Antibiotics are an acne treatment used to kill acne-causing bacteria. They may be applied directly on the skin (topical) or taken by mouth (oral). Topical antibiotics kill bacteria in the upper portion of your pores, while oral antibiotics can reach to the lower depths of the pores. Antibiotics used for acne treatment include, clindamycin, or tetracyclines like doxycycline or minocycline. These antibiotics are the most effective for treating acne because they both kill bacteria and act as anti-inflammatory agents to calm down the skin.
But, sometimes a particularly aggressive blemish is truly on a mission to leave its permanent mark. "Acne scars occur when normal tissue in the skin is destroyed and replaced with fibrous tissue. You can think of an acne lesion as a wound. When the damage caused by acne is severe, the body can respond by creating too much tissue or too little tissue. The production of too much tissue forms a keloid or a hypertrophic scar, and too little tissue leads to that depression in the skin, or atrophic scar. The deeper and more inflamed the acne lesion, or the more that it is picked or squeezed, the more likely it is to scar," says Dr. Bowe.
Fractional laser treatment is less invasive than ablative laser treatment, as it targets only a fraction of the skin at a time. Fractional lasers penetrate the top skin layers, where its light energy stimulates collagen production and resurfaces the top layer of the epidermis. Treatments typically last between 15 and 45 minutes and effects become visible in 1 to 3 weeks.
This unique ability of cocoa butter to lock moisture at deeper levels of your skin makes it effective in healing your acne scars. This way, it keeps your skin hydrated. A well-hydrated skin can only regrow skin tissue. New skin tissue in place of scarred ones definitely will give you a blemish free skin. Thus, when you apply cocoa butter daily, you help your damaged skin to get repaired.
Ablative lasers deliver an intense wavelength of light to the skin, removing thin outer layers of the skin (epidermis). In addition, collagen production is stimulated in the underlying layer (the dermis). Patients are typically numbed with local anesthetic and the ablation is done as an outpatient procedure. CO2 and erbium are the ablative lasers most often used for acne scar treatment.
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).

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.
Prescription Medications. Medications that affect hormones, like birth control pills, can help control acne. You might also discuss antibiotic pills and prescription retinoids with your dermatologist. There are also antibiotics that are effective. Doctors may prescribe Aldactone (spironolactone), which was first made to treat high blood pressure, to treat acne. "That works miracles but it can take three months to kick in," Day says. Isotretinoin is another prescription drug for acne, but you can't take it if you're pregnant or planning to get pregnant.
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.
Do not—we repeat, do not—even think about attempting to get this out yourself. "With deep zits, there’s no exit strategy, so if you’re pushing on it to try to get rid of it, it could actually leak sebum into the dermis and cause more lesions," explains Dr. Hale. Instead, this is the time to visit your dermatologist for a cortisone injection, which should take care of it in 24 hours. If you're sitting here wondering why doctors don't just shoot all of your zits up with cortisone, that's because that it can actually lead to scarring or even a depression in your skin, especially with smaller zits, says Dr. Chwalek. That's why cortisone shops reserved for the oversize monsters like these.
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.
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