Ask the Expert: How Do I Reduce My Persistent Acne?


There are so many acne cream medications with several types and brands on the shelves. So, which is the most effective to battle my acne problem? What else can be done to reduce my persistent acne?


Most acne sufferers resort, at least initially, to self treatment and in the case of mild acne, most will respond well to OTC treatments. For moderate to severe acne cases, you should consult your doctor or pharmacist for treatment options.

The severity and grading of acne will determine the types of treatment, which can be of either single agent or combination therapy.

  • Comedones – Topical retinoids (e.g. tretinoin, andapalene and tazarotene), azelaic acid
  • Mild inflammatory acne – Topical antibiotics (e.g. erythromycin, clindamycin), benzoyl peroxide or both
  • Moderate acne – Oral antibiotics (e.g. minocycline, doxycline, tetracycline, erythromycin);
  • Severe acne or moderate acne unresponsive to antibiotics – Oral isotretinoin
  • Cystic acne – Intralesional triamcinolone.

Benzoyl peroxide can be considered as first-line OTC treatment for acne. It has a keratolytic action and antibacterial properties.

For acne with endocrine disorders, anti-androgen (anti-male hormone) such as spironolactone – which has some anti-androgen effects – and cyproterone acetate have been used.

When To Seek Professional Help

See your doctor if:

  • It is acne in a baby or infant
  • Your acne gets worse or does not improve with self-treatment within eight weeks
  • Your pimples become large and hard or filled with pus (moderate to severe, or cystic acne)
  • Your acne began after starting a new medication (drug-induced acne)
  • You develop acne after being exposed to chemicals, oils or other substances (chemical-induced acne)
  • If there is a strong family history of acne, or you are emotionally affected or scarred by acne

Practical Pointers for Being Acne Free

The three basic points of focus are to (1) unclog pores, (2) kill bacteria, and (3) minimise sebum – and, to include these points in a good basic skin regimen.

For effective removal of comedones, you can apply hot compresses or steam to pustules and cysts, and to get facials. Never pick or squeeze pimples; if necessary use a comedone (pimple) expressor or extractor correctly.

Skin washes and soaps containing antiseptic agents such as chlorhexidine and tea tree oil, are useful to degrease the skin as well as to reduce the skin flora (bacteria). Wash the affected areas gently once or twice daily.

Sunlight (ultraviolet rays) can be helpful in some cases of acne due to its peeling effect and drying (or degreasing) of oil on the skin. Also, use a light skin moisturiser and oil-free or water-based makeup.

Treating acne requires patience and perseverance. Most treatments take two to three months to start working, and a period of up to six months may be required for maximum benefit. Patients must give each regimen or drug enough time to work before giving up on it and moving on to other treatments, unless there are severe side effects


[See also: Get Rid of Your Pimples: 6 Must Dos for Clear Skin]


Ask the Expert is where we answer questions on all aspects of your health and wellness. Send in your health-related questions to


Ask the Expert is where we answer questions on all aspects of your health and wellness. This panel of experts is facilitated by our content partner Only Health, which include Beldeu Singh, Datin Farah Diba Khan, Dr Ahmad Fauzi Md Sharif, Dr George Yap, Dr Harvinder Singh, Dr Kuljit Singh, Dr Leow Chee Seng, Dr Muhaya Hj Mohamad, Dr Shalini Kanagasingam, Dr Yap Yoke Yeow, Prof Dr Muhaya Hj Mohamad, and Prof Ong Kok Hai.

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