Acne is caused when the pores in your skin become blocked with oil, bacteria or dead skin cells. In your pores, there are glands that release an oil called sebum, which helps to keep your skin moisturized. With clear skin, your oil glands release the right amount of sebum and your pores remain clear of bacteria and dead skin cells. However, when your body releases too much sebum or there is an overgrowth of acne-causing bacteria, pores can become blocked and cause acne.

While nearly everyone experiences acne to some degree, some people experience occasional mild acne, while others have constant, severe acne. Mild acne may not have a root cause and may be treatable with homemade remedies or over-the-counter acne medications like salicylic acid or benzoyl peroxide. Severe acne, and especially hormonal acne, may require a prescribed treatment from a dermatologist.

Cystic acne is a severe type of acne characterized by inflamed, painful cysts deep under the skin and inflamed, red acne on the skin’s surface. Acne cysts are typically infected and difficult to treat with over-the-counter medications. Because cystic acne is painful and long-lasting, treatments from a dermatologist can be the most effective option. A dermatologist can look at your skin and prescribe a clinical-strength medication, either topical or oral, which can treat your cystic acne and keep it away for good.

Hormonal acne is caused when certain hormones, especially androgens, cause an overproduction of sebum, clogging pores and causing breakouts. Hormonal acne can often flare up during menstrual cycle changes, pregnancy or puberty, but some women experience constant and annoying hormonal acne. Because androgens are often the root cause of hormonal acne, treatment typically involves reducing the level of androgens. Many women take oral contraceptives (birth control pills) for their skin benefits, and others take spironolactone, a diuretic with anti-androgen properties.

Painful acne is typically caused by inflamed and infected cysts deep in the skin. It is the infection and inflammation that causes the irritation and pain, so painful pimples can best be treated with medication that reduces inflammation, namely a hydrocortisone cream or a corticosteroid shot from a dermatologist. If you consistently get painful pimples, you may have cystic acne and should talk to a dermatologist about treating the root cause of your acne with a prescription topical or oral acne treatment.

Most people have acne at some point during their lives and some people struggle with acne throughout their adult lives. The duration of acne depends on its cause. If you have a constant issue with excess sebum on your skin, acne could go on indefinitely without treatment. On the other hand, acne may be temporary and go away on its own. After starting a new acne treatment, it typically takes at least a month to start seeing results, as the skin needs time to turn over and heal.

With antibiotic medications like doxycycline, you may start to see improvement after just a couple weeks as the p. acnes bacteria begin to clear. With hormonal treatments, it may take significantly longer to see results. With all acne treatments, the full effects of treatment should be visible in approximately three months.

The key to getting rid of adult acne, and all acne, is to determine the root cause of the acne breakouts and treat the cause. Problematic cystic acne that doesn’t respond at all to over-the-counter or topical medications may be hormonal in nature and need treatment with hormonal contraceptives or spironolactone. If the acne is primarily papules, pustules and redness, a treatment with tretinoin and clindamycin might be the best option. Dermatologists are able to examine your acne and prescribe you the right treatment.

Stubborn acne is really just acne that hasn’t been attacked with the right treatment method. If you are trying to treat your acne with drugstore benzoyl peroxide, but your acne is hormonal, the treatment will not be effective. If you have tried every over-the-counter acne treatment, it is important to visit a dermatologist to figure out what is causing your stubborn acne and develop a treatment plan. A dermatologist can prescribe a variety of medications that are prescription-only, such as antibiotics and stronger retinoids. Even stubborn acne can be eliminated with the right treatment.

The best acne treatment is usually a personalized prescription treatment plan developed with a dermatologist. Some people can treat their acne with routine face care or over-the-counter treatments. People with an overgrowth of acne-causing bacteria may respond best to topical clindamycin cream or oral doxycycline. Women who are experiencing severe hormonal acne may need to consider oral contraceptives, spironolactone or a combination of both. A dermatologist can help you figure out which treatment is going to work the best for your specific acne.

There are three types of birth control that are FDA-approved to treat acne. These are Ortho Tri-Cyclen, Estrostep and Yaz. All of these pills are combination birth control pills, which contain both estrogen and progestin. Other oral contraceptives have also been shown to treat acne, but have not received FDA approval. However, progestin-only pills, also called the “mini-pill,” typically do not have the same effect on acne and some progestin-only birth control actually makes acne worse. If you have acne, it is important to discuss this with your doctor when choosing birth control.

Sometimes, a combination of spironolactone and birth control is used to treat acne. This is an excellent combination because it is important to prevent pregnancy while on spironolactone, and the birth control provides added anti-acne benefits. Talk to your doctor about whether birth control is the best option to treat your acne.