommendation for these medications. 
The side effects depend on the type of treatment you use. Generally, for topical, over-the-counter creams, you can watch out for stinging, redness, irritation and peeling — these side effects usually don’t go any deeper than the skin. Others, like oral antibiotics or hormonal medications, could come with new sets of complications, so we suggest talking to your doctor before pursuing the treatment.
Toothpaste is a good option if you have a mammoth pimple that you want to take care of quickly. It is effective because it contains silica, which is the same substance that can be found in bags of beef jerky to keep moisture out. As such, toothpaste has been know to dry out and reduce the size of pimples over night. Simply apply some to the affected area before sleep and wash it off in the morning.
Although the late stages of pregnancy are associated with an increase in sebaceous gland activity in the skin, pregnancy has not been reliably associated with worsened acne severity.[137] In general, topically applied medications are considered the first-line approach to acne treatment during pregnancy, as they have little systemic absorption and are therefore unlikely to harm a developing fetus.[137] Highly recommended therapies include topically applied benzoyl peroxide (category C) and azelaic acid (category B).[137] Salicylic acid carries a category C safety rating due to higher systemic absorption (9–25%), and an association between the use of anti-inflammatory medications in the third trimester and adverse effects to the developing fetus including too little amniotic fluid in the uterus and early closure of the babies' ductus arteriosus blood vessel.[47][137] Prolonged use of salicylic acid over significant areas of the skin or under occlusive dressings is not recommended as these methods increase systemic absorption and the potential for fetal harm.[137] Tretinoin (category C) and adapalene (category C) are very poorly absorbed, but certain studies have suggested teratogenic effects in the first trimester.[137] Due to persistent safety concerns, topical retinoids are not recommended for use during pregnancy.[138] In studies examining the effects of topical retinoids during pregnancy, fetal harm has not been seen in the second and third trimesters.[137] Retinoids contraindicated for use during pregnancy include the topical retinoid tazarotene, and oral retinoids isotretinoin and acitretin (all category X).[137] Spironolactone is relatively contraindicated for use during pregnancy due to its antiandrogen effects.[1] Finasteride is not recommended as it is highly teratogenic.[1]
Medical conditions that commonly cause a high-androgen state, such as polycystic ovary syndrome, congenital adrenal hyperplasia, and androgen-secreting tumors, can cause acne in affected individuals.[45][46] Conversely, people who lack androgenic hormones or are insensitive to the effects of androgens rarely have acne.[45] An increase in androgen and oily sebum synthesis may be seen during pregnancy.[46][47] Acne can be a side effect of testosterone replacement therapy or of anabolic steroid use.[1][48] Over-the-counter bodybuilding and dietary supplements are commonly found to contain illegally added anabolic steroids.[1][49]

Pimples are raised red spots with a white center that develop when blocked hair follicles become inflamed or infected with bacteria. Blockages and inflammation that develop deep inside hair follicles produce cystlike lumps beneath the surface of your skin. Other pores in your skin, which are the openings of the sweat glands, aren't usually involved in acne.
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