• They should form part of just about all acne treatment plans.
• Not to be used at the same time as benzoyl peroxide – use Benzoyl peroxide in the morning and retinoid at night.

• Increased exfoliation.
• Decreased clogging of pores.
• Less pimples and comedones.
• Less Inflammation.
• Less hyperpigmentation.
• It helps to enhance the penetration of other products into the skin.

• A Retinol Peel is available as a professional product applied once every 6-8 weeks at a doctor’s office.
• Apply retinoid cream at night.
• Use pea size amount of cream for the whole face.
• Apply to clean dry skin.
• Irritation may be reduced by waiting 20 min after face wash.
• Start with low dose cream and gradually increase strength.
• Side Effects include skin dryness, flaking and sun sensitivity which usually resolves after few weeks of treatment.
• Should not be used in pregnancy and breastfeeding.

• The retinoid is in the form of isotretinoin also known as Roaccutane, Accutane or Orotane.
• In addition to the above list – It works by reducing the oily production in the skin and shrinking the oily gland.
• Should preferably be used in the few selected cases where severe nodular and or cystic acne is present and  the normal treatment of antibiotics, topical retinoids and/or hormonal treatments have failed.
• This medication WILL seriously harm an unborn baby  if taken during pregnancy.
• Women have to comply with precautions in terms of birth control or agree to abstinence during course of treatment.
• One month after stopping the treatment no further risk exists for falling pregnant.
• This medication may cause liver abnormalities and abnormal cholesterol (triglycerides) levels – therefore monthly blood tests are required.
• It causes  dryness of the mouth, lips, nose, eyes, and skin, which usually improves within few weeks of being on the treatment.
• A treatment course usually lasts 16-20 weeks.
• A Treatment course may put acne into remission.

• Effectiveness of the antibiotics is increased when used with benzoyl peroxide and/or retinoids.
• Should never be used alone as a treatment for acne due to possible bacterial resistance.

• Clindamycin and erythromycin mostly used.
• To be applied twice a day usually.

• Ideally used 3-4 months WITH retinoid product.
• May be prescribed as pulses – for example, few days out of week or 1-2 weeks out of month.
• May repeat course of 3-4 months after break of few months.
• Usually higher doses for the first month of treatment and then decreased to lower maintenance dose.
• Thrush and gastrointestinal side effects are most common with antibiotic use.

• Combined Oral Contraceptives and Spironolactonens.
• They are usually tolerated very well and side effects are mild.
• They should not be used when there is a very strong family history of strokes, deep vein thrombosis or heart attacks.
• They should be used with caution in smokers.
• Best results usually with the use of Retinoids also.