Mild acne will often respond to prescription topical treatments (creams and ointments) including benzoyl peroxide, topical antibiotics and topical retinoids. Over the counter products containing retinol, retinoids, AHAs, azelaic acid and salicylic acid can also be of benefit. Where topical treatments are not effective the next step would be tablet treatments such as antibiotics or the oral contraceptive pill (for women).
Moderate acne will not generally respond to over the counter products and also may not respond to prescription topical treatments on their own. It will often require tablet treatments such as antibiotics, the oral contraceptive pill (females only) spironolactone (females only) or isotretinoin (roaccutane).
Inflammatory acne affecting the chin and jawline area in women can be driven by increased levels of the male sex hormone testosterone (which is naturally present at low levels in women as well). Topical treatments tend to be less effective, however tablets which block the male sex hormone such as spironolactone or the oral contraceptive pill can be effective.
With severe acne there are widespread lesions and it is important to treat promptly and effectively to minimize scarring. This will almost always require a systemic (tablet) treatment