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]
Aqua (Water, Eau), Glycerin, Triethanolamine, Sodium Laureth Sulfate, Propylene Glycol, Isopropyl Alcohol, Salicylic Acid, Dimethicone, Aloe Barbadensis Leaf Juice, Chamomilla Recutita (Matricaria) Flower Extract, Thymus Vulgaris (Thyme) Leaf Extract, Sodium Hyaluronate, Carbomer, Parfum (Fragrance), Diazolidinyl Urea, Methylparaben, Propylparaben, Benzyl Benzoate, Benzyl Salicylate, Eugenol, Linalool.
See Your Doctor If You Get Large, Deep Breakouts or Acne Cysts: While smaller blemishes can still scar the skin, it's the big guys that usually do the damage. Because they extend deeper into the skin, deep nodular breakouts or cystic breakouts are more likely to destroy skin tissue and leave scars. Over-the-counter acne products just won't help these types of breakouts. Get an appointment with a dermatologist. Quick, effective treatment can help lessen the chance of developing deep scars.
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.

Cleansing . Create a cleansing routine, washing your face each morning and before bed. This alone can significantly reduce acne breakouts. Wash your face for at least a minute to ensure that all bacteria are killed. Make sure to wash away any makeup before going to bed as these products can increase acne outbreaks while damaging the skin. Use oil free products that will not clog the pores during this step. Also wash any other areas where acne appears during this ritual such as your chest, back or shoulders.

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.)


Photodynamic therapy (PDT) is one of the newly available treatments. PDT uses a topical photosensitizer liquid that one applies to the skin and a light to activate the sensitizer. Levulan (aminolevulinic acid) and blue light, commonly used to treat pre-cancers (actinic keratosis) and acne vulgaris, can treat some rosacea patients. The use of PDT in rosacea is off-label, since it is primarily designed for regular acne. PDT works at reducing the inflammation; PDT is performed in a physician's office. The treatment takes anywhere from one to one and a half hours to complete. Strict sun avoidance for approximately one to three days is required after the treatment. Mild discomfort during the treatment and a mild to moderate sunburn appearance after the treatment is common. Some patients have experienced remissions (disease-free periods) of several months to years from these types of treatments. Other patients may not notice significant improvement.
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.
Wear sunscreen everyday and do not tan. Ultraviolet Radiation is the number one cause of premature aging. It also leads to skin cancer in high enough doses. Treat the sun like the death ray that it is. Exposing your skin to harmful UVA and UVB rays damages skin and prolongs post inflammatory erythema(PIE)--red acne marks, as the sunlight stimulates pigment-producing cells.
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.
"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
What you can do differently: When washing and conditioning your hair in the shower, tilt your head over to the side to keep the product's residue off your face, chest, and back as you rinse it away. And be sure to wash your face last when you're in the shower to make sure you haven't accidentally gotten any product on your skin that could break you out later.

"I often recommend PCA Skin Pigment Gel to patients looking to treat scars left behind from acne," explains Rebecca Kazin, a dermatologist at Washington Institute of Dermatologic Laser Surgery and Johns Hopkins department of dermatology. "This gel contains 2 percent hydroquinone blended with other skin brighteners, like kojic acid, resorcinol, and azeleic acid, which work to lighten the pigmentation without irritating the skin," she says. The addition of lactic acid helps maintain moisture to prevent overdrying, which can worsen pigmentation.
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).
Exfoliate dead skin cells that can clog pores and lead to breakouts with the power of salicyclic acid. Mario Badescu's Acne Facial Cleanser was specially formulated to effectly target acne-prone or acne-erupted skin. A soothing blend of botanical extracts including aloe, chamomile, and thyme help to improve the look and feel of troubled skin, while leaving skin thoroughly refreshed.
Sometimes even though they wash properly and try lotions and oil-free makeup, people get acne anyway — and this is totally normal. In fact, some girls who normally have a handle on their acne may find that it comes out a few days before they get their period. This is called premenstrual acne, and about 7 out of 10 women get it from changes in hormones in the body.

Since the UV rays and visible light from the sun can further darken acne marks, all the dermatologists agree it’s essential to wear sunscreen daily. “Sun protection can make a big difference in whether or not these marks remain permanent,” says Nagler, so much so that she’ll often recommend patients wait and see what their scars look like after a year of careful sun protection before opting for an expensive or invasive procedure. This CeraVe oil-free sunscreen is ideal for acne-prone skin, and also contains niacinamide, which is known to help brighten skin and fight inflammation.
Light treatments: Recent years have brought reports of success in treating acne using special lights and similar devices, alone or in conjunction with photosensitizing dyes. It appears that these treatments are safe and can be effective, but it is not clear that their success is lasting. At this point, laser treatment of acne is best thought of as an adjunct to conventional therapy, rather than as a substitute.
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