Acne treatments: Medical procedures may help clear skin

Acne treatments aren't one-size-fits-all. If prescription creams and antibiotics aren't working for you — or if you can't tolerate the side effects that medications can cause — you might consider acne treatments that can be provided at your doctor's office.

Several types of office-based medical procedures — such as light therapy, chemical peels and steroid injections — may be helpful.

Regardless of which acne treatments you use, try to keep your expectations realistic. In most instances, acne can't be cured, only controlled. You won't start seeing improvements from most treatments for four to eight weeks. And your acne might appear worse before it gets better.

The redness and swelling that can occur with acne is caused by a type of bacteria that can be killed by exposing your skin to different types of light. Before the procedure, your doctor might apply a medication to your skin to make it more sensitive to light (photosensitizers). You might need to visit your doctor for multiple treatments.

Your treatments may use blue light, red light or a combination. More study is needed to determine the best methods for treating acne with light.

Acne bacteria can also be killed with pulsed light and heat energy. These treatments may also shrink oil (sebaceous) glands, which decreases oil production.

Possible light therapy side effects in the treated areas include:

• Redness
• Crusting and peeling
• Changes in skin tone
• Sensitivity to sunlight
• Pain

Steroid injections are most often used for the types of acne that cause painful lumps beneath the surface of the skin (nodules and cysts). These conditions can take weeks to resolve on their own. After steroid injections, the pain decreases, lumps flatten and the skin can clear up within days.

This drug is effective, but it can cause side effects, including:

• Thinning of the skin
• Skin tone that turns lighter than normal

Steroid injections are typically used as a temporary or occasional fix for stubborn cysts and nodules. They aren't used to treat widespread acne because of the possible side effects and the need for frequent doctor visits.

Chemical peels might mildly improve the appearance of skin for people with mild acne. This procedure has traditionally been used to lessen the appearance of fine lines, sun damage and minor facial scars.

Chemical peels that dermatologists use aren't available over-the-counter. During a chemical peel, your doctor applies a mild chemical solution to your skin. This solution helps unclog pores and remove dead skin cells, whiteheads and blackheads. A chemical peel can also generate new skin growth. You'll likely need multiple treatments for best results, which are not long-lasting.

Possible side effects include redness, scabbing, swelling, scaling, crusting and changes in skin color.

Talk with your doctor about the risks of chemical peels, especially if you:

• Have skin that tends to form exaggerated scar tissue (keloids)
• Have used the oral acne medication isotretinoin (Myorisan, Claravis, others) in the past six months
• Are pregnant
• Have frequent or severe outbreaks of cold sores

Your doctor might use special instruments to remove cysts, whiteheads and blackheads. This temporarily improves the appearance of your skin, though it might also cause scarring.