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.
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Sometimes it seems like pimples sprout up overnight, but the process of pimple formation is a bit more complex. So what are the most common causes of pimples? A variety of factors can result in an acne blemish. Pimples can develop on anyone at any age, but tend to be most common amongst teens. Why do teenagers get the brunt of breakouts? Hormone fluctuations. When hormone levels increase, the sebaceous glands found within the skin’s hair follicles produce an excess of sebum. Sebum is a waxy substance that the body produce to keep the skin soft and moisturized. However, when hormonal changes cause an increase in sebum production, the pores can become clogged. This sticky substance can collect dead skin cells, debris, and bacteria, forming a plug in the follicle. Blackheads, whiteheads, pimples, and pustules all begin the same way. Preventing pimples means discovering the reasons you’re breaking out and doing all you can to combat these factors. There is no single answer to the age old question of how to get rid of pimples.
Acne scar treatment: Energy-based skin resurfacing with a laser, radiofrequency, or an ultrasound device can help treat boxcar scars, according to Nada Elbuluk, MD, an assistant professor at the Ronald O. Perelman Department of Dermatology at New York University Langone Medical Center in New York City. “They all work by creating new collagen beneath the surface of the skin.” A series of treatments is likely needed based on the extent of scarring, she says. Chemical peels can also help but to a lesser extent. With either procedure, using a retinoid to increase cell turnover and further boost collagen can help improve results, Dr. Elbuluk adds.
While acne is a much more visible condition than most, it is important to remember that it is like most diseases, in which early detection can help to mitigate its impact. Bearing that in mind, we have taken the time to put together 10 of the most common causes for acne, so that you can be better informed and potentially avoid some (and only some) of its root causes.
29. Antibiotics are an option. Oral antibiotics are usually used for moderate to severe acne, especially on the back or chest, and kill bacteria in your skin pores. The ones most commonly used are tetracycline and erythromycin. Like all antibiotics, they can cause yeast infections as well as more severe side effects and can interfere with the effectiveness of birth control pills. They can also cause increased sun sensitivity, so you'll need to be extra careful when going outside and use SPF daily. For more extreme cases, your doctor may suggest Isotretinoin (Accutane), which is used in moderate to severe cases of acne when nothing else works, but can have more extreme side effects.
Laser resurfacing. This procedure can be done in the doctor's or dermatologist's office. The laser removes the damaged top layer of skin and tightens the middle layer, leaving skin smoother. It can take anywhere from a few minutes to an hour. The doctor will try to lessen any pain by first numbing the skin with local anesthesia. It usually takes between 3 and 10 days for the skin to heal completely.
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.
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.
Stress: Being under stress can boost the production of male hormones called androgens. These hormones, which naturally occur in both men and women, stimulate oil production and can worsen acne. Experts believe that an excessive amount of androgens, a condition called hyperandrogenism, may be a significant cause of late-onset acne in women who didn't have acne as adolescents.
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,.
Punch excisions: "This procedure is best for those with icepick scars, which aren't as wide as rolling or boxcar scars," says Dr. Shah. "If you use a punch excision on a scar that's wide at the surface, you're making a bigger punch and trading in one scar for another," she says. "Your dermatologist will numb up the area and use a tiny cookie-cutter like device to cut out the scar, and then sew it closed with a tiny stitch. The stitch is removed in less than a week," says Dr. Bowe. However, Dr. Idriss cautions against this method for those with darker skin or undertones who are prone to hyperpigmentation.
There are several low-level light devices designed as at-home acne remedies on the market — but do they really work? Some, like the Zeno electronic "zit-zapper" are FDA-approved as acne remedies, but reviews with these products are typically mixed. Even the best acne treatment won't work for everyone, as the severity of the acne, types of acne and quality of the device are all factors. Ask your dermatologist for a recommendation if you're considering purchasing an at-home light device to treat your acne.
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.
Doxycycline is another of the tetracyclines that is equally effective in treating acne. It comes in generic versions and also as the branded Doryx and Acticlate which are easier on the stomach. Originally FDA approved for the treatment of rosacea, Oracea is a non antibiotic dose of doxycycline that is often used as an acne treatment, as well. Taken orally, it can be used as solo therapy or in combination with a topical acne treatment regimen. More severe cases of acne might need higher doses of doxycycline, but since Oracea is not an antibiotic, many patients can be “down-graded" to Oracea after improvement and it is suitable for longterm use as it does not cause antibiotic resistance.
Make sandalwood paste. Sandalwood is known for its skin healing properties, and is easy to prepare at home. Just mix one tablespoon of sandalwood powder with a few drops of rosewater or milk to form a paste. Apply this paste to the affected area and leave it on for at least 30 minutes before rinsing. Repeat this process daily until your scars have vanished.
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Bellafill is a dermal filler approved for the correction of moderate to severe, atrophic, distensible facial acne scars on the cheeks in patients over the age of 21. This injection provides immediate improvement — like, your skin is improved by the time you leave the office. Once it's injected, the collagen goes to work immediately, adding natural-looking volume and lift to soften acne scars. Over time, your body naturally metabolizes the collagen — but the results remain intact. In fact, Z. Paul Lorenc, a New York City-based plastic surgeon, explains, “90 percent of patients who used Bellafill to treat their acne scars were still satisfied with the results at the one-year mark." The best part? There is no downtime and you can return to normal activities right away.
Wondering how to get rid of acne fast? While you can't get rid of a pimple overnight, there are plenty of doctor-approved acne treatments that can shrink zits significantly—and zap redness and irritation—in a mere 24 hours (which should make it much easier to cover up. We talked to top dermatologists to get the scoop on what actually works when it comes to banishing blemishes. Read on for 11 ways to get rid of acne, plus learn about the different types of acne and what each type responds to best when it comes to treatment.
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.
"Retinoids work over time by continuously increasing cell turnover which in turn helps fade hyperpigmentation," says Dr. Idriss. Dr. Shah agrees, noting that Retin-A helps with acne marks by causing your skin cells to "divide more rapidly and pushing out cells with discolored pigments." Since retinoids make your skin super-sensitive to the sun, it's best to not only wear SPF, but to also apply a treatment like RoC Retinol Correxion Sensitive Night Cream before you go to bed.
It is a myth that women get acne because they don't wash enough. Too much washing or scrubbing the skin harshly can make acne worse. And washing away surface oils doesn't do much to prevent or cure acne, because it forms under the skin. The best way to clean the face is to gently wash it twice a day with a mild soap or cleanser. Be careful to remove make-up without harsh scrubbing.
Doctors infrequently prescribe isotretinoin for severe and resistant rosacea. Often physicians prescribe it after multiple other therapies have been tried for some time and have failed. Patients take a daily capsule of istotretinoin for four to six months. Typically, isotretinoin is most commonly used in the treatment of severe, common acne called acne vulgaris. Close physician monitoring and blood testing are necessary while on isotretinoin. Generally, at least two forms of birth control are required for females using this medication, as pregnancy is absolutely contraindicated while on isotretinoin.
“After sweating, immediately use an exfoliating cleanser to help keep your pores clear and remove excess oil,” says Dr. Zein Obagi of ZO Skin Health. Try keeping Neutrogena Rapid Clear Treatment Pads in your gym bag or locker for those times you need an on-the-go cleanse. These will remove any leftover dirt while treating your skin with acne-fighting salicylic acid.
Because I'm constantly testing out new products, I don't often end up with "empties" (as in, products so good you've emptied out the bottle). However, I loved Sunday Riley's Good Genes so much I literally twisted the pump off and stuck my finger in it to try and get every last bit. The magic potion's main ingredient is lactic acid, which exfoliates away dead skin cells — key for clearing pores, fading scars, and revealing fresh skin on the surface.
This revolutionary treatment is designed to clear skin, help control acne pimples and revitalize fatigued, stressed and dull skin. A 5-step treatment, with a unique Oxygen Complex and Patented Anti-Microbial Peptides, purifies and deeply hydrates to restore the skin’s natural radiance and glow. The skin becomes luminous, moisture-balanced and younger looking.
Hypo-pigmentation is characterized by the light spots that result from a lack of melanin. With this type of skin damage, melanocytes are depleted from the injured area or lose their ability to produce melanin. This occurs when healthy skin has been replaced with scar tissue. Because scar tissue has a light pink color, it’s more noticeable on people with darker skin tones.
Extractions: An extraction is the physical unclogging of a clogged pore. The aesthetician pushes a tool called an extractor around each acne lesion, forcing the pus, bacteria, and sometimes blood up through the clogged follicle opening. It is an aggressive procedure that should only be performed by an experienced aesthetician or dermatologist as it can damage your pores if done incorrectly.
Lin says he recommends applying egg whites directly to a pimple to shrink a breakout. “The protein in the egg will help dry out the pimple,” he says. “You can also apply honey to a breakout to calm redness. Honey is a naturally soothing ingredient with anti-inflammatory properties that helps heal the skin. Leave it on for five to 10 minutes, then wipe away with a damp cloth.”
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.
You've probably seen the Proactiv clear skin system advertised on television at some point over the last several years, but does it work? Proactiv is one of the better acne remedies out there for mild cases of inflammatory and noninflammatory acne, hormonal acne, and adult acne. The basic kit comes with a gentle glycolic acid and benzoyl peroxide exfoliator, a benzoyl peroxide pore cleanser, and an oil-free moisturizer that contains both glycolic acid and salicylic acid. Prices and shipping rates vary by location but Proactiv typically starts at $30.
Our skin contains millions of small sebaceous glands underneath the surface. These glands excrete an oil, called sebum, that helps to keep our skin smooth and supple. This oil is released via pores, which are small holes on the surface of the skin, which is also where hairs grow out of. When the body produces a lot of sebum, the skin can feel oily and these pores can become clog. It is when these pores become clogged that germs and bacteria can thrive and grow. The result – pimples.
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.