In most cases, acne products need to be used for at least 30 days before you can begin to ascertain its efficacy. Some skin and acne types may see noticeable results in a few days and end up totally clear in just a few weeks. Others may take several weeks to see the slightest change, or need to have their regimen adjusted as their skin adapts. Treating acne can often be a months-long process.
Every expert we spoke with said the most critical part of combating acne is combating it every day. “The only way to make any medication work is to use it on a daily basis,” says Dr. Green. Fitz Patrick emphasizes that it really comes down to what you can maintain for the long term: “Kits are great because they take out all the guesswork -- you just follow the instructions. But if four steps is going to be too many for you to keep up week after week, you’ll be better off finding one that has fewer treatments.”
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Azelaic acid has been shown to be effective for mild to moderate acne when applied topically at a 20% concentration. Treatment twice daily for six months is necessary, and is as effective as topical benzoyl peroxide 5%, isotretinoin 0.05%, and erythromycin 2%. Azelaic acid is thought to be an effective acne treatment due to its ability to reduce skin cell accumulation in the follicle, and its antibacterial and anti-inflammatory properties. It has a slight skin-lightening effect due to its ability to inhibit melanin synthesis, and is therefore useful in treating of individuals with acne who are also affected by postinflammatory hyperpigmentation. Azelaic acid may cause skin irritation but is otherwise very safe. It is less effective and more expensive than retinoids.
The key is patience — don’t pick up a new cleanser and expect to see dramatic results right away. While you may be able to spot-treat a pimple or two overnight, it can take weeks before you really see a difference from switching cleansers. “It’s about trying different brands with different strengths and giving it sufficient time to work,” says Anna Avaliani, MD, a cosmetic and laser skin care specialist in NYC.
Considerations: Benzoyl peroxide is able to produce complete clearing of acne only when used in an adequate dosage and within a properly applied benzoyl peroxide regimen. Some dryness, redness, and itchiness is to be expected in the first few weeks of use.6 Scientists call this initial period the "hardening effect" of benzoyl peroxide. About 1-3% of people are allergic to benzoyl peroxide and experience an inflammation of the skin or severe crusting.3This should not be confused with the "hardening effect" of benzoyl peroxide. Benzoyl peroxide, like any other peroxide, can bleach hair and fabric.1
Scars (permanent): People who get acne cysts and nodules often see scars when the acne clears. You can prevent these scars. Be sure to see a dermatologist for treatment if you get acne early — between 8 and 12 years old. If someone in your family had acne cysts and nodules, you also should see a dermatologist if you get acne. Treating acne before cysts and nodules appear can prevent scars.