"I have seen many patients develop a tolerance to prescription acne treatments, and when they stop working, it’s devastating. Treating acne demands a more holistic approach that includes lifestyle, nutrition, and advances in topical skincare. I developed Outsmart Acne™ Clarifying Treatment to be used as part of a whole-person regimen to help skin stay consistently clear."—Howard Murad, M.D., FAAD
21. You might try a prescription. Topical antibiotics are available only with a prescription and work by killing the bacteria on your skin that cause acne, and by reducing inflammation. Some examples of topical antibiotics are erythromycin and clindamycin. Your doctor may prescribe you them in conjunction with another topical treatment such as one containing benzoyl peroxide or a retinoid such as Retin-A.
2. You're OD'ing on spot treatments. Overusing topical salicylic acid, benzoyl peroxide, or sulphur over-the-counter treatments can dry out your skin, causing it to produce more oil and possibly blemishes. Those ingredients can actually make the appearance of your pimples look worse, since the active ingredients can slightly burn the top layer of your skin if used too often, making the pimple appear even redder and harder to conceal than if you had just left it alone. (Tip via Samantha Wright, a licensed aesthetician and Skinovator at the Dangene Institute.)

If you have oily or combination skin and are prone to breakouts, you should be using skin-care products labeled "oil-free," "non-comedogenic," or "water-based," Dr. Schultz says. Just one of these will ensure that the lotion you're slathering on isn't going to clog your pores and make matters worse. Try a gel-based moisturizer like Belif The True Cream Aqua Bomb; for an SPF option, we like PCA Skin Weightless Protection Broad Spectrum SPF.
Severe acne. Severe acne consists of deep cysts, redness, swelling, extreme damage to the skin and scarring. You should see a dermatologist to care for this type of acne. Scarring can be prevented with appropriate treatments. Your dermatologist can prescribe oral antibiotics and oral contraceptives. Large inflamed cysts can be treated with an injection of a drug that lessens the redness, swelling, and irritation, and promotes healing.
Scarring from severe cystic acne can have harmful effects on a person's self esteem, happiness and mental health. Thankfully, there are many different acne scar treatment options available, ranging from chemical peels and skin fillers to dermabrasion and laser resurfacing. According to the American Academy of Dermatology, these are all safe and effective acne scar treatment methods. However, Baldwin says it's important to first clarify what you mean by 'scar.' “Many people point to red or brown spots leftover from old zits and call them scars," she says. “These are marks, not scars and they'll fade with time. Scars have textural changes and are not flush with the surface of the skin. There are several types of acne scars – innies and outies. Outies can be injected with corticosteroids and flattened. Innies can be either deep and narrow or broad, sloping and relatively shallow. Deep and narrow scars need to be cut out, but broader sloping scars can be made better by fillers, laser resurfacing and dermabrasion."
What you can do differently: Wipe your face, chest, and back down before you work out with facial wipes, like Neutrogena Makeup Remover Cleansing Towelettes, to remove your makeup. Then, if you don't have time to shower immediately after the gym, use another fresh facial wipe to clear away any sweat and bacteria on your skin to minimize the chance of new pimples popping up.
Consider cosmetic surgery. As a last resort, consult with a medical professional about surgery for large, deep lesions or scars. In this procedure, a doctor will use a punch excision to cut out the scar and replace it with stitching or a skin graft. Smaller lesions require only stitching, while large lesions may require a skin graft from another part of your body.[15]
Dr. Day says another product ingredient to look out for is retinol to "help minimize and even avoid scarring." Dr. Chiu suggests this particular SkinMedica product because it "induces new collagen formation, which can soften acne scars, as well as unclogs pores for acne prone skin while bringing pigment to the surface with its exfoliative properties." Start using it twice a week and you'll notice fine lines start to fade as well.

Doctors can treat telangiectasias with a small electric needle, a laser, intense pulsed light, or minor surgery to close off the dilated blood vessels. Usually, multiple treatments are required for best results, and only a portion of the blood vessels improve with each treatment. Not everyone responds the same to these types of treatments, and a physician can help someone decide which treatment is best for his or her skin type, condition, and size of blood vessels.
Caused by a bacteria that lives on our skin, acne comes to life at any age when our hormones cue our body to produce excess oil, essentially throwing fuel on the fire. “Our skins’ oils are a wonderful environment for acne bacteria to thrive in, unfortunately,” says Dr. Robert Anolik, clinical assistant professor of dermatology at the NYU School of Medicine. Add dead skin cells, dirt, stress, irritation from everything from diet to skin products, and a breakout is going to result unless you (constantly) work to prevent it.
Consider cosmetic surgery. As a last resort, consult with a medical professional about surgery for large, deep lesions or scars. In this procedure, a doctor will use a punch excision to cut out the scar and replace it with stitching or a skin graft. Smaller lesions require only stitching, while large lesions may require a skin graft from another part of your body.[15]
Mix and match: "Since acne scars vary, so do treatments. Depending on the individual, I often use a multimodal approach to treating acne scars. First, I might use Fraxel treatments to smooth out the skin texture. Then, I often use a combination of the fillers Restylane and Belotero to lift the depressed scars. Finally, I perform a few punch excisions to surgically remove any deep scars that may remain," says Dr. Bowe. There are also topical treatment options for active breakouts that help prevent scarring, which can be used to get out ahead of things.
Get at least eight hours of sleep. Sleeping kills two birds with one stone, as it helps to relax your body as well as detoxify it. If you aren’t getting enough sleep, chances are your skin hasn’t had the time or ability to renew its skin cells. Regulate your sleep cycle by going to bed at a consistent time every night and sleeping for a minimum of eight hours at least.[12]
Sunscreen: "Sun exposure during an active breakout can lead to darkening of inflammatory lesions, prolonging their appearance on your skin and making them harder to fade over time," says Dr. Shereene Idriss from Union Square Dermatology, which means it's important to lather on the sunscreen daily — even when it's cloudy. And don't worry about breaking out from a pore-clogging sunscreen; the latest formulas are more innovative and acne-friendly than ever. Elta MD UV Clear Broad-Spectrum SPF 46 is a top derm-approved favorite. It contains niacinamide, which is an anti-inflammatory that helps reduce redness.

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.
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