Acne is a common condition—affecting about 85% of people between ages 12 and 24, according to the American Academy of Dermatology—but it can occur at any age.
Severe acne goes beyond the occasional pimple. It often includes large, painful cysts or inflamed nodules that cover substantial areas of the skin. This form of acne can lead to swelling, scarring, and significant discomfort.
Managing severe acne can be challenging, and it’s easy to make things worse with the wrong approach. Fortunately, effective treatments exist. With the right care, you can reduce breakouts, prevent complications, and improve your skin over time.
Skin Care Tips: Be Gentle but Consistent
A consistent skincare routine is essential, but aggressive washing can worsen acne. Stick to these tips:
Clean your face twice a day using mild soap or a gentle cleanser.
- Wash again after sweating.
- Avoid harsh scrubbing—use your hands, not washcloths or sponges.
- Shave carefully.
- Remove makeup before bed.
- After exercise, shower to remove sweat and oil.
Choose noncomedogenic (non-pore-clogging) products and avoid abrasive exfoliants. Over-washing or using harsh products can irritate your skin further.
Be Cautious with Sun Exposure
While sunlight may temporarily dry out acne, it can also worsen irritation, especially if you’re using certain acne medications.
To protect your skin:
- Check if your treatments increase sun sensitivity.
- Avoid direct sunlight when possible.
- Use wide-brimmed hats and breathable clothing.
- Apply noncomedogenic sunscreen daily, especially on affected areas.
Try Over-the-Counter (OTC) Treatments
Some OTC options can help manage breakouts:
- Look for ingredients like benzoyl peroxide, salicylic acid, adapalene, sulfur, or azelaic acid.
- Apply to clean skin and follow package directions.
- Results may take up to 3 months, so be patient.
- Stop use and consult your doctor if you experience severe irritation.
For persistent or severe acne, OTC products alone are usually not enough—you may need professional treatment.
Soothe Discomfort with Cold or Warm Compresses
- For swelling: Apply an ice cube wrapped in a towel for 10 minutes. Repeat up to three times with breaks.
- For whiteheads: Use a warm compress for 10–15 minutes several times a day to help drain pus naturally.
When to See a Dermatologist
Severe acne often requires professional care. A dermatologist can create a personalized treatment plan to reduce breakouts, prevent scars, and improve your skin health.
Consult a dermatologist if:
- OTC treatments aren’t working.
- Acne is worsening or painful.
- You notice signs of infection or scarring.
- Your acne impacts your confidence or emotional well-being.
Common Dermatological Treatments
Antibiotics: Help reduce bacteria and inflammation. Common options include doxycycline, minocycline, erythromycin, and Bactrim. Be aware of side effects like sun sensitivity or stomach upset.
Topical Retinoids: Medications like tretinoin speed up cell turnover and help prevent clogged pores. Use sparingly (a pea-sized amount), ideally at night.
Steroid Injections: Used for large, painful cysts, these can rapidly reduce inflammation. However, they’re not a long-term solution.
Oral Contraceptives: Can help regulate hormones that trigger acne, though they come with risks like blood clots or migraines.
Spironolactone: A diuretic that treats hormonal acne by blocking certain hormones. Side effects should be discussed with your doctor.
Laser and Light Therapy: These treatments reduce bacteria and help with scarring but often require multiple sessions.
Chemical Peels: Exfoliate skin layers to improve acne and pigmentation. Those with darker skin should be cautious of hyperpigmentation.
Drainage and Extraction: Dermatologists can safely remove cysts—don’t attempt this at home, as it can cause infection or scarring.
Isotretinoin (Accutane): A powerful option for severe, cystic acne. It’s highly effective but comes with serious potential side effects and requires close medical supervision.
What to Avoid
- Harsh Products: Skip scrubs, alcohol-based astringents, and fragranced skincare.
- Picking or Squeezing: This can lead to scarring and infection.
- Friction: Avoid pressure on acne-prone areas from phones, helmets, or backpack straps.
- “Miracle” Cures: Be skeptical of treatments with bold claims. Even natural products can interfere with medications or worsen acne.
Final Thoughts
Severe acne can be tough, but it’s treatable. You don’t need to suffer through it or risk long-term skin damage. The earlier you get the right help, the better your chances of clear, healthy skin. Consult a dermatologist to explore the best options for your needs.
