Acne treatments work by reducing oil production, by increasing cell turnover, or by fighting the acne-causing bacteria Propionibacterium acnes (P. acnes), and many work in combination on two or all of these fronts.

A dermatologist’s first course of action in managing acne is to prescribe topical treatments and oral antibiotics. Retinoids, derived from vitamin A, promote cell turnover and prevent the plugging of the hair follicle, and benzoyl peroxide, combined with topical antibiotics, dries up oil, kills bacteria, and sloughs off dead skin cells. Most topical applications don’t have any serious side effects beyond redness and irritation, but oral antibiotics—especially when taken for long periods of time—can lead to antibiotic resistance and yeast infections. According to the Mayo Clinic staff, combination therapies are less likely to lead to bacterial resistance.

For those who don’t accept the risks of long-term antibiotic use to treat their acne, there are other options, though they are expensive and few insurance companies cover them. Laser and light therapies—including blue light therapy, pulsed light and heat energy therapy, and diode laser treatment—reduce oil production, fight P. acnes, and lessen the appearance of existing acne scars. They may prove effective for those with severe acne, and have not yet yielded any serious side effects beyond temporary redness and swelling of the treated areas. These therapies are still in their developing stages, though, so their actual effectiveness and long-term risks are unknown.

Keep Your Skin Peeled
Two other remedies for acne and wrinkles, as well as for other skin imperfections, are chemical peels and microdermabrasion. And these treatments do exactly what they sound like: they strip the skin from your face.

Now, we do lose billions of skin cells every day from our bodies, so helping the process along isn’t such a bad thing. In fact, it makes sense to remove dead skin cells before they clog pores and become pimples. But Samantha’s beet-red face in season five of Sex and the City taught a generation of women that when you play with chemical peels, you might get burned.

Dermatologists and cosmetic specialists perform chemical peels to lessen the appearance of fine lines, sun damage, and minor facial scars, according to the Mayo Clinic staff, but the process of applying glycolic or salicylic acid to the skin has achieved more successful results in treating acne. Chemical peels help to exfoliate skin and generate new cell growth, and are often used in combination with acne creams or gels to allow the medication to penetrate further into the skin. Potential risks include redness, blisters, scaling and crusting, scarring, infection, and abnormal skin coloring.

If you think you really need that deep exfoliation, try a slightly less harmful alternative like microdermabrasion. This treatment involves a hand-held device that blows crystals onto skin, gently sloughing off dead skin and unclogging pores; then a vacuum tube removes the debris. It’s like a sander for your face. Like a chemical peel, microdermabrasion is usually a complement to other skin treatments. But unlike chemical peels, it has almost no scary side effects.

Bargain for Beauty?
Helen of Troy’s face launched a thousand ships. Is yours worth all the health risks, the money, the time that these skincare procedures entail? Maybe. After all, our faces give the world its first—and sometimes its only—impression of who we are. But if you’re going to put your best face forward by getting one of these treatments, you need to know what you’re up against before you dive in. 

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