For some people, the problem can be fixed through topical over-the-counter treatments and a healthy lifestyle. For others, more drastic methods will need to be used, over a longer period of time.

Lastly, many women feel they have tried everything, stumbling from one failure to another.

And yet suitable solutions are currently available for all types of acne. A pharmacist, general practitioner or dermatologist can help you find the right one.

So when is it time to see a doctor? What are the various types of medications available for acne, depending on how severe it is? What birth control pill should you use if you have acne?

Whether in adolescence or in adulthood, people with acne tend to go see their doctor or a dermatologist much sooner than in the past. This is good news, since the early management of acne can keep it from progressing to more severe forms and most importantly limits the risk of scarring.

The development of severe acne
(see the severity grading scale for acne) and the risk of scarring are the two main reasons for seeing a doctor. In any case, if your self-confidence is declining, or if you are experiencing poor self-esteem or difficulties in your social life due to spots or blemishes, even moderate, you should go see a doctor.

Acne is often linked with depression, in which case it should be managed in order to keep the situation from becoming worse. This recommendation is valid for adolescents, who are often fragile, as well as for adults, for whom feelings of guilt and stress can further exacerbate problems.

Whenever acne has an impact on your quality of life, there is no point in waiting to seek proper treatment for your skin.

Doctor with a patient in a medical office

What type of medication is appropriate for your acne, depending on its severity?

The French Dermatology Society (SFD) has defined a targeted plan of attack depending of the severity of acne and its symptoms. Here are the various severity levels and types of acne along with the recommended treatments.

Acne level 1

Very mild acne – GEA Grade 1:  a few comedones, blackheads and whiteheads and only a few scattered red spots

The SFD recommends topical treatments, generally retinoids or benzoyl peroxide. If there is no improvement after three months, the two types of active ingredients can be combined.

Acne level 2

Mild acne – GEA Grade 2: comedones (blackheads and whiteheads) and a few red spots on less than half of the face

The doctor often prescribes a combination of retinoids and benzoyl peroxide for topical application. If there is no improvement after three months, the dose can be increased, or a topical antibiotic can be added, before switching to an oral antibiotic treatment containing cyclins. Erythromycin is not very effective, and bacteria are highly resistant to this type of molecule, whose use should be reserved for some very specific cases.

Acne level 3

Moderate to severe acne – GEA Grades 3 and 4: more than half of the face is involved, and the whole face is involved in stage 4. There may be spots on the nose, forehead and chin, and sometimes the back, with comedones (blackheads and whiteheads), numerous red spots, and a few cysts and nodules.

If the above therapeutic strategies have failed to work, oral isotretinoin may be considered, especially if there is a high risk of scarring.

Acne level 5

Very severe acne – GEA Grade 5: the entire face is affected, with numerous cysts and nodules.

Treatment with oral isotretinoin is indicated, especially for inflammatory acne. Microsurgery for the removal of comedonal lesions is recommended before the start of treatment to prevent inflammatory flare-ups, typical in the first weeks.

What birth control pill should you use if you have acne?

Due to its hormonal action, the birth control pill can play a positive role in acne, but this should not be your sole reason for choosing this type of contraception.

Your doctor or gynaecologist will recommend the most suitable type of birth control pill, taking into account the risk of thrombosis, which is higher for 3rd and 4th generation pills. Overall, birth control pills with high levels of oestrogen tend to improve acne but it all depends on the type of progestin used.