How long is treatment needed?
Whatever treatment is used, it is normal to take up to four weeks for there to be any noticeable improvement in the skin. There is often a good response to treatment by six weeks. However, it can take up to four months (sometimes longer) for maximum response to a treatment, and for the skin to be generally free of spots. The most common reason for a treatment failure is because some people think that treatment is not working after a couple of weeks or so, and give up.
Therefore, persevere with any treatment for at least six weeks before deciding if it is working or not. If there is no improvement after six weeks of taking a treatment regularly and correctly, do not despair. Adding in another treatment, or a change to a different or more powerful treatment will usually be advised, and is likely to work. Although treatment can usually clear most spots, no treatment will make your skin perfect, and the odd spot may remain.
Will acne return after treatment?
Once the spots have cleared, acne commonly flares up again if you stop treatment. Therefore, after the spots have gone or are much reduced, it is common to carry on with a 'maintenance' treatment to prevent acne from flaring up again. It is common to need maintenance treatment for 4-5 years to keep acne away. This is typically until the late teens or early 20s. In a small number of cases, acne persists into the 30's, or even later. For these people it is possible to continue to treat the skin to keep it under control.
Maintenance treatment is usually with either benzoyl peroxide or a topical retinoid. These can both be used indefinitely. The dose used to prevent spots from returning is often lower than that used to treat acne. For example, one application to the skin every other day with a low strength preparation may be sufficient to keep spots from returning.
It is not usual to use topical antibiotics or antibiotic tablets as maintenance treatment once the spots have cleared. This is because long-term use of antibiotics can lead to resistance of germs to the antibiotics. Also, azelaic acid, another topical treatment, is only licensed for treatment periods of six months. Also, it is best not to take 'the pill' long term solely to prevent acne. Therefore, if at first you are treated with an antibiotic, azelaic acid or 'the pill', you may be advised to switch to benzoyl peroxide or a topical retinoid for maintenance treatment.
© EMIS and PIP 2006 Updated: June 2006 PRODIGY Validated
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