Medical Treatments for Acne & Oily Skin

​Oily Skin can strike anyone - woman or man, from your average Joe, to A-list celebrities.  While most people tend to believe that oily skin and acne are just “teenage problems”, if you were born with large & overactive sebaceous glands, you will battle oily skin for your entire life. If you have it, you hate it. And, chances are if you have oily skin, you also suffer from acne breakouts.

While most articles claim that using over the counter products like face masks, lotions & gels will help stop your oily skin, they are really only effective for those with mild oily skin problems, or very mild acne.

Those of us with severely oily skin and breakouts need to bring out the big guns! Recently, some new treatments have emerged to target the source, where the problem starts. Here's a run-down of the best treatments for oily skin and acne, to permanently rid yourself of these complexion busting nightmares. 

Treatments to Shrink Sebaceous Glands

If sebaceous glands are the culprit cause for oily skin, wouldn’t you think that by shrinking these glands, your skin would produce less oil? You would be right! Luckily, scientists have discovered a few methods for shrinking sebaceous glands, controlling oil, and preventing acne.

Accutane (Isotretinoin) is a chemical cousin of Vitamin A, which actually shrinks sebaceous glands. When the glands become smaller, they cannot produce as much oil. Without all that oil to clog pores, occurrences of acne breakouts drastically decrease.

Accutane was very popular in the 1990’s because it was a highly effective way to control oil and reduce acne breakouts. Some people reported side effects such as decreased liver function and depression during treatment with this prescription drug.  As a result, it is difficult to find now. You may want to ask your dermatologist if it is available, or check online if there are ways to order Accutane without a prescription. It can also be found under the names Claravis, Sotret and Amnesteem. ​

How does Accutane work? The ingredients in Accutane target sebaceous glands and physically shrink them, thereby reducing oil production and acne for 10-15 years after treatment is completed.  During your 6 month course of Accutane, you should not drink alcohol (since the medication can temporarily decrease liver function), and should not get pregnant (as it can cause birth defects). 

Do Vitamin A supplements Work the Same as Accutane?
Not really. It may seem that since the effective ingredient in Accutane is a cousin to Vitamin A, taking the supplement by itself would have the same effect. Unfortunately, this isn’t true. Due to slow absorption rates by the body, supplementing with Vitamin A allows for only a slight reduction of breakouts and sebum production. Even when higher doses are taken, the body cannot absorb all the product, and it ends up being excreted in urine.

Accutane is effective because its main ingredient Isotretinoin (also known as 3-cis-retinoic acid), is rapidly absorbed from the gastrointestinal tract. Studies have also shown that Isotretinoin can be reabsorbed from bile, so that none goes to waste.

Who should use Accutane? This treatment is best suited for those with moderate to severe acne, cystic acne, and exceptionally oily skin. If you have tried a variety of topical treatments but have not had positive results, Accutane is an excellent choice.  Topical treatments normally just penetrate through the Epidermis (outer layer of the skin), and cannot reach the Reticular Dermis (inner layer of skin) where sebaceous glands are found. Accutane targets the problem at its source, shrinking these oil-producing glands. When pores stop becoming clogged with oil, breakout frequency is reduced. 

By doing an image search on Google, you can find hundreds of successful before & after photos of people who have used Accutane.  "I battled acne all through my teen years and was a social outcast in high school because of it”, says Accutane user Ada Hunt.  “I went on Accutane at age 18, and it changed my life. Now 6 years later, I still have clear skin. My only regret is that I didn’t start using it sooner.” ​

Method #2: Blue Light Therapy

On our “What Causes Acne & Oily Skin?” page, we explain how P. acne bacteria is responsible for acne outbreaks. So is there a way to kill Propionibacterium Acne Bacterium? Yes!  With Blue Light Therapy. During this treatment, an aesthetician will place the blue light a few inches away from your skin.  The blue light will trigger molecules within P. acnes to produce free radicals, which will in turn kill the P acnes bacteria. ​

Blue Light Therapy can either be done at home, in a dermatologist’s office, or at a salon. Hand-held blue light devices can be found online for $70 - $150.  Hand held lights are best for those who only experience a few trouble spots of acne, since they provide targeted light to one area at a time. Table Top Blue Light devices are more pricey (from $175 - $350), because they provide the blue light to your entire face. These are best for people with severe acne breakouts on the entirety of their complexion. Some Blue Light devices also come with the option for a red light, which helps reduce inflammation so that skin recovers faster from an acne breakout.

While Blue Light Therapy alone won’t shrink sebaceous glands, it will kill the P. acne bacterium surrounding the glands to help you become acne-free. (Read on to find treatments that will also shrink sebaceous glands.)   ​

Method #3: Intense Pulse Light Therapy ​

​Intense Pulse Light (IPL) Therapy entails the use of topical medication, such as Levulan or Metvix (which make skin more receptive to light). This is followed by the Light Pulse treatment to shrink sebaceous glands. Pulse Light is used directly on the skin, in targeted areas, to both reduce oil gland activity and P. acnes bacteria. This can also help in reducing scars left by acne. The patient must undergo these treatments 1x per month for 4-6 months initially, and then follow-up with 1 treatment once every 2-3 months.  
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Method #4: Diode Laser Therapy 

Diode Laser Therapy is the best method for permanently shrinking sebaceous glands to control oily skin. In extreme cases, it can even destroy sebaceous glands within the dermis (your thick middle layer of skin). It will not harm the outer layer of skin, and only has mild side effects such as redness and puffiness, which normally dissipate within 48 hours. As an added bonus, Diode Therapy increases collagen production, which minimizes the appearance of acne scars.
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With Laser Therapy, you can expect a minimum of 4 consecutive monthly treatments from a dermatologist or aesthetician – but unlike Light Therapy, you don’t need to continually return for maintenance treatments. If you are not interested in risking drug therapy like Accutane, this is definitely your best bet for permanently shrinking sebaceous glands. While the Diode Laser does not kill P.acnes bacteria, most people find that shrinkage of sebaceous glands is enough to control even severe acne. In some patients, another series of treatments is needed 5-6 years after the initial treatment, but this is rare. ​

Method #5: Carbon Laser Peel 

​One of the most popular new solutions for problem skin is a Carbon Laser Peel. Think of this as an amped up charcoal mask.  The carbon (in addition to the power of the laser light) extracts dirt, oil, and old makeup from pores.  It also exfoliates to remove dead skin cells. The result is a smooth, fresh surface, immediately after treatment. In addition, these treatments encourage skin to produce more collagen and elastin – providing long lasting results to keep skin looking plump and healthy for years to come. 

​The best part? Little or no down time! This treatment might trigger slight redness, but no peeling unlike harsh chemical remedies.  

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​If you only have mild skin problems, 1-2 treatments should be sufficient. However, if you have deeply pitted acne scars, and excessively large pores, it would benefit you to get 4-6 treatments. These are normally spread a few weeks apart, so your skin has time to recover and rebuild in between. 

Before and After a Carbon Laser Peel - Reduced Pores and Smooth Complexion

Before and After a Carbon Laser Peel - Reduced Acne Pitting

Method #6: Experimental Virus Therapy ​

Scientists at UCLA are working on a method of controlling P.acnes bacteria with a harmless virus called bacteriophages. The phages already exist in our pores (but not in large enough quantities to prevent P.acnes from taking over). By boosting the effect of phages to target and kill P.acnes in the form of a topical cream, the negative effect could be reduced and acne brought under control.

How to Kill Acne Bacteria?

The researchers used over-the-counter pore cleansing strips to collect the bacteria and P. acnes phages from the noses of two groups of volunteers: those with acne and those with clear skin. The phage genomes were sequenced and it was found that on top of their powerful ability to destroy P. acnes bacteria these viruses are also small and have limited genetic diversity making them fitting candidates for building targeted antimicrobial drugs. The researchers explain that the lack of genetic differences from phage to phage makes it difficult for bacteria to form resistance.

In her study Propionibacterium acnes Bacteriophages Display Limited Genetic Diversity and Broad Killing Activity against Bacterial Skin Isolates, Laura Marinelli states “phages are programmed to target and kill specific bacteria, so P. acnes phages will attack only P. acnes bacteria, but not others like E. coli." Her study, published in the American Society for Microbiology’s mBio journal gives hope for virus therapy acne treatment.  “This trait suggests that they offer strong potential for targeted therapeutic use."