Acne Treatments: From Creams to Scripts

Acne is one of the most common skin problems – it’s almost a universal teen experience (affecting over 93% of Australian 16–18 year olds) and often lingers into adulthood. The good news is that there’s a wide range of treatments available, from over-the-counter creams you can buy at the chemist to prescription medications (even via online prescriptions). This article will walk you through acne treatment options in a reassuring, factual way – uncovering everything from simple cleansers to prescription “scripts,” and when to seek a GP or dermatologist’s help. Whether you’re a teenager or an adult dealing with breakouts, read on to learn how to manage acne with patience and consistency (and clear up some confusion along the way).

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Over-the-Counter Acne Treatments

For mild acne, many people start with over-the-counter (OTC) products available at pharmacies. Benzoyl peroxide is one of the most effective OTC ingredients​. It’s an antiseptic that kills acne-causing bacteria and helps prevent new pimples from forming. Benzoyl peroxide comes in gels or creams (typically 2.5%, 5% or 10% strengths) which you apply to affected areas. A thin layer on the skin once or twice a day can significantly reduce breakouts – just be aware it can cause dryness or slight irritation, and it bleaches fabrics, so use white pillowcases and towels! Dermatologists note you need to use it consistently for at least 6–8 weeks to see noticeable improvement​, so don’t give up if you don’t wake up with clear skin after a few days.

Another popular OTC ingredient is salicylic acid, often found in acne cleansers and toners. Salicylic acid is a beta-hydroxy acid that gently exfoliates inside pores, helping to unclog them. It’s great for treating blackheads and whiteheads by removing dead skin cells and excess oil. Many acne face washes in Australia contain 1–2% salicylic acid – for example, medicated cleansers you can pick up at Chemist Warehouse or your local pharmacy. Like benzoyl peroxide, salicylic acid may cause some dryness or stinging at first. Start slowly (e.g. using it once daily) and moisturize if needed. If your skin gets too irritated, take a short break for a few days and then resume once it calms down​.

Aside from these, you might encounter other OTC treatments such as azelaic acid (an acid that can unplug pores and also help with redness or pigmentation) and sulfur-based spot treatments. These can be helpful for mild acne or as add-ons. It’s a good idea to talk to a pharmacist about which OTC product might be best for you​. A pharmacist can guide you to a proper acne cleanser or gel based on your skin type. Don’t rely solely on flashy advertisements or well-meaning friends’ advice – a healthcare professional’s input is more trustworthy. For some people with very mild acne, just using a gentle cleanser and oil-free (“non-comedogenic”) moisturizer regularly might be enough to keep pimples at bay. But if you’ve given OTC remedies a solid try (usually a couple of months of regular use) and your acne is still troublesome, it may be time to consider prescription options.

Prescription Treatments for Acne

When drugstore creams and gels aren’t doing the trick, a doctor can prescribe stronger treatments. Prescription acne therapies range from medicated creams to oral pills – we’re now moving into the “scripts” part of acne care. General practitioners (GPs) handle most acne cases in Australia and can prescribe various medications as needed. In more severe cases, a dermatologist (skin specialist) might be involved for advanced treatments. These are the main prescription options:

• Topical retinoids: These are vitamin A derivatives that you apply to the skin. Common examples are tretinoin cream (Retin-A) or adapalene gel (Differin). Retinoids help by unblocking pores and promoting cell turnover – essentially they prevent the formation of new comedones (clogged pores) and reduce inflammation. They are great for treating blackheads, whiteheads, and superficial acne. Topical retinoids are usually applied at night (because they can make you sun-sensitive). Early on, you might notice some redness or peeling – this is normal. Start using them every other night and then nightly as your skin adjusts, and use a gentle moisturizer to minimize irritation. Over several weeks, retinoids can significantly improve skin texture and reduce breakouts​.
• Antibiotic treatments: Antibiotics can be used in two ways for acne – topically or orally (by mouth). Topical antibiotic lotions (like clindamycin or erythromycin gels) can reduce bacteria on the skin and are often combined with benzoyl peroxide in a single product to boost effectiveness and prevent bacterial resistance. Oral antibiotics, on the other hand, work from the inside to reduce the bacteria Propionibacterium acnes (now renamed Cutibacterium acnes) and tame inflammation. Doctors commonly prescribe oral tetracycline antibiotics such as doxycycline or minocycline for moderate acne. A typical course might last a few months. You’ll usually use topical treatments (like a retinoid or benzoyl peroxide) alongside oral antibiotics​ – this combo approach helps hit different causes of acne and also prevents antibiotic resistance​. Antibiotics can rapidly calm down red, angry pimples, but they are not meant for long-term solo use. Once the acne is under control, the oral antibiotic is stopped and you might continue with just topicals to maintain the improvement.
• Hormonal therapy (for females): If you’re a female with acne that might be hormone-related (for example, flare-ups around your period or acne persisting into adulthood), doctors might suggest treatments that target hormones. One option is the combined oral contraceptive pill (birth control pill). Certain birth control pills can help clear acne by regulating hormones that cause oil production. Another medication is spironolactone, an oral anti-androgen medication that isn’t officially an “acne drug” but is often used off-label for adult women with stubborn hormonal acne. Spironolactone works by blocking androgen (male hormone) receptors, thereby reducing oiliness of the skin. These hormonal treatments can take a bit longer to see results (a few months at least), but many women find them very effective for deep, cystic acne along the jawline or chin. Of course, these require a prescription and discussion with your doctor about risks (for example, the pill isn’t suitable for everyone). The Australian health guidelines acknowledge that hormonal agents like the pill or anti-androgens can be useful additions for female patients.
• Isotretinoin (Accutane): This is often considered the “last resort” but also the closest thing to an acne cure for severe cases. Isotretinoin is an oral retinoid (a powerful vitamin A derivative) used for severe cystic acne or acne that causes scarring and hasn’t responded to other treatments. In Australia, isotretinoin is commonly known by the original brand name Roaccutane. It’s a potent medication that essentially works on all causes of acne: it dramatically reduces oil production, helps unplug pores, and has anti-inflammatory effects. A typical course lasts about 4–6 months, after which many people’s acne goes into long-term remission. In fact, after a completed course of isotretinoin, most people are cured of their acne​. This can be life-changing for those with very severe acne. However, isotretinoin comes with significant side effects (we’ll discuss those shortly), so it’s prescribed with caution. Generally, dermatologists prescribe isotretinoin in Australia​, though some GPs with dermatology experience may start patients on it as well. If you’re started on isotretinoin, you’ll have regular check-ins and possibly blood tests to monitor your health during treatment. Despite the scary reputation, isotretinoin can be safely used under medical supervision and has a very high success rate for severe acne.

With any prescription, you’ll need to consult a doctor first. Your GP will assess your skin and decide on the best treatment or combination of treatments​. Keep in mind that it’s not uncommon to use multiple treatments together – for example, a topical retinoid at night and a benzoyl peroxide wash in the morning, or an oral antibiotic alongside a topical regimen. Combining therapies can yield better results than using one alone, because acne has multiple causes (clogged pores, bacteria, oil, inflammation). Today it’s easier than ever to access medical help for acne. You can visit your local clinic or even get prescriptions online through telehealth services. (For instance, NextClinic is an Australian telehealth platform where you can consult a GP via video and potentially get an online prescription for acne treatment, or a referral to see a dermatologist, all without leaving home.) The key is that you don’t have to struggle alone with severe acne – effective medications are available with a doctor’s guidance.

When to See a GP or Dermatologist

So, when should you move from DIY acne care to seeking a medical opinion? A good rule of thumb: if you’ve been using over-the-counter treatments consistently for about 6–12 weeks with little improvement, or if your acne is moderate to severe from the start, it’s time to see a doctor​. Mild acne (a few pimples here and there) can often be managed with pharmacy products and good skincare habits. But you should consider seeing a GP if:

• Your acne hasn’t improved after a few months of using OTC treatments (like benzoyl peroxide or salicylic acid).
• You have moderate acne – meaning a lot of pimples, or pimples that are red and inflamed – or you have painful cysts/nodules under the skin.
• You notice any scarring or dark marks developing. Early medical treatment can prevent acne scars​, so don’t wait for scars to get worse.
• Your acne is causing you significant distress or affecting your self-esteem. If you’re really upset or anxious about your skin, even “mild” acne warrants seeing a doctor for help.

A GP can assess your acne and prescribe tailored treatments specific to your skin’s needs​. They’ll also check if there are any signs that you should see a dermatologist. In Australia, GPs often handle acne first-line, but for very stubborn or severe cases (like cystic acne with risk of scars), a GP can give you a referral to a dermatologist​. You might especially be referred to a dermatologist if isotretinoin is being considered, since oral retinoids are usually initiated by specialists here​. Dermatologists have the expertise for advanced treatments and can supervise things like isotretinoin therapy safely.

Don’t be shy about seeking medical help – acne is one of the most frequent reasons people visit doctors, and it’s absolutely valid to do so. Early intervention can save you from years of frustration and permanent scars. As mentioned, telehealth has made this easier: you can now consult a GP online and get a prescription online if appropriate. For example, through NextClinic’s telehealth service, a doctor can evaluate your acne over a video call or photos and prescribe treatment, or send a referral for you to see a dermatologist, all electronically. These online prescriptions are legal and just as valid as a paper script, and you can have the medication delivered or pick it up at your local pharmacy. This is a convenient option if you can’t easily get to a clinic.

In summary, see a GP when acne is not responding to OTC methods or is affecting your life. See a dermatologist if your GP recommends it for severe cases – especially if considering isotretinoin, which, after a full course, has a very high chance of clearing up acne for good​. Getting professional help is not an overreaction; it’s the best step toward clear skin when drugstore remedies alone aren’t enough.

How Long Until Acne Treatments Work?

One of the most important things to know about treating acne is that results take time. In a world of quick fixes, it can be frustrating that that new pimple cream or prescription gel doesn’t seem to work overnight. Patience is key – dermatologists emphasize that you should give any acne treatment at least 4 to 6 weeks to start working​. In fact, it’s common to only see noticeable improvement after about 2 to 3 months of consistent use​.

This means if you start a new routine or medication, stick with it as directed and resist the urge to hop from one product to the next every few days. Switching treatments too frequently can actually worsen acne or irritate your skin​. For example, using a salicylic acid wash one week, then abandoning it for a tea tree oil the next week, then trying someone’s DIY mask – this kind of inconsistent approach often backfires. Instead, pick a plan (ideally one your doctor or pharmacist recommends) and give it a fair trial.

You should start to see small signs of improvement by about a month in – maybe fewer new pimples, or existing ones healing a bit faster​. If by 6–8 weeks there’s zero change, or things have gotten significantly worse, check back with your doctor to tweak the plan. Otherwise, you may need to continue for a full 12 weeks or more to really judge the effectiveness. Many acne treatments, especially retinoids, have an initial adjustment period (sometimes called the “purge” or breakout phase) where things might even seem slightly worse before they get better. This is temporary, and it’s important to push through with consistent use unless the side effects are truly intolerable.

Once your skin does clear up, don’t abruptly stop everything. Acne has a tendency to come back if you discontinue treatment too soon. For example, if a topical retinoid got you clear, you may need to keep using it a few nights a week as maintenance. Or if oral antibiotics helped, you’d stop those after the prescribed course, but continue with a good topical regimen to keep results. In essence, consistency – both in the short term and long term – pays off. Think of acne treatment like a marathon, not a sprint.

It can be emotionally hard to wait it out when you’re feeling self-conscious, but try to stay positive. Take progress photos every few weeks; sometimes improvement is so gradual that you don’t notice until you compare how you looked a while back. And remember, you’re not alone – acne is incredibly common and there’s no shame in having it while you work towards clearer skin.

Managing Side Effects of Acne Treatments

Almost every effective acne treatment comes with some side effects. Knowing what to expect and how to manage these side effects will make your journey much easier. Here we’ll cover common issues and tips to deal with them:

• Dryness and irritation: This is by far the most common side effect, especially with topical treatments like benzoyl peroxide and retinoids. These products can dry out your skin, leading to flakiness or a tight, red feeling​. To combat this, use a gentle, fragrance-free moisturiser daily. Don’t be afraid to moisturize even if you have oily, acne-prone skin – keeping your skin hydrated can actually reduce irritation and doesn’t necessarily worsen acne if you use a non-comedogenic (won’t clog pores) product. If you experience peeling or redness from a new cream, you can start applying it every other day instead of daily, and gradually increase frequency as tolerated. Also, use a mild cleanser (avoid harsh scrubs or excessive exfoliation which can further irritate). If your skin becomes very dry or irritated, take a short break from the active treatment (a few days off) and then restart more slowly. Your skin often adapts over a few weeks.
• Sun sensitivity: Some acne treatments make your skin more sensitive to the sun. Retinoids (both topical and oral isotretinoin) and tetracycline antibiotics like doxycycline are known to cause photosensitivity. This means you can burn more easily. It’s important to protect your skin from UV rays: wear sunscreen (SPF 30 or higher, broad-spectrum) every morning, and reapply if you’re outdoors. Also wear a hat and avoid intentional tanning. This isn’t to say you have to hide indoors, just be mindful that your skin needs a little extra protection while on these meds. Sunscreen will also help prevent dark spots or hyperpigmentation that can occur after pimples heal.
• Stomach or systemic side effects (from oral medications): Oral antibiotics can sometimes cause gastrointestinal upset – e.g. doxycycline might give you nausea or diarrhoea​ if taken on an empty stomach. The workaround is to take these pills with a full glass of water and, if allowed, with a meal (check if the specific antibiotic has to be on an empty stomach; doxycycline usually can be taken with food, which helps). Antibiotics may also alter your normal bacteria balance, occasionally leading to things like yeast infections in women or gut flora imbalance. These are not super common, but let your doctor know if you develop new symptoms while on an antibiotic. Notably, doxycycline can also reduce the effectiveness of the oral contraceptive pill in some cases, so use backup contraception if advised. Oral contraceptives and spironolactone might have side effects like headaches, mood changes, or menstrual cycle changes – these should be discussed with your doctor when considering treatment, and weighed against benefits.
• Isotretinoin side effects: Because isotretinoin (Accutane/Roaccutane) is so potent, it has a long list of side effects. The most universal one is dryness – dry skin, dry chapped lips, and dry eyes/nose. Nearly everyone on isotretinoin needs a good lip balm (carry one with you at all times!) and a rich moisturizer. Your lips may peel and crack without constant hydration, and your skin might feel like sandpaper if you don’t moisturize. Applying a plain lip balm and moisturizer multiple times a day is a must​. Some people get nose dryness or mild nosebleeds – using a saline nasal spray or a dab of petroleum jelly in the nostrils can help. You might also experience your skin getting red or easily sunburnt (again, sunscreen is non-negotiable)​. Less commonly, isotretinoin can cause joint or muscle aches, and very rarely can affect your liver or cholesterol levels (hence why doctors sometimes do blood tests during treatment).
• Mood and other concerns on isotretinoin: In the past, there have been concerns about isotretinoin and mood changes (like depression), but definitive scientific evidence is mixed. Many dermatologists believe isotretinoin is safe for mood in most people, but as a precaution, they will monitor your mental well-being and advise you to report any mood swings or depressive symptoms. This is something to be aware of, not scared of – the majority of patients do not experience psychiatric side effects, and some actually feel happier as their skin clears up. Always communicate with your doctor if you notice any changes.
• Absolutely no pregnancy on isotretinoin: The single most serious precaution with isotretinoin is that it causes birth defects. If a woman becomes pregnant while on isotretinoin, or even within a month after stopping, there is a very high risk of severe congenital abnormalities in the fetus​. Therefore, doctors will require female patients to use strict contraception (usually two forms, e.g. the pill plus condoms) during isotretinoin treatment and for a month after. Regular pregnancy tests may be done. This is a non-negotiable aspect of therapy because of how dangerous isotretinoin is to an unborn baby​. Men taking isotretinoin do not have this concern, although they should not donate blood during treatment (in case that blood were given to a pregnant woman). The pregnancy issue is why in Australia, isotretinoin is often managed by specialists and in a controlled manner. As long as these precautions are followed, isotretinoin is a very safe medication for the patient themselves.

With all medications, communication with your doctor is important. Most side effects are manageable with simple steps like those above. Your doctor can also adjust doses or switch medications if side effects are too troublesome. For example, if doxycycline makes you too nauseous, a different antibiotic or a lower dose might be tried. If a topical cream is irritating, your GP might recommend a different formulation or adding a soothing product to your routine. Don’t be afraid to speak up about side effects – there are “strategies you can use to manage them”​, and your healthcare team will have tips and alternatives.

Lastly, remember that side effects are often temporary. As your skin gets used to a retinoid, the initial irritation usually subsides. As you finish an antibiotic course, any minor gut disturbances will resolve. And once you complete an isotretinoin course, your lips and skin return to normal moisture (and you’ll hopefully have much clearer skin to show for it!). By being prepared and proactive, you can navigate the side effects without derailing your treatment.

By now, we’ve uncovered the spectrum of acne treatments from simple creams to potent prescription pills. The journey to clear skin can be a bit of a rollercoaster – it takes time, and you might hit a few bumps (or pimples!) along the way. The key takeaways are: be patient, stay consistent with your routine, and seek help from professionals when needed. Acne is not your fault, and you shouldn’t feel embarrassed to get proper treatment. With modern options (including the ability to get prescriptions online through Australian telehealth services) and a bit of perseverance, you can manage acne effectively. Keep your head up and stick with the plan – clearer days are ahead.

Below, we answer some frequently asked questions to recap and clarify common points about acne treatment:

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Disclaimer

This medical blog provides general information and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with your regular doctor for specific medical concerns. The content is based on the knowledge available at the time of publication and may change. While we strive for accuracy, we make no warranties regarding completeness or reliability. Use the information at your own risk. Links to other websites are provided for convenience and do not imply endorsement. The views expressed are those of the authors and not necessarily representative of any institutions.