An overproduction of naturally occurring oil and cells inside the skin follicle causes the development of acne. This causes a blockage of the pore, causing the follicle underneath to swell. The buildup of oil and dead cells allows the bacteria Propionibacterium acnes to grow unchecked. The result is an infection. The infection can present itself as a blackhead, whitehead, a tiny pimple barely visibly, larger pus-filled nodules, and even fluid-filled cysts embedded deeply in the skin.



For years, doctors and dermatologists have treated acne with both a pore cleanser (benzoyl peroxide) and topical antibiotic to kill the bacteria. For mild to moderate acne, this is still a very effective treatment. It is both easy and economical and works well for most people. Prices range from $5 to $20 depending on the type of treatment you prefer. The drawback is that these treatments have a tendency to dry out the skin leading to irritation.

Oral antibiotics like minocycline, doxycycline, and tetracycline have been used for a number of years with good results. The monthly cost for these antibiotics is relatively inexpensive at about $20. Retin-A (about $40 an ounce) and oral antibiotics, once quite popular, are now being used less and less frequently. Retin-A has been shown to cause skin inflammation and redness while taking oral antibiotics long term may contribute to drug resistant bacteria.

Other prescription topical products like Azelex, Finacea, Benzaclin, Benzamycin, Cleocin, or A/T/S can cost between $20 and $60 per ounce depending on the medication.

Recently, a product known as ProActiv Solution has hit the market. This treatment was developed due to the complaints of dry and irritated skin. With infomercials and celebrity endorsements, it quickly became the most popular and asked about acne treatment on the market. The solution used is not as drying as the creams and ointments found in traditional treatments and the concentration of benzoyl peroxide is lower. These adjustments make ProActiv less irritating to the skin. ProActiv does not require a prescription and costs about $40 for a one month supply.

Another brand new product for acne is Nicomide-T. The cream or gel derived from vitamin B has been shown to reduce the redness and inflammation associated with acne. It has also been shown to be equally effective as the topical antibiotic clindamycin. The cost for Nicomide-T is about $40 a month.

The latest acne treatment is neither a cream nor an antibiotic but rather a device for electronically killing the acne causing bacteria. It is marketed under the name Zeno and literally heats up the pimple for two to three minutes killing the bacteria. To completely destroy the pimple, one to three treatments in 24 hours are needed. This treatment is best for the occasional acne breakout and not for a severe widespread problem. The unit sells for about $210.

For those with severe acne, one can choose to use several different laser options. The professional lasers work similarly to the Zeno product but can be used over the entire problem are. These specialized lasers not only destroy the acne causing bacteria, but shrink the oil producing glands. The procedure is relatively painless but requires several treatments. With each treatment session costing between $500 and $800, this option is certainly not cheap. The results are also not permanent.

Another option is called ?Photo Dynamic Therapy.? The procedure involves pulsed light or lasers combined with a topical product known as Levulan. The light activates the Levulan causing it to destroy the bacteria and shrink oil producing glands. The good news is that the therapy has been shown to remain effective for three years after treatment. The bad news is that it makes the skin very sensitive to the sun, requiring sun block. This regimen is also expensive at between $500 and $800 per session with a minimum of six sessions.

Accutane is an oral medication used for severe acne. It has recently gained publicity due to its two serious side effects, birth defects and suicidal thoughts. Females receiving Accutane must have a negative pregnancy test before each prescription and it must be dispensed with seven days. Dry skin, eyes, and nose are common other side effects. The cost for Accutane is high at about $600 a month.

Accepted treatment step guidelines for acne are as follows:

Step 1. benzoyl peroxide 2.5% - 10% for a period of at least 4 weeks,

Step 2. benzoyl peroxide and topical antibiotic cream or Retin-A for a period of at least 4 weeks,

Step 3. add oral antibiotics like minocycline, doxycycline, or tetracycline for at least 8 weeks,

Step 4. Accutane

Step 5. surgery to remove or drain the infections

From the common teenage acne to midlife acne, the condition is treatable. Using the above step therapy generally follows the less expensive to most expensive schedule. Begin therapy with inexpensive cleansers containing a small amount (2.5%) of benzoyl peroxide for at least a month. If there is still acne present, see your doctor or dermatologist for topical antibiotic creams. Cleocin and A/T/S both are available in generic form and cost about $20. The next step is to add oral antibiotics. The least expensive is tetracycline at only about $10 a month. After another 8 weeks of unsuccessful treatment, you may consider Accutane. Be sure to discuss the side effects and significant cost ($600 a month) with your doctor.

The newest, non-traditional laser treatments may be of interest to those who do not prefer the medicinal options. These options are just coming into their own and you must weigh the advantages and disadvantages.