The different treatments for acne can be thought of as a ladder starting with over the counter products, moving up through prescription topical treatments (creams, ointments and lotions) and then on to tablet treatments. Generally as this ladder is ascended the treatments are more effective, however there can be a greater potential for side effects.

In most cases, patients will have tried over the counter and prescription topical (creams, ointments and lotions) treatments prior to moving on to tablet treatments. However, there are are certain scenarios where is is reasonable to move on to tablet treatments sooner

Where acne is moderate or severe, particularly where there is evidence of scarring, it is unlikely that topical treatments will prove effective and important to find an effective treatment rapidly to minimize the permanent consequences of scarring.

The combined oral contraceptive pill (OCP) can be an effective treatment for acne in women. Where women are considering the OCP for contraception the presence of acne can be another reason to start since certain brands of the OCP, such as Yasmin, have additional activity in blocking the action of the male sex hormone testosterone and can be particularly effective for acne.