Many theories about diet and acne abound; Anolik is most convinced by the ones surrounding sugar and dairy. “Dermatologists really didn’t believe in all the dietary restrictions for acne, but studies in the past ten years have convinced us a bit,” he says. “Dairy and high-glycemic foods do seem to play a part.” High-sugar diets are known to feed bacteria; any diet that increases overall inflammation in the body doubtlessly plays a part. Specific diets—from Ayurveda to low-carb to veganism—definitely work for some people.
Common knowledge would dictate that most people are aware that certain foods, and in turn, the nutrients they contain, can be beneficial for specific body parts. For example, healthy bones require calcium and vitamin D; our hearts function better when we eat certain seafood that is rich in omega-3 fatty acids. However, this does beg the question as to what food promotes healthy skin?
Rosacea is a skin disease that causes redness of the forehead, chin, and lower half of the nose. In addition to inflammation of the facial skin, symptoms include dilation of the blood vessels and pimples (acne rosacea) in the middle third of the face. Oral and topical antibiotics are treatments for rosacea. If left untreated, rhinophyma (a disfiguring nose condition) may result.
8. You can't stop picking at your pimples. It's tempting in the moment, but it's never a good idea to play dermatologist, because it's impossible to pick your own pimple and not make a red mark that could turn into a scar. Even worse, when you try to press the plug or oil or puss out of your pore, you run the risk of pushing the bacteria deeper or spreading it around underneath your skin, multiplying your pimples.
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.
If you use hair sprays or gels, try to keep them away from your face, as they also can clog pores. If you have long hair that touches your face, be sure to wash it often enough to keep oil away. And if you have an after-school job that puts you in contact with oil — like in a fast-food restaurant or gas station, for example — be sure to wash your face well when you get home. It also can help to wash your face after you've been exercising.
Cysts, which are also called blind pimples, are the very worst kind of acne. Basically, cysts are made up of sebaceous content (again, a gross combination of oil, dirt, and bacteria) that's trapped beneath the skin and has no way out—so they just live and grow under the skin, causing both a bump and, in some cases, pain. "These take longer to resolve on their own, are less responsive to topical treatments, and over time may lead to scarring," says Dr. Chwalek. Um, no thanks.
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 inflammation caused by your breakout can cause more than just the pimple you see on the surface, it can also cause damage below the skin. "The inflammatory response produces a loss in collagen and the overlying skin will collapse and leave a depression," Howard Sobel, M.D., a NYC dermatologist and founder of DDF Skincare, tells SELF. To get rid of these tiny pockmarks, Dr. Karolak relies on a TCA Cross chemical peel. TCA stands for trichloroacetic acid. "We use a little applicator and go into the hole with chemicals to cause a burn. That causes the wall of that ice pick to heal itself and close in on itself," explains Dr. Karolak.
Scars that are indented aren't going to go away on their own and most likely need professional treatment. Talk to your derm about laser options, as well as subcision and microneedling—all proven methods to get rid of scarring. But those brown spots left behind once a zit goes away? You can treat them at home if you're diligent. Dr. Schultz says you have to stick to a regimen of daily sunscreen use, exfoliation, and application of a bleaching product that will help remove the excess pigmentation in the skin. Try Murad Rapid Age Spot and Pigment Lightening Serum.
Laser treatment may cause some discomfort. While most patients are able to endure the procedure, ice packs and topical anesthetic cream can help alleviate the discomfort. Multiple treatments are typically necessary, and most insurances do not cover the procedure. Doctors recommend treatments in three- to six-week intervals; during this time, sun avoidance is necessary. Review risk, benefits, and alternatives with a physician prior to treatment. Combine laser treatments with photodynamic therapy (light-activated chemical using Levulan) for more noticeable results.
Alcohol-based toners have been an anti-acne step since forever, but are so harsh and drying on skin that they can cause skin to produce even more oil, and they can irritate; as with benzoyl peroxide or any other irritant, they can further inflame a case of acne. But dabbing skin with witch hazel or non-alcohol toner (we love S.W. Basics’ toner with witch hazel and raw apple cider vinegar, $9.99, swbasicsofbk.com) can serve as a mild exfoliant, to unclog pores and deposit ingredients like tea tree oil or salicylic acid. Tea Tree Oil Facial Cleansing pads from Desert Essence ($7.99, desertessence.com) are particularly brilliant, combining both ingredients.
Not that you needed an excuse to pop open a bottle of bubbly, but if a pimple should threaten to ruin your evening out, reach for the Champagne. Its tartaric acid (found in grapes) is said to not only ease acne, but also to contain anti-aging properties. So, soak up a cotton pad with your champs, and apply it to the infected area (it won’t hurt to rub it on your whole face, either). High-class problems? We’ll drink to that!
Treatment of acne scars: For those patients whose acne has gone away but left them with permanent scarring, several options are available. These include surgical procedures to elevate deep, depressed acne scars and laser resurfacing to smooth out shallow acne scars. Newer forms of laser resurfacing ("fractional resurfacing") are less invasive and heal faster than older methods, although results are less complete and the procedures may need to be repeated three or more times. These treatments can help, but they are never completely successful at eliminating acne scars.
The exact cause of rosacea is still unknown. The basic process seems to involve dilation of the small blood vessels of the face. Currently, health researchers believe that rosacea patients have a genetically mediated reduction in the ability to dampen facial inflammation that is incited by environmental factors such as sunburn, demodicosis (Demodex folliculorum in the hair follicles), flushing, and certain medications. Rosacea tends to affect the "blush" areas of the face and is more common in people who flush easily. Additionally, a variety of triggers is known to cause rosacea to flare. Emotional factors (stress, fear, anxiety, embarrassment, etc.) may trigger blushing and aggravate rosacea. Changes in the weather, like strong winds, or a change in the humidity can cause a flare-up. Sun exposure and sun-damaged skin is associated with rosacea. Exercise, alcohol consumption, smoking, emotional upsets, and spicy food are other well-known triggers that may aggravate rosacea. Many patients may also notice flares around the holidays, particularly Christmas and New Year's holidays.
Contrary to popular belief, acne isn't caused by a harmful diet, poor hygiene, or an uncontrolled sex drive. The simple truth is that heredity and hormones are behind most forms of acne. Swearing off chocolate or scrubbing your face 10 times a day won't change your predisposition to this unsightly, sometimes painful, and often embarrassing skin problem.
True acne scars — as in indentations in the skin like ice-pick scars — can only be erased with professional procedures like microneedling or lasers. Fortunately, what most of us refer to as “scars,” according to Julia Tzu, M.D., founder and medical director of Wall Street Dermatology, are actually marks caused by post-inflammatory hyperpigmentation (brown spots) or post-inflammatory erythema (red spots), that will fade over several months or years. Fortunately, there are products that can speed up the process.
Other concerns include inflammatory bowel disease and the risk of depression and suicide in patients taking isotretinoin. Recent evidence seems to indicate that these problems are exceedingly rare. Government oversight has resulted in a highly publicized and very burdensome national registration system for those taking the drug. This has reinforced concerns in many patients and their families have that isotretinoin is dangerous. In fact, large-scale studies so far have shown no convincing evidence of increased risk for those taking isotretinoin compared with the general population. It is important for those taking this drug to report changes in mood or bowel habits (or any other symptoms) to their doctors. Even patients who are being treated for depression are not barred from taking isotretinoin, whose striking success often improves the mood and outlook of patients with severe disease.