Search this site Search Home Page
Search Tips

members Home
Peter Yao, MD 

Instructions On Using Acne Medications

INSTRUCTIONS ON ACNE MEDICATIONS

2% salicylic acid wash. A liquid wash for acne. (Neutrogena makes good acne washes).

Comes in a bottle and is over the counter (no prescription needed). It contains 2% salicylic acid, which helps to control acne. Use this to wash your face and wherever else on your body that you may have acne. Usually the other common location for acne will be on your chest and back. Wash one section at a time. Start with your face, and then proceed to your chest and back as needed. Wet the area first. Pour out about a dime size amount onto your palm; lather it, and wash your face with a gentle massaging motion for about 30 seconds. DO NOT SCRUB THE SKIN AS THIS WILL CAUSE IRRITATION. Take special effort to rinse your face thoroughly with water, especially the nasal creases. Failure to do so will cause the nasal crease skin area to crack and burn and sting, not a very pleasant experience. If necessary, proceed to washing the chest and back in the same manner. You will need more of this product for this part of your body. This wash should be used only to areas with acne. It's not meant to be used over the entire body. Use your regular soap or body wash for the rest of your body. Give your face and chest and back one final rinse with water before you step out of the shower. Begin using the wash just once daily for the first 2 weeks. DO NOT OVER USE IT INITIALLY. If you can tolerate it after this period of time, you may begin to wash your face with this product twice daily, usually this means once in the morning and once at night. Unless you take 2 showers a day, otherwise just wash your face in the sink the other time of the day. You may not see improvement in your acne for at least 2 to 4 weeks. So hang in there and continue to use it unless it is causing intolerable side effects, which will include redness, extreme dryness, burning sensation, peeling or puffiness. They usually can be avoided if you go slow with the wash initially.

ANY ACNE MEDICATION, BE IT A WASH, CREAM OR GEL CAN CAUSE SKIN IRRITATION IF TOO MUCH IS USED TOO SOON, TOO LONG, TOO FREQUENTLY. THE CONTROL OF ACNE REQUIRES TIME AND PATIENCE AND PERSISTENCE. ONE CAN'T GET ACNE UNDER CONTROL IN A MATTER OF DAYS OR EVEN WEEKS (LESS THAN 4 WEEKS SOMETIMES). THEREFORE, USING TOO MUCH MEDICATION WILL ONLY LEAD TO SKIN IRRITATION AND DISCOMFORT. REMEMBER, THE GOAL OF ACNE THERAPY IS TO CONTROL YOUR ACNE AND SCARS, AND NOT TO TURN YOUR FACE INTO A RED LOBSTER. GO SLOW AND DON'T RUSH IT. THE SIDE EFFECTS ARE REDNESS, DRYNESS, PEELING, BURNING SENSATION, AND PUFFINESS.

Benzoyl peroxide 5% or 10% aqueous gel.

This comes in a tube and is over the counter (no prescription needed). It is a very good medication to control and kill the bacteria responsible for causing acne, and also reduces the acne inflammatory process. It can be used both in the morning and at bedtime. THIS PRODUCT CAN BLEACH YOUR FABRIC AND CARPET. Therefore, use it with care. Apply this medication only to the face down to the jaw line. If you need to use this on your neck, be careful to stay away from your clothes. Always put your shirt on first before putting this medication on your face for obvious reasons. When you are done wash your hands and under the nails with ample soap and water and dry them on a towel, not on your clothes. I recommend that you begin using this gel in the morning. I would start out just twice a week, for example, Sunday and Thursday, or Monday and Friday, or Tuesday and Saturday, or Wednesday and Sunday. Do this for 2 weeks. If you can tolerate it without significant side effects, then proceed to using it every other morning for 2 weeks. Use a calendar to help you keep track. If again you can tolerate it, you are now ready to use this every morning. Usually you leave this on your face all day until you are ready to wash your face or take a shower at your regular time. If you are using an acne wash to your face, you can apply this gel to your face about 10 to 15 minutes after it is thoroughly dried with a towel. The acne medication always has to go on the face first, then you can apply anything else after that such as your makeup, moisturizing lotion or sunscreen. You should see improvement in your acne in about 4 weeks.

Benzaclin gel (contains both benzoyl peroxide and clindamycin). It requires a prescription. It comes in a jar. The instruction is the same for using Benzoyl peroxide above. Due to the bleaching, I recommend this to be used in the morning on the face only. It will not bleach your skin or hair, just fabric and carpet.

INSTRUCTIONS FOR APPLYING BENZOYL PEROXIDE GEL, BENZACLIN GEL,BENZAMYCIN GEL, DIFFERIN CREAM OR GEL, TAZORAC CREAM OR GEL OR RETIN-A PRODUCTS TO THE FACE.

THE PROPER APPROACH IS TO USE THE SO CALLED GREEN PEA SIZE, 4-DOT METHOD.

IT TAKES ONLY 4 GREEN PEAS TO COVER YOUR ENTIRE FACE. SQUEEZE OUT AN AMOUNT EQUAL TO A GREEN PEA, AND DIVIDE THAT INTO SEVERAL DOTS ON YOUR FOREHEAD. TAKE ANOTHER GREEN PEA, AND DIVIDE THAT INTO SMALLER DOTS ON YOUR LEFT CHEEK. REPEAT THIS FOR YOUR RIGHT CHEEK. TAKE ANOTHER GREEN PEA AND DIVIDE IT ON YOUR NOSE, UPPER LIP, AND CHIN. IF THERE IS ACNE ON YOUR NECK, USE TWO GREEN PEA SIZED MEDICATION TO COVER THE ENTIRE NECK. YOU ARE NOW READY TO SPREAD THE MEDICATION ALL OVER YOUR FACE AND NECK USING A GENTLE MASSAGING MOTION WITH YOUR FINGERTIPS UNTIL THERE IS A THIN AND EVEN COATING ALL OVER YOUR FACE ( FROM YOUR HAIRLINE TO YOUR JAWLINE, SPARING YOUR EYES) AND UNTIL THE MEDICINE COMPLETELY DISAPPPEARS INTO YOUR SKIN. DO NOT OVERUSE. A THIN, EVEN COATING IS ALL YOU NEED.

Differin 0.1% cream, gel or solution. This medication requires a prescription.

The cream is more suited for someone with dry skin.

The gel is more for someone with an oily complexion.

The solution is for extremely oily skin. It is also the most irritating form of Differin.

Differin is a form of Retin-A. It is, however, more potent and powerful, more effective, and yet has fewer side effects, and easier to use than Retin-A.

The advantages of Differin over Retin-A are

1) Differin can be applied to the face as soon as it is thoroughly dried with a towel; there is no waiting time as in Retin-A (usually at least 20 minutes after the face is dried).

2) Differin is not light sensitive, and, therefore, does not usually require the use of a sunscreen in the morning. However, in the central valley where it can get up to the high 90s to low 100s, it may be a good idea to use a sunscreen anyway to protect the skin from the harmful effects of the sun.

Differin is applied at nighttime to the entire face and can also be applied to the chest and back as needed . Once again, start out slowly and gradually work up to every night usage.

I recommend that you begin using Differin for just 3 hours everyday for one week. For example, apply it to the entire face and chest and back (if needed) early in the evening, and wash it off in 3 hours. Do this during your waking hours. If you can tolerate it, then increase the time to about 5 to 6 hours every night for week two. If you have little to no side effects, then consider using Differin overnight by the 3rd or 4th week. In this case you will apply Differin at bedtime, and do not wash it off until the next morning. Apply the Differin using the petite green pea size 3 dot method. Remember, Differin may at first slightly worsen your acne before it makes it better. It doesn't happen in every case though.

With all these medications, your skin may get a little dry or irritated. Therefore, you may need a moisturizing lotion to reduce the dryness. I recommend something such as Cetaphil moisturizing lotion for this purpose. This is also over the counter. You can use this as needed. Always be sure that the acne medication goes on the face first.

If you are motivated and use your medication faithfully, you should begin to see improvement in your acne in about 6 weeks. Remember, we can not get rid of your acne, we can control it.

There are several oral antibiotics available for the treatment of acne. The more common ones are Tetracycline, Doxycycline, Minocycline, Erythromycin.

 


Disclaimer
If you think you have a MEDICAL OR PSYCHIATRIC EMERGENCY, CALL 911 IMMEDIATELY or go to the nearest hospital. DO NOT attempt to access emergency care through this web site. An emergency medical condition is a medical or psychiatric condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in any of the following: serious jeopardy to your health, serious impairment to your bodily functions, or serious dysfunction of any bodily organ or part. An emergency medical condition is also "active labor," which means a labor when there is inadequate time for safe transfer to a Plan hospital (or designated hospital) before delivery or if a transfer poses a threat to the health of the member or unborn child.

This site may contain links to other web sites outside of www.permanente.net. Kaiser Permanente has no control over the content or the availability of these sites, and is not responsible for the privacy practices or the content of such Web sites. Web links are provided as an educational tool, and should not be relied upon for personal diagnosis or treatment. A link or reference to a web site should not be construed as an endorsement of the site or its contents. Any medical content that you feel may be important to your health should always be discussed with your Kaiser Permanente physician.