How to Deal With Really Bad Cases of Acne

Acne affects different people differently. In younger people, acne is almost always related to hormonal changes, stress of exams or improper diet. In women, acne is usually linked to the menstrual cycle. Acne does tend to get better with age; however, even some women in their 40s and 50s could develop really bad acne breakouts.

Naturally, acne is a highly upsetting illness. Many women tend to feel depressed or develop low body image or poor self esteem due to it. However, one must not let bad acne run its course. Today, advances in medicine and acne treatments can help resolve almost each and every case of acne. The best part is: acne can also be prevented.

In this guide, we will deal with bad acne and what one can do about it.

Dealing with bad acne

Mild cases of acne can be resolved with over-the-counter (OTC) medicines. These may or may not work on very bad acne. For the most severe cases, visiting a dermatologist is the best bet. S/he can give you prescription medicines to deal with the acne. Women suffering from moderate acne can also benefit more from prescription acne medications than OTC acne products.

Let us consider some of top acne medicines for dealing with very bad acne.



These can be oral or topical. Topical acne antibiotics are available in the form of creams and lotions. If you are opting for prescription topical antibiotics, these creams will typically contain zinc. As far as oral antibiotics for very severe acne is concerned, tetracycline is the best bet. This class of drug effectively kills the acne causing bacteria and also reduces inflammation. However, you will need to take this drug for a few weeks to see the effects. Also, stopping the medication could bring back the acne. Moreover, this medicine is not entirely devoid of side effects as many have been known to experience dizziness, upset stomach, hives, and teeth discoloration and so on.

Topical antibiotic solutions have lower side effects and they usually contain Benzoyl Peroxide (BP). The concentration of BP in the topical acne medicine depends on the severity of one’s acne breakouts. Do note that Benzoyl peroxide works by peeling off layers of skin; so sun exposure should be minimized when using this drug. Other popular drugs with antimicrobial ingredients for treating bad acne are: Clindamycin, Sodium Sulfacetamide, Azelaic acid, Erythromycin etc.


Many women have experienced clearer skin after using retinoid based creams and they also provide anti-aging skin benefits. Retinoid is a derivative of vitamin A and can help treat blackheads, whiteheads, clogged pores etc. Oral retinoids are also available but they have been linked to some side effects like skin peeling, severe depression and liver damage. Topical retinoids for treating bad acne in adults consist of drugs like Tazarotene, Adapalene, and Tretinoin.

Birth Control Pills

Some types of oral contraceptives (OCPs) can also prevent and treat acne. These work at the hormonal level and help reduce acne by controlling testosterone levels in the body. Mild doses of OCPs are estrogen-based and give lesser episodes of headaches, breast tenderness or nausea. It is important that you consult both, your dermatologist as well as your gynecologist prior to taking birth control pills for treating moderate to bad acne.

Preventing severe acne

The key to dealing with really bad cases of acne is preventing new ones. And yes, there are ways in which this can be achieved. You are all probably aware of the three steps of skin care regime to be used on a day-to-day basis: Cleansing-Toning-Moisturizing.

  1. Cleansing– We all know how acne is formed: clogged pores. Naturally, it makes sense to gently clean away the grime and dirt which the skin accumulates throughout the day. However, one must not scrub too hard or try to exfoliate aggressively. Instead; choose a gentle circular motion for cleaning the skin. Talk to your doctor about the right acne preventive face wash for your particular skin type.
  2. Toning– A mild, alcohol-free toners can further help minimize bacteria on the skin. Look for natural toners containing witch hazel/salicylic acid etc as these provide anti bacterial properties without being over harsh.
  3. Moisturizing– This is an important step for acne prevention as most acne products cause the skin to dry and peel. Use sunscreen/SPF based non-comedogenic moisturizers as sun exposure can also aggravate bad acne.

Educate yourself about what triggers the acne

It often helps to keep a diary of things you have eaten or products you have used that give rise to episodes of bad acne.

  • Some women breakout just before their menstrual period.
  • Some women tend to crave sugary foods prior to the onset of the period. It is believed that sugar could trigger acne.
  • Stress is another factor that can give rise to hormonal changes which, in turn, lead to adult acne.
  • Pregnancy and menopause or starting and stopping oral contraceptives could also cause acne.
  • Certain medicines containing lithium, or those used for treating depression and epilepsy all lead to very bad acne.
  • Pressure or friction of clothes, helmets, backpacks, touching the skin often, oily hair touching the face, or the use of comedogenic makeup/ cosmetics, greasy hair products, etc can also lead to acne.

Best treatment for very bad cases of adult acne

The best treatment for severe cases of adult acne should include prevention of scars, acne clearance as well as morbidity minimization. As stated before, bad acne sufferers must be advised to gently cleanse their skin using mild cleansers and also use non comedogenic products. It is also essential to prevent touching or popping the acne as this can give rise to scarring. Patients must also drink tons of water as this can help flush out bacteria and open the skin pores.

If all else fails, there are many invasive or surgical solutions for treating acne and acne scars, mainly laser therapy. This can certainly diminish the marks and blemishes left behind by bad acne.

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