While over-the-counter products don’t treat the hormonal component of acne, salicylic acid—a.k.a. willow bark, a.k.a. what aspirin is made of—addresses all other aspects involved in a breakout. “It works,” says Anolik, who recommends using salicylic acid-based products in conjunction with benzoyl peroxide preparations that target acne bacteria with greater strength. Benzoyl peroxide can definitely cause dryness and irritation; if you decide not to use it, know that you’ve got to be even more vigilant about the bacteria on your skin, so cleanse and treat more often. Tea-tree oil preparations like Tammy Fender’s Clarifying Dermagel ($72, goop.com) help. Burt’s Bees Natural Solutions Acne Spot Treatment ($10, burtsbees.com) combines tea tree and salicylic acid for powerful (yet easy on skin) results.
"Fluctuation in hormones, such as before one's menstrual cycle, is the main cause," explains dermatologist Julia Tzu, M.D., of Wall Street Dermatology. Specifically, androgens (male hormones) like testosterone. This usually rears its ugly head in the form of deep (painful) cystic acne around the chin, neck, and back, says dermatologist Rebecca Kazin, M.D., F.A.A.D., of the Washington Institute of Dermatologic Laser Surgery and the Johns Hopkins Department of Dermatology.
There are many who recommend that those with acne-prone skin use non-comedogenic ingredients, that is, cosmetics designed to avoid clogging the pores. It’s best to use products that are labeled hypoallergenic and oil free, and some find that makeup products with salicylic acid help the skin remain clear. It’s also important to avoid applying layer upon layer of makeup.
Cystic Acne: The most severe type of acne, cystic acne requires dermatological care and prescription acne medication to treat. Even the best acne products available over the counter are no match for this painful condition in which the area of the outbreak becomes inflamed, but not infected. Cystic acne can result in permanent scarring. However, it's important to know that all acne lesions can scar. Scarring is related to size, amount of inflammation, genetics and delay in therapy.
The facialist, Tanya Eubanks, first exfoliates and steams my face. Then she uses her gloved fingers and a medical needle to perform extractions. And it is as painful as it sounds. The worst part is when I hear the noise of the needle pricking each cyst. It sounds like a tiny burst of air, which might not seem bad, but all I can think about is all the gunk coming out each time, and it makes me cringe. By the time she applies a mask to reduce redness, I've lost all feeling in my face.
Similar to the above natural acne remedies, these acne treatments can be inexpensive and worth giving a try. Best of all, these use products you probably already have in your household, like apple cider vinegar and toothpaste. Use home remedies for acne with caution if you have cystic acne, open sores, or inflammatory acne, which are best treated with medical supervision.
You’ll also learn how to prepare for your treatment. We’ll give you products to apply before your procedure to prime your skin and avoid pigmentation. You’ll also receive information on pain medication and the downtime you’ll need as you recover. If you decide to take time off work, you can schedule your procedures before a weekend or take a few days off.
Inflammatory Acne: Inflammatory acne is red bumps and pustules, not whiteheads, blackheads and comedones. It does not necessarily start as them, either. It arises on its own. Whiteheads, blackheads or comedones that become inflamed can be painful and unsightly. Persistent inflammatory acne may require treatment by a physician or dermatologist, in addition to over-the-counter acne remedies.
3. You're eating spicy foods. Spicy foods often contain tomatoes and peppers, which contain acidic lycopene that can be an irritant to some people, throwing off their skin's pH levels and triggering breakouts. However, it isn't just spicy foods that can irritate your skin. Some people have an aversion to dairy, bread, or other types of foods — how your skin reacts to what you eat just depends on your own personal make-up. (Tip via Dr. Downie.)

"Leafy green vegetables and other brightly-colored fruit and vegetables which are rich in antioxidants and nutrients dampen inflammation and improve skin quality (studies have shown acne patients have higher oil production and lower antioxidant levels)," says Dr. Weiser. "Limit intake of dairy products, which can contain hormones and antibiotics that can worsen acne breakouts." Other skin-boosting superfoods include eggs, nuts, legumes, and quinoa.
There’s no quick fix for acne. Medicines don't work overnight. Many treatments take weeks of daily use before your skin improves. Some acne may take up to 6 months to clear up. Afterward, basic skin care -- bathing daily and washing your face and hands with mild soap -- may not be enough. You may need to keep using your medicine even when your skin clears. Follow your doctor’s directions. Don’t use too much or too little.
Keloid bumps are generally discolored and raised. These scars form when the body tries to recover from the inflammation caused by cystic acne. According to Dr. Sobel, you can get a keloid if too many fibroblasts or dermal cells are produced during the healing process. The first step in treatment is to flatten the bump with a shot of cortisone. Then, you can follow up with other treatments like laser or retinol to even out the skin tone.
The spots that linger after a pimple has healed are caused by inflammation that has disrupted the skin's natural healing process. "When your skin is opened up (like when you pop a pimple) and then closes back together, you can get abnormal pigmentation, texture, and tone that looks different from the rest of your skin. Sometimes the broken blood vessels that remain after an acne lesion fades can result in a mark," says Dr. Bowe. For a number of people who are able to refrain from picking, inflamed pimples or blemishes can still leave a dark brown or red mark — but these naturally fade over the course of a few months, notes dermatologist Heather C. Woolery-Lloyd, MD.
When it comes to skin care, we're not usually ones for hard and fast rules. Everyone has unique skin types, skin tones, lifestyles, and genetic histories that make it impossible to have a single piece of one-size-fits-all advice. It can take years — and dozens of trips to the dermatologist — to discover how to treat acne effectively on your unique skin. But here at Teen Vogue, we've pretty much made it our life mission to figure out the best tips from the pros to point you in the right direction. They've seen it all and won't recommend it unless it's backed up by experience and science,.
lThis at-home skin peel available at Sephora tightens pores, reduces oil, helps retexturize skin and diminishes dark spots. It's paraben and sulfate free, non-comedogenic, and is not tested on animals. Use this peel each week as part of your clear skin regimen to help even out skin tone and gently remove unhealthy top skin layers, revealing new, healthier skin underneath.
Medications prescribed for mental illnesses can have the unfortunate side effect of causing acne. Some antidepressants have been purported to trigger acne breakouts, including brands like Wellbutrin and Lexapro. Those diagnosed with bipolar disorder are often prescribed lithium to help handle their condition. Unfortunately, lithium can cause acne breakouts. Often the benefits of these types of drugs outweigh the negative onset of acne, but it’s important to look into various options to determine what might have the minimal amount of side effects.
Topical (external) applications: Antibacterial cleansers come in the form of gels, creams, and lotions that are applied to the affected area. The active ingredients that kill surface bacteria include benzoyl peroxide, sulfur, and resorcinol. Some brands promoted on the Internet and cable TV (such as ProActiv) are much more costly than identical and sometimes more potent products one can buy in the drugstore.
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