People trying to lose weight or build muscle are often encouraged to take photos along their journey—there's nothing more motivating than visible progress. I applied the same logic to my breakout. I took a photo of it at its worst to start, then continued. The second photo you see is one week after doing all of the above—you definitely see remnants of the breakout but they are not as active nor as inflamed (they're also flat and easy to cover up with my BFF, concealer). The last photo is four weeks later after me following these tips religiously—all clear.
In occasional cases, patients may use short-term topical cortisone (steroid) preparations of minimal strength to reduce local inflammation. Some mild steroids include desonide lotion or hydrocortisone 1% cream applied sparingly once or twice a day just to the irritated areas. There is a risk of causing a rosacea flare by using topical steroids. Prolonged use of topical steroids on the face can also cause irritated skin around the mouth (perioral dermatitis).
People who escaped their teen years almost pimple-free may develop persistent adult-onset acne as they get older. Despite the normal increase in androgen levels during puberty, some doctors believe that flare-ups of acne have less to do with androgen levels than with how a person's skin responds to an increase in sebum production or to the bacteria that causes acne. The bacteria Propionibacterium acnes occurs naturally in healthy hair follicles. If too many of them accumulate in plugged follicles, they may secrete enzymes that break down sebum and cause inflammation. Some people are simply more sensitive than others to this reaction. Sebum levels that might cause a pimple or two in one person may result in widespread outbreaks -- or even acute cystic acne -- in another person.
In unusual cases, a skin biopsy may be required to help confirm the diagnosis of rosacea. Occasionally, a dermatologist may perform a noninvasive test called a skin scraping in the office to help exclude a skin mite infestation by Demodex, which can look just like rosacea (and may be a triggering factor). A skin culture can help exclude other causes of facial skin bumps like staph infections or herpes infections. Blood tests are not generally required but may help exclude less common causes of facial blushing and flushing, including systemic lupus, other autoimmune conditions, carcinoid, and dermatomyositis.

Some of us are more at risk for acne scars than others, although there is no way to say for sure who will develop scars after acne and who will not. These scars tend to occur more commonly after inflammatory acne, especially when it’s not treated early and aggressively. Other risks include picking squeezing or popping zits. (But whatever you do, never, ever pop a zit in the “danger triangle.”) Genetics can also play a role. “The earlier that acne gets treated, the better,” says Dr. Levine. “If somebody has active acne at 13 or 14, we want to jump on it.” Some scar resurfacing treatments also help keep acne at bay, she says. Dr. Imber adds that Youth Corridor RetinUltimate Transforming Gel applied twice daily can help treat active acne and prevent recurrence. Next, find out how to get rid of acne once and for all.
"Other good over-the-counter options are benzoyl peroxide-containing agents," says Dr. Engelman. "I like La Roche-Posay Effaclar Duo. Benzoyl peroxide is anti-microbial, attacking the bacteria that is associated with acne. The La Roche Posay product also contains Lipohydroxy acid (LHA), which serves as an exfoliator to smooth roughness and even out skin texture."
Take a fresh lemon and squeeze out its juice. Apply this juice directly on your scars with fingertips or a cotton ball, leave it for ten minutes and wash it off with water. Do this once a day for two to three weeks during which you can see your scars diminish considerably. If you want, you can also mix honey with your lemon juice to make it some more effective in reducing the acne scars.
Post-inflammatory hyperpigmentation is not an acne scar, but a red, pink, brown or tan skin discoloration where acne has previously flared up. It will usually disappear on its own in a year or so. Many skin lightening products claim to help reduce the visibility of these acne “scars." Their active ingredient, hydroquinone, works to slow melanin production and can reduce dark brown marks, but melanin isn't the cause of red and pink acne discolorations. A better option is to use the best foundation for acne prone skin you can find to hide the marks until they naturally fade away.
Spot treatments are key for treating a pimple ASAP. Benzoyl peroxide is often vilified for being harsh, but when it comes to really zapping a zit, it should be your best friend. Just dab it on the trouble spot to dry it out and kill bacteria. For heavy-duty action, try Neutrogena Rapid Clear Stubborn Acne Spot Gel; for something gentler, we like Arithmetic Acne Control Complex, which has soothing ingredients to counter the drying effects and is made with adult skin in mind.

The bad news: There's no secret ingredient or miracle gadget that makes scars totally disappear. Don't get discouraged, though. A lot of what you think is acne scarring is really just hyperpigmentation or erythema (brown or red spots) rather than an actual change in the texture of the skin. Plus, there's a bevy of gels, creams, and treatments that can bring that discoloration down. We asked top dermatologists to recommend the most effective of the bunch.

Punch excisions: "This procedure is best for those with icepick scars, which aren't as wide as rolling or boxcar scars," says Dr. Shah. "If you use a punch excision on a scar that's wide at the surface, you're making a bigger punch and trading in one scar for another," she says. "Your dermatologist will numb up the area and use a tiny cookie-cutter like device to cut out the scar, and then sew it closed with a tiny stitch. The stitch is removed in less than a week," says Dr. Bowe. However, Dr. Idriss cautions against this method for those with darker skin or undertones who are prone to hyperpigmentation.


You've probably seen the Proactiv clear skin system advertised on television at some point over the last several years, but does it work? Proactiv is one of the better acne remedies out there for mild cases of inflammatory and noninflammatory acne, hormonal acne, and adult acne. The basic kit comes with a gentle glycolic acid and benzoyl peroxide exfoliator, a benzoyl peroxide pore cleanser, and an oil-free moisturizer that contains both glycolic acid and salicylic acid. Prices and shipping rates vary by location but Proactiv typically starts at $30.
Over-the-counter retinol or vitamin A can also help. Anolik says retinols can be incredibly effective, especially higher-strength prescription retinoids: “They’re the gold standard in acne and aging treatments.” The prescription versions, from Tazorac to Differin, are usually covered by insurance in the case of acne. Vitamin C can also treat pores and exfoliate; Tammy Fender’s System ($165, tammyfender.com) comes with a vitamin C toner.
This powerful, medicated cleanser delivers a luxuriously whipped texture and three percent sulfur to address acne and blemishes, draw out impurities, and target congested pores. Honey and rice bran extracts calm redness, while natural oat extract addresses excess sebum. With continued use, this gentle, yet effective daily cleanser leaves skin clearer with visibly minimized pores.
I couldn't just let the worst breakout ever live on without a visit to the dermatologist, so I went to BeautyRx founder Dr. Neal Schultz. He gave me this incredible "Z Stick" spot treatment that contains mild cortisone (the same substance derms use to inject pimples to make them die down in 24 to 48 hours), and Clindamycin, an antibiotic. I applied this every morning and evening to all my spots and it acted like an extra layer of armor against further inflammation. Sadly, it's prescription-only and/or only available through Dr. Schultz's practice in New York—but he's working on making one for consumers.
13. You're still a sun-worshipper. You're probably already aware that lying out in the sun and going to tanning beds cause skin cancer, but if that still hasn't stopped you from hitting the beach without sunscreen or the proper protective gear (aka that chic sun hat), perhaps this will. Contrary to popular belief, the sun isn't healing your acne, it's actually making it worse. What happens is, as your face gets red from the sun, it makes any breakouts you might already have blend in, creating the appearance of clearer skin. But what's really going on is the sun causing your skin to dry out and triggering more oil production, which can lead to more zits.
If you have body acne, taking a shower as soon as possible after working out is also key. It turns out that standing around in tight, sweaty workout clothes puts you at the greatest risk for body acne and rashes. “The whole idea is that the bacteria that live on the skin can get trapped in the hair follicles and cause inflammation,” says dermatologist Dr. Elizabeth Hale. “The more you work out in the heat the more likely this is.” Dr. Levin agrees that showering right after a workout is your best defense against body acne. But in a pinch, body wipes like the Yuni Shower Sheets will do the trick.
Since there is some overlap between acne and rosacea, some of the medications may be similar. Acne and rosacea have in common several possible treatments, including (but not limited to) oral antibiotics, topical antibiotics, sulfa-based face washes, isotretinoin, and many others. It is important to seek a physician's advice before using random over-the-counter acne medications since they can actually irritate skin that is prone to rosacea. Overall, rosacea skin tends to be more sensitive and easily irritated than that of common acne.
Apply fresh lemon juice. Lemon juice has natural skin bleaching properties, and can help to effectively lighten your acne scars. Simply combine equal parts lemon juice and water and apply this liquid directly onto your scars, avoiding the surrounding skin. Wash off the lemon juice after 15 to 25 minutes or you could put the lemon juice on overnight as a mask.

If you’ve made a concerted effort with over-the-counter regimens and/or diet and still aren’t seeing results, a dermatologist is absolutely worth it. There are many levels of care: Prescription retinoids (Retin A, Tazorac, Differin et al) and/or topical antibiotics are the mildest, along with blue-light treatments like Isolaze, which kill bacteria and clear pores, with virtually no downtime. Light lasers like Clear and Brilliant can clear pores and treat the red and brown tones left by old acne lesions. “Some patients think they’ve got a severe problem, when they really only have a few pimples, surrounded by red and brown marks from old breakouts,” notes Anolik. Oral antibiotics represent a more aggressive (and unsustainable long-term) solution; birth control pills and hormone-mitigating medications like Spironalactone and Deldactone can get many more-severe patients’ acne under control. Most aggressive is Accutane; while it can be severely drying and can cause birth defects if taken during pregnancy, it represents a cure for truly-severe acne cases, says Anolik. “Used correctly, it is something of a miracle for people who’ve tried everything and failed,” he says.
20. Know your options. Benzoyl peroxide products are great at fighting pimples, but can be drying to your skin, so use them only once a day (or every other day). If it's drying out or irritating your skin, switch out your cleanser for a gentle formula. (Keep up your regular acne spot treatment, but use just a dab!) It will clear away dirt and oil without stripping your skin of moisture. Salicylic acid (in creams, gels, astringents, or masks) dries less than benzoyl peroxide, so it can be used with more-drying cleansers.
If you have body acne, taking a shower as soon as possible after working out is also key. It turns out that standing around in tight, sweaty workout clothes puts you at the greatest risk for body acne and rashes. “The whole idea is that the bacteria that live on the skin can get trapped in the hair follicles and cause inflammation,” says dermatologist Dr. Elizabeth Hale. “The more you work out in the heat the more likely this is.” Dr. Levin agrees that showering right after a workout is your best defense against body acne. But in a pinch, body wipes like the Yuni Shower Sheets will do the trick.
Moderation and regularity are good things, but not everyone can sleep eight hours, eat three healthy meals per day, and drink plenty of water a day. Probably the most useful lifestyle changes one can make is to never to pick or squeeze pimples. Playing with or popping pimples, no matter how careful and clean one is, nearly always makes bumps stay redder and bumpier longer. People often refer to redness as "scarring," but fortunately, it usually isn't permanent. It's just a mark that takes months to fade if left entirely alone.
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