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).
Even if battling zits is a distant memory, filed away with high-school gym class and algebra tests, acne marks and scars can annoyingly linger long after pimples are gone. “If someone gets a very large pimple or cyst, the natural healing process of the skin will create a scar,” says David Avram, M.D., of Heights Dermatology and Laser. “The more intense the inflammation, the more likely it will leave a scar.”
Common acne, known medically as Acne Vulgaris, is generally caused by hormonal changes in the body, and its onset usually can be found in teenage years when puberty rears its head. Acne is directly attributed to the rise of androgen hormone levels. The production of these hormones rise when a child begins puberty, and is the reason much acne is prevalent in adolescence. As androgen levels rise, the oil glands sitting directly underneath the skin enlarge and produce increased levels of oil, also known as sebum. When pores are filled with excessive sebum, it can cause surrounding skin cells’ walls to rupture and create a breeding ground of P. acnes bacteria. As the sebum attempts to push out of the pore, it can attach to this infectious bacteria and dead skin cells, causing a blockage that begins the formation of a pimple. According to Medical News Today, dermatologists purport that almost three quarters of 11 to 30-year-olds will deal with acne at some point, but acne breakouts can continue on into adulthood, and have been observed in patients in their fifties.
Oral contraceptives: Oral contraceptives (birth control pills), which are low in estrogen to promote safety, have little effect on acne one way or the other. Some contraceptive pills have been shown to have modest effectiveness in treating acne. Those that have been U.S. FDA approved for treating acne are Estrostep, Ortho Tri-Cyclen, and Yaz. Most dermatologists work together with primary care physicians or gynecologists when recommending these medications.
Helicobacter pylori (H. pylori) is a bacteria that causes chronic inflammation (gastritis) of the inner lining of the stomach, and also is the most common cause of ulcers worldwide. About 50% of people in the world carries or is infected with H. pylori. Common symptoms of H. pylori infection are occasional abdominal discomfort, bloating, belching or burping, and nausea and vomiting. H. pylori infection is difficult to erdicate, and treatment is with two or more antibiotics.
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.
If you wear tight clothing when working out or don heavy equipment for sporting purposes, you may have experienced Acne Mechanica. This type of acne is prevalent among athletes, students, and soldiers, and is directly caused by excessive heat, pressure, and covered skin. It also may be triggered by consistent rubbing of different materials against the skin. This type of acne can be alleviated by changing out of sweaty gear and clothing and showering immediately after a workout. It’s also important to clean gear of acne bacteria and prevent friction by ensuring a comfortably tight fit. If you believe your acne flare up has been caused by a tight or heavy uniform, wearing a clean, cotton t-shirt underneath can help absorb the sweat and keep your skin protected.

Avoid touching or rubbing your face, since that can make acne worse. Try to keep your cell phone from touching your face, too. Use earbuds instead of having the phone against your skin. Also, don't lean your face on your hands, which may carry oils and germs that can irritate blemishes. Sweat can also make acne worse. Sweaty after exercise? Wash up.


Your dermatologist may prescribe Accutane®, if other treatments have not worked. This is a strong medicine that can help prevent scarring and treat active disease. But, Accutane also can cause birth defects. It is important that you are not pregnant and do not plan to get pregnant while taking this medicine. You must use two methods of birth control at the same time. This is done for one month before treatment begins, during treatment, and for a full month after stopping the drug. Talk with your dermatologist about when it's safe to get pregnant. Other side effects of this drug may include dry eyes, itching, mood changes, and changes in the blood and liver. You and your dermatologist can decide whether this medicine is right for you based on the pros and cons. Use any prescribed medicine exactly as you are advised. Taking more medicine than you are supposed to take may make acne or your general health worse. Ask your doctor what to do if you miss a dose.
As mentioned above, genetics are thought to play a major role in your susceptibility to acne. However, using the best acne products and taking good care of your skin can help you prevent worsening acne and scars later in life. Check out these other known acne causes and aggravators and see how to prevent acne by cutting some of these out of your life:
The process involves first removing makeup with an emollient formula—I use her Soothing Aloe Cleansing Milk, which looks and feels like lotion—on dry skin for 30 seconds, then rinsing and follow with another cleanser. Rouleau's AHA/BHA Blemish Control Cleanser has been my lifesaver, it's a blend of salicylic, lactic, and glycolic acids, plus jojoba beads for physical exfoliation. It sloughs away residue and oil and targets pimples, blackheads, and leftover scarring. I always followed this with Rouleau's Balancing Skin Tonic before applying any other layers.
Can’t use the good stuff: The best medications for clearing acne include topical retinoids like Differin and Retin-A. The strong chemicals that are used in exfoliants can cause severe inflammation and sun irritation when combined with these medications. This means that you will have to choose between facials or proper medications. The choice is yours.
Retinoids: Retin-A (tretinoin) has been in use for years, and preparations have become milder and gentler while still maintaining its effectiveness. Newer retinoids include adapalene (Differin) and tazarotene (Tazorac). These medications are especially helpful for unclogging pores. Side effects may include irritation and a mild increase in sensitivity to the sun. Adapalene 0.1% is now available without a prescription. With proper sun protection, however, they can be used even during sunny periods. The combination medication known as Epiduo gel -- which contains the retinoid, adapalene, along with the antibacterial, benzoyl peroxide -- is applied once a day.
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