Acne is a chronic condition, usually triggered by the onset of puberty and increasing hormone levels. It cannot be cured, but there are many things you can do to keep acne from becoming a major problem. Remember that all teens have acne to some extent, so you are not alone. Take control of your condition with good basic skin care using carefully selected products. Do not listen to every advertisement you hear, as some things might not be appropriate for you. Follow the instructions given by your healthcare provider. Try to be patient. Acne improvement takes time and attention.

Acne Myths Myth 1: Vigorous cleansing with abrasive cleansers or sponges will remove blackheads and prevent acne. False. This causes microscopic tears in the skin and increases sites where Propionibacterium acnes (acne-causing bacteria) can enter the skin.

Myth 2: Eliminating certain foods from your diet will control acne. False. Foods do not worsen acne; however, a balanced diet helps the immune system work to maintain resistance to the bacteria that contribute to acne. Myth 3: Squeezing pimples will clear them more quickly. False. Squeezing or touching pimples disrupts the follicular wall and causes redness and swelling of the surrounding skin, thus increasing the severity of acne and potential for scarring.

Dos and Don'ts of Skin Care Do wash with mild, unscented soap. Twice daily cleansing is plenty. More frequent washing will only irritate the skin. Don't use abrasive sponges or cloths. They cause irritation and allow bacteria to grow. Do protect your skin from the sun. Use a sunscreen with SPF 15 daily, and wear a broad-brimmed hat for shade. Don't use astringents and after-shaves that contain alcohol. Do be faithful to daily skin care. The medication won't work if it stays in the bottle!

Medication	Brand Names	Strengths	Vehicles	Comments
Benzoyl peroxide	Persagel, Desquam-E Oxy Wash, Fostex	2.5%, 5%, 10%	Gel, wash, cream, lotion	Initially irritating. Contact allergy in 2% of users. Start with 5% strength.
Lactic acid	Clean & Clear, Fostex, Aveeno, Neutrogena		Liquid soap, bar soap, lotions
Retinol	Neutrogena Multivitamin Acne Treatment, Neutrogena Skin Clearing Moisturizer	Variable, not controlled by US Food and Drug Administration		Effectiveness not documented.
Salicylic acid	Oxy Wash, PropaPh, NeutrogenaAcne Wash	1%, 2%, 5%	Lotion, cream, wash, gel	May irritate initially. Some are available with tint for cover-up.

Medication	Brand Name	Strengths	Vehicles and Dispensing Size	Comments
Adapalene	Differin	0.1%	Cream -- 15 g, 45 g Gel -- 15 g, 45 g Solution -- 30 cc Wipes -- 60/box	Photosensitizing. Less irritating than tretinoin.
Azelaic acid	Azelex	20%	Cream -- 30 g, 50 g	Not photosensitizing. Synergistic when used with tretinoin.
Tretinoin	Retin-A Avita	0.025%, 0.05%, 0.1%	Cream -- 20 g, 45 g Gel -- 15 g, 45 g Lotion -- 28 cc	Photosensitizing. Initiate treatment at the lowest strength. Gels are stronger than cream, due to increased absorption.
Tazarotene	Tazorac	0.05%, 0.1%	Cream -- 15 g, 30 g, 60 g Gel -- 30 g, 100 g	No advantage over other products.
Combination Products
Benzoyl peroxide and erythromycin	Benzamycin	BP 5%, erythromycin 3%	Gel	Must be refrigerated. Often irritating.
Benzoyl peroxide and clindamycin	BenzaClin	BP 5%, clindamycin 1%	Alcohol-free, water based gel	Sometimes irritating. Contraindicated in those having a history of regional enteritis, ulcerative colitis, or antibiotic-associated colitis.

Medication	Brand Names	Vehicles and Dispensing Size	Comments
Erythromycin	EryDerm, ATS, Emgel, Erycette	Solution -- 60 cc Gel -- 27 g, 50 g Wipes -- 60/box	66% alcohol 77% alcohol 66% alcohol
Clindamycin	Cleocin	Solution -- 30 cc, 60 cc Gel -- 30 g, 60 g Lotion -- 60 cc Wipes -- 60/box	50% alcohol 50% alcohol 5% alcohol 50% alcohol
Gentamycin 1%	Garamycin	Cream -- 15 g Ointment -- 15 g	Rarely used. Petrolatum base of ointment may help in acne excoriée
Metronidazole	MetroGel 0.75%, MetroCream 0.75% Noritate 1% MetroLotion 0.75%	Gel -- 28 g Cream -- 45 g Cream -- 30 g Lotion -- 60 cc	No alcohol but still irritating. No alcohol. No alcohol.
Sodium sulfacetamide 10%, sulfur 5%	Sulfacet R, Novacet, Klaron	Lotion -- 25g	Not for use by patients with kidney disease.

Medication	Strengths	Starting Dose	Maintenance Dose	Comments
Tetracycline	250 mg 500 mg	500 mg twice a day	250-500 mg daily	Calcium decreases absorption. Photosensitizing.
Doxycycline	50 mg 100 mg	100 mg twice a day	50-100 mg daily	Calcium decreases absorption. Photosensitizing. Erosive esophagitis.
Minocycline	50 mg 100 mg	100 mg twice a day	50-100 mg daily	More expensive. More side effects including a potential to cause blue discoloration of teeth and skin.
Erythromycin	250 mg 500 mg	500 mg twice a day	500 mg daily	Sustained release less irritating to gastrointestinal tract.
Amoxicillin	250 mg 500 mg	500 mg twice a day	500 mg daily	Useful if erythromycin not tolerated.
Cephalexin	500 mg	500 mg twice a day	500 mg daily	Rarely used.