From Angela Palmer,
Your Guide to Acne.
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About.com Health's Disease and Condition content is reviewed by Casey Gallagher, MD

Although there is no cure for acne, treatments are available to help control breakout activity. Acne treatments are divided into three categories: topical, systemic, and procedural. The course of treatment is determined by the type and severity of acne.

Knowing your grade of acne will help you choose the most effective treatment plan. Grade I and Grade II (mild to moderate acne) can often be treated with over-the-counter products. A dermatologist must treat Grade III and Grade IV (moderately severe to severe, or cystic acne).

It's common to try several treatments before finding the one that works for you. Try not to get discouraged. And remember, with any acne treatment or therapy, consistency is key to a successful outcome.

Seeing a Dermatologist

A dermatologist is a medical doctor who specializes in the science of the skin, its treatment, and diseases. Your dermatologist is a great asset in the fight against acne. He can offer many treatment options, as well as advice and support.

Your dermatologist will work with you to develop a treatment plan that may include topical and systemic medications. If you suffer from Grade III or Grade IV acne, or cystic acne, you must see a dermatologist. Acne of this severity does not respond to over-the-counter treatments. Also, see your doctor if your mild acne isn't responding to treatment, or if you just need guidance in treating your acne.

• Top 5 Reasons to See a Doctor
• Find a Dermatologist

Seeing an Esthetician

An esthetician, or skin care therapist, specializes in the treatment and beautification of the skin. Estheticians are not medical doctors; rather they perform cosmetic treatments of the skin such as facials and waxing. Estheticians are required to complete 300 to 600 hours of education, depending on the state.

If you have mild acne, you may want to see an esthetician. They can recommend skin care products for acne-prone skin, and offer advice on daily skin care. Estheticians can also perform deep cleansing treatments to help ward off comedones. Estheticians work at day spas or skin spas. Many dermatological offices and medi-spas also employ estheticians to offer supportive therapy under the supervision of the doctor.

• What Is an Esthetician?
• Should I See an Esthetician or Dermatologist?

Topical Acne Treatments

Topical treatments are products such as creams, ointments, or lotions that are applied to the skin. They are used in the treatment of mild to severe acne, depending on the strength. Topical treatments are available both over the counter or by a prescription. Mild to moderate acne generally responds to over-the-counter treatments while more severe acne will need a prescription medication.

Topical treatments available over-the-counter include:

• Salicylic acid
• Benzoyl peroxide
• Sulfur
• Resorcinol

Topical treatments available by prescription include:

• Azelaic acid
• Topical retinoids - adapalene, tazarotene, tretinoin
• Topical antibiotics - clindamycin, erythromycin, sulfacetamide

Systemic Acne Treatments

Systemic treatments work internally. They may be taken orally, as in pill form, or be injected into the skin. Severe acne and cystic acne must be treated systemically. Systemic treatments may also be used in cases of moderate acne when topical treatments are not enough. Systemic acne treatments are available by prescription only, and are often used in conjunction with topical treatments.

Systemic acne treatment medications include:

• Oral antibiotics - oral erythromycin, tetracycline, minocycline, doxycycline
• Hormonal treatments - birth control pills, spironolactone
• Isotretinoin - sold under the brand names Accutane, Amnesteem, Claravis, Sotret

Procedural Acne Treatments

Procedural treatments are therapies performed by a dermatologist, health care practitioner, or esthetician. They are used in the treatment of mild to severe acne, depending on the treatment. Procedural therapies are meant to be supportive and used in conjunction with topical and/or systemic treatments.

• Comedo extractions - Often performed by estheticians during a facial, comedo extractions involve gently coaxing plugs of sebum and cellular debris from the pore. By removing blackheads, milia, and soft closed comedones the overall number of breakouts can be reduced. Estheticians are not permitted to extract cysts or serious lesions. These may only be extracted by a dermatologist through surgical methods.
• Light chemical peels - Despite the name, light chemical peels do not "peel" the skin. Instead, they deeply exfoliate the skin using an alpha-hydroxy, beta-hydroxy, or glycolic acid. Light chemical peels improve acne by removing dead skin cells and helping to clear pores of debris. Estheticians may incorporate chemical peels into a facial for those with mild to moderate acne. Those with more serious acne should have their dermatologist perform the chemical peel.
• Microdermabrasion - This treatment may be performed at a skin spa or your dermatologist's office. A machine is used to rapidly discharge super-fine crystals over the skin's surface, blasting away dead skin cells. It is not painful. A microdermabrasion treatment deeply exfoliates the skin, loosening debris from within the pore. It is best for those who have non-inflamed acne, with many blackheads and/or whiteheads.
• Phototherapy - Phototherapy is the term used to describe any treatment utilizing laser or light. They work by killing P. acnes, reducing inflammation, or shrinking the sebaceous glands, depending on what therapy is used. There are many different light and laser treatments available including blue light, red light, and photodynamic therapy. Phototherapy can be used to treat all stages of acne, from mild to very severe. Your dermatologist can help you decide which treatment, if any, would be most effective for you.
• Corticosteroid injections - Cysts are serious lesions that damage skin tissue. Dermatologists can inject a cyst with corticosteroid, reducing inflammation and the chance of scarring. Corticosteroid injections speed healing of the lesion to just a few short days.