Conventional wisdom says that acne is a rite of passage, something we endure in our teenage years and then put behind us. Nothing can be done, in this view, while acne is active: everything is down to prevention, and possibly to recovery after the fact.
But acne can be treated while it is active, especially within a few days of an outbreak. For sufferers of severe acne or acne that continues to present itself into adulthood, this is terrific news.
Before listing some of the latest treatments for active acne, here are a few bits of conventional wisdom that really are true:

1. You should never squeeze your pimples.
2. You should avoid facials and similar face treatments when acne is active
3. You should be especially careful of any creams or moisturizers you apply to your face, and avoid non-medicated creams altogether.
With that out of the way, here are some treatments that actually do help manage or cure active acne.

Treatments for moderate acne outbreaks

Steroids

Small doses of steroids injected directly into acne lesions can dramatically reduce inflammation and discomfort, especially in cystic acne. While the average acne cyst heals by itself in a few weeks, steroid injections can begin working in one day. Because steroid injections greatly reduce the amount of time skin is affected by the cyst, they can greatly reduce the risk of scarring after the cyst is completely healed.
Only one injection per acne cyst is usually required, and each injection typically costs upward of $60. Steroids are hormones and can have serious consequences if applied too heavily.

Low-level light therapy

LLLT, as it is commonly known, is a gentle and effective treatment for the inflammation associated with acne. It may not be effective against particularly aggressive or advanced cases of acne, but for mild-to-moderate, widespread outbreaks of acne, a 15-minute LLLT treatment can make quite a bit of difference.

Antibiotic creams

Acne is caused by bacteria, and antibiotic creams attack its root cause. Used alone, these treatments usually show results within five days or so, but antibiotic creams are especially useful as follow-ups to other treatments, like steroid injections. Preparations like Dalacin T are available for roughly $50 per bottle.

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Treatments for severe acne

Severe acne involves more than 125 pimples or more than five acne cysts. This prevents treatments like steroids and LLLT from being effective: severe acne requires a different, more varied treatment regime.
Many sufferers of severe acne experience outbreaks into their 30s and 40s; this means that treatments often must be devised to work around employment and family schedules. Most of these patients also have scars to show for previous outbreaks, along with the pimples and cysts that mark new attacks; this makes comprehensive treatment all the more complex.
A representative treatment schedule for such patients should involve the least possible number of sessions, each brief enough to accommodate a busy schedule, and include a preventative component to anticipate future outbreaks. Consider this example:
Prevention

A daily preventative skin-care routine might be based around a facial cleanser containing salicylic acid. This will go a long way toward preventing comedones, also known as blackheads and whiteheads, which form when hair follicles are stopped up during acne outbreaks. Any moisturizers or sunblock products the patient uses should be formulated to be non-comedogenic.
As a supplement to these measures, a retinoid cream such as Differin can be used to suppress sebum, the oil that contributes to acne breakouts.
When acne first begins to appear, its severity may be controlled using Clindoxyl, a gel containing the antibiotic clindamycin and benzol peroxide, which peels back layers of affected skin to deliver clindamycin more directly than a simple topical application would.
Oral Medication

Medicines based on isoretinoins, such as Accutane, are sometimes prescribed to patients suffering severe acne. Isoretinoins are effective at long-term suppression of sebum, but they can have dangerous side effects, particularly to fetuses and children who are still growing. Because they mimic a chemical that contributes to embryonic development and to skeletal development in children, isoretinoins are not recommended either for children or for women who may become pregnant at any time during treatment. Because their effects can be so devastating, prescriptions for isoreinoins are even more highly regulated in many jurisdictions than standard prescription medications.
While antibiotic cream is useful against outbreaks of mild- to moderate acne, severe acne is best addressed with an oral antibiotic. These are available by prescription, after careful consideration of each patient’s condition and needs.

Clinical Treatments

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Clinical treatment for severe acne tends to involve several brief sessions combining multiple therapies. These include:

1. Picosecond laser therapy to address subdermal features of acne outbreaks
2. LLLT to suppress inflammation and promote the growth of healthy skin
3. Chemical peels to address the presentation of acne on the skin’s surface
4. Medical facials to soothe the skin, reduce inflammation, and control sebum

Post-Treatment Care

Even after successfully addressing an outbreak of severe acne, patients may benefit from ongoing treatment. Medical facials and chemical peels can suppress acne-causing bacteria and reduce sebum; even laser treatment can be used along with these topical therapies to control the sources of sebum and bacteria.
Many severe-acne sufferers bear scars to show for previous outbreaks. Combinations of LLLT, specific kinds of laser treatments, and even minute suturing of stubborn scars can dramatically improve skin that has been pitted by acne attacks.
Above all, patients should know that a wide range of treatments is available for acne outbreaks of all severities, and that treatment becomes more difficult as acne attacks progress.

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