Extraction reactions: When performed correctly, extractions can be very helpful in getting rid of whiteheads, blackheads, and even pimples. But that’s when they’re performed correctly. Getting extractions from anyone other than an experienced aesthetician or dermatologist can lead to facial scarring and severe inflammatory acne. Some believe that all extractions lead to larger pores, and a larger likelihood of developing more severe acne, however many aestheticians refute the claim.
Use oil-free makeup. If you wear makeup, you may be stuck in a vicious cycle of covering up acne while simultaneously causing it with your cover-up usage. Find acne-fighting oil-free mineral makeup to help prevent worsening your acne while simply trying to hide it. Power foundations are also recommended. When possible, avoid wearing make-up at all though as it clogs your pores over the course of the day.
Your body is capable of taking care of your scars and they will get lighter with time. However, if you expose them to the sun, their healing process will slow down and the scars will get darker. So, avoid the sun. If it’s essential to go out in sun, use sunscreen to guard your skin and also cover yourself with hat, umbrella, clothes- whatever you can lay hands on.
Comedo (whiteheads or blackheads) or papules. The comedo is the basic acne lesion, which is a plugged pore. If the plugged pore stays under the skin, it's called a closed comedo and forms a white bump or whitehead. Blackheads are comedos that open up and appear blackish on the surface of the skin. This black color is not due to dirt, but because the air reacts with the excess oil.
Photodynamic therapy (PDT) is one of the newly available treatments. PDT uses a topical photosensitizer liquid that one applies to the skin and a light to activate the sensitizer. Levulan (aminolevulinic acid) and blue light, commonly used to treat pre-cancers (actinic keratosis) and acne vulgaris, can treat some rosacea patients. The use of PDT in rosacea is off-label, since it is primarily designed for regular acne. PDT works at reducing the inflammation; PDT is performed in a physician's office. The treatment takes anywhere from one to one and a half hours to complete. Strict sun avoidance for approximately one to three days is required after the treatment. Mild discomfort during the treatment and a mild to moderate sunburn appearance after the treatment is common. Some patients have experienced remissions (disease-free periods) of several months to years from these types of treatments. Other patients may not notice significant improvement.
Oral antibiotics: Doctors may start treatment with tetracycline (Sumycin) or one of the related "cyclines," such as doxycycline (Vibramycin, Oracea, Adoxa, Atridox, and others) and minocycline (Dynacin, Minocin). Other oral antibiotics that are useful for treating acne are cefadroxil (Duricef), amoxicillin (Amoxil, DisperMox, Trimox), and the sulfa drugs.
Like acne on your face, back acne occurs when your pores become blocked with oil and dead skin cells.. Exfoliating your back regularly might help remove these dead skin cells and pore-clogging debris before they have a chance to block pores. However, you want to take care not to scrub too hard, especially if you are experiencing an active breakout. Use a soft cloth to gently brush away surface impurities as you shower.
Acne scar treatment: “Rolling scars can be treated with microfat injections followed by microneedling with platelet-rich plasma (PRP),” says Dr. Imber. Microneedling creates tiny wounds or pinpricks in the skin. The body’s natural, controlled healing process then kicks in to boost internal collagen production. Microneedling is also a great acne scar treatment because it opens up channels within the skin that give PRP—the healing factors in your own blood—and skin care products direct access to deeper layers of the skin where they’re needed most. PRP is created by taking some of your blood, isolating the platelet-rich plasma, which contains proteins and other growth factors, and injecting it back into the scar. “The objective is to build up the collagen layer under the depression in order to raise it to the level of the surrounding skin,” Dr. Imber says. You’ll likely need multiple treatments, but the results are worth it. This approach is backed up by a new study in the January 2017 issue of Aesthetic Plastic Surgery, which found that fat plus PRP improve depressed scars alone and in combination with laser skin resurfacing. What’s more, the treatment improved the social life and relationships of people with scarring, the study showed. These are the innocent habits that practically guarantee your acne will scar.
Worried moisturizer will make your acne worse? Think again — it can actually help improve your skin. “If the skin surface is dry and dehydrated, the oil glands tend to overproduce oil and this can make acne worse,” Dr. Weiser says. “Hydrating the skin surface can re-balance oil glands and help control acne and improve healing.” When buying a moisturizer, she recommends looking for a lightweight, oil-based product that won’t clog your pores. Dr. Levin likes Differin Soothing Moisturizer because it's "a great lightweight pH balanced moisturizer you can use in combination with acne topical treatments."
Rolling scars can look like little saucers, giving the skin a wavy texture. Lasers that resurface the skin are Dr. Karolak's top treatment pick for this type of scar, and Dr. Sobel agrees. "Many scars can be improved with lasers such as the matrix CO2, which remove the outer layers of skin, burning away the scar tissue and stimulate new collagen production," he says. "Non-ablative lasers such as the Fraxel can help activate the production of collagen without damaging the surface of the skin." Keep in mind, that these laser treatments can take a bit of recovery time and require multiple treatments to see results. For a quicker solution, your dermatologist can plump the bowl-like scar with fillers like Juvederm, Restylane, or Bellafill.
So if popping pimples doesn't cause scarring, what does? Long-lasting scars typically turn up after a recurring bout with cystic acne. Cystic acne is a breakout that burrows deep into the skin. These red, painful nodules occur when clogged pores are filled with pus and bacteria, which causes inflammation. Cystic breakouts are often tied to an internal fluctuation of hormones like testosterone (that's why they're common during puberty, monthly menstruation, and perimenopause). "If there is a cyst in the skin, it's going to cause a scar the longer it sits there because pus or bacteria deeper inside the pores cause surrounding inflammation," says Dr. Karolak. And as a result, the inflammation affects the collagen production as well as the fat stores under the skin, creating a visible scar on the surface.
Millions of teens and adults alike have had some form of acne at some point in their lives. It is a very common occurrence, and each type of acne that exists affects a different cross-section of people. However, what is important in every single case is finding a reliable acne treatment so symptoms go away quickly and without all that much hassle or expense.
"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."

Although acne remains largely a curse of adolescence, about 20% of all cases occur in adults. Acne commonly starts during puberty between the ages of 10 and 13 and tends to be worse in people with oily skin. Teenage acne usually lasts for five to 10 years, normally going away during the early 20s. It occurs in both sexes, although teenage boys tend to have the most severe cases. Women are more likely than men to have mild to moderate forms into their 30s and beyond.
Scrubbing your face daily with grainy cleansers and exfoliating products can do more harm than good. When done too often, it can cause redness, inflammation, and irritation. “Exfoliating a pimple can pull away healthy skin cells and create an open wound and higher risk for scarring,” says Jessica Weiser, MD, from New York Dermatology Group. “Exfoliation should be done with caution, and not more than 2-3 times a week maximum.”

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
×