Once the spots have cleared, acne commonly flares up again if you stop treatment. Therefore, after the spots have gone or are much reduced, it is common to carry on with a 'maintenance' treatment to prevent acne from flaring up again. It is common to need maintenance treatment for 4-5 years to keep acne away. This is typically until the late teens or early 20s. In a small number of cases, acne persists into the 30s, or even later. For these people it is possible to continue to treat the skin to keep it under control.
Maintenance treatment is usually with either benzoyl peroxide or a topical retinoid. These can both be used indefinitely. The dose used to prevent spots from returning is often lower than that used to treat acne. For example, one application to the skin every other day with a low strength preparation may be sufficient to keep spots from returning.
It is not usual to use topical antibiotics (or antibiotic tablets) as maintenance treatment once the spots have cleared. This is because long-term use of antibiotics can lead to resistance of germs to the antibiotics. Also, azelaic acid, another topical treatment, is only licensed for treatment periods of six months. Therefore, if at first you are treated with an antibiotic or azelaic acid, you may be advised to switch to benzoyl peroxide or a topical retinoid for maintenance treatment.
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