Acne vulgaris is a common condition, and there is significant demand for effective acne therapies. Many over-the-counter products are marketed. In addition, a number of procedural therapies are utilized for the treatment of acne vulgaris with variable effectiveness.
The use of over-the-counter and light-based therapies as well as several adjunctive therapies (office-based chemical peels, microdermabrasion, comedo extraction, intralesional glucocorticoids, and heat therapy) will be reviewed here. Conventional therapies, hormonal therapy, and isotretinoin therapy for acne vulgaris are discussed separately. (See "Treatment of acne vulgaris" and "Hormonal therapy for women with acne vulgaris" and "Oral isotretinoin therapy for acne vulgaris".)
OTHER TOPICAL MEDICATIONS
For many people with acne, treatment begins with non-prescription regimens. Numerous products are available, and non-prescription treatments are effective for some individuals. Some of the most common ingredients found in non-prescription acne products include salicylic acid, benzoyl peroxide, sulfur, and alpha hydroxy acids. Tea tree oil has also been used for treatment of acne.
Patients with mild to moderate acne who do not respond to non-prescription products after three months of treatment should be clinically evaluated. Patients with more severe acne should be evaluated earlier, to consider the use of the most effective treatment regimens to prevent or minimize scarring.
Salicylic acid — Salicylic acid (0.5 to 2%) is a beta hydroxy acid available in a number of non-prescription gels, lotions, solutions, cleansers, pads, and masks. It is a desquamating agent, and its lipophilic properties enable it to penetrate the pilosebaceous follicle, producing a comedolytic effect . Topical salicylic acid also possesses mild antiinflammatory properties.