Treating Mild to Moderate Comedonal and Inflammatory Acne

Most cases of mild comedonal acne occur in teenagers and young adults, and these can usually be treated with traditional topical creams and gels. The most common of these are retinoids, like Retin-A, Differin, Renova, and Tazorac. They work by unblocking clogged pores.

Dermatologists will often combine a topical retinoid with an oral antibiotic, such as doxycycline, tetracycline, minocycline or erythromycin, which kills the bacteria that cause inflammation around the blocked pores.

"This type of treatment is focused on teenagers, who usually have a period of a year to four years when they’re breaking out because of changing hormone levels and increased oil production, and in some cases, genetics," says Amy Taub, MD, founder and medical director of Advanced Dermatology in Lincolnshire, Ill. Taub is also an assistant clinical professor of dermatology at Northwestern University’s Feinberg School of Medicine.

Each of the antibiotics has its own set of side effects -- doxycycline causes sun sensitivity, for example, and tetracycline can cause yellowing of teeth in children -- so dermatologists will work with their patients to help choose an antibiotic that works best for them.

Mild to moderate comedonal acne can often be aggravated by external triggers, like hair gels and makeup. "Some of these makeups and gels are so occlusive that when the person stops using them, the acne goes away," says Macrene Alexiades-Armenakas.


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