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.
"If you occupy the area [under the skin] with a cyst, it destroys fat around it. Once the cyst goes away, the loss causes indentation," Dr. Karolak explains. A boxcar scar is a depression that has hidden scar tissue, which acts like an accordion pulling the scar downward. Subsicion is one solution for these deeper scars. Subsicion uses a sharp needle to go under the surface and break up that scar tissue. Then, you can fill it in with fillers made specifically for acne scars like Bellafill. Or you can do a fat transfer. "One of my favorite treatments for volume loss is fat transfer, which allows me to take inject a patient's own body fat instead of synthetic filler," says Dr. Karolak. Another treatment for boxcar scars is punch excision where the indented area of the scar is removed and the edges are pulled together with a suture. These treatments are often followed up with a collagen-boosting laser treatment.

Strat beauty editor Rio Viera-Newton mentioned this paraben- and fragrance-free concealer in her post on makeup for broken-out skin. “This has helped me conceal even the worst of the worst,” she wrote. Designed for buildable coverage, it will also work on masking those acne marks until they gradually fade away, and the gentle formula means it won’t cause additional irritation.


Steroids have long been known to cause acne. These drugs are generally taken without a prescription in order to gain muscle, but there are instances in which women are prescribed steroids for rare conditions. Steroids cause hormonal changes, and as the androgen hormones increase, so too does oil production. The more sebum, the greater chance of clogged pores. Steroids might also accelerate the growth of P. acnes, which can make pimples and inflammation worse.
Clear, perfect, glowy skin is pretty much a magical unicorn we’ve been chasing since we hit puberty. We love to believe it exists, but for most of us it’s a myth that only exists in fairy tales. And, honestly, the internet doesn’t help much. There are so many supposedly “natural” DIYs floating around the World Wide Web, it’s hard to tell what treatments and tips are real—and what’s a bunch of BS.

I tried many different products from over-the-counter acne treatments to expensive prescription medications. Price ranged from $5 to over $100. I even have books on “How to Clear Acne in 24 Hours”, “How to Clear Pimples in a Week”, or even “How to Clear Break Outs through Hypnosis”. I was an acne treatment junkie! I would buy anything for a clear complexion.
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.
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.
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.
This is all to the fact that it hydrates the skin well using its moisturizing properties. There is one more theory that regards vitamin E with its effectiveness in reducing acne scars. This theory implies that vitamin E helps vitamin A in the body. Vitamin A is thought to be important for a good skin. When you have vitamin E in the body, present in several fruits and vegetables, the fat in the body absorbs this vitamin E.
Retinol is a vitamin A derivative, which the skin absorbs and converts to retinoic acid. Retin-A is the prescription form. "Topical retinoids are fortunately one of the most effective treatments for acne, and also happens to be a highly effective antiaging ingredient, because of its collagen-building properties," Dr. Tzu notes. The biggest downside is they're harsh and can sometimes be too much for sensitive skin. For an elegant OTC option, try Dr. Dennis Gross Skincare Ferulic Acid + Retinol Brightening Solution.
This might annoy your mom, but using your fingers to chat could save your skin. Just think of all those oils, all that bacteria and all those germs on your iPhone. When you hold it up to your face, it’s a little like rubbing your cheek on a New York City sidewalk. {Shudder.} When you need to talk, wipe your phone with a cleansing wipe or go hands-free.

You’ll need more than one: Facials can clear away comedonal acne and reduce breakouts for the following month, but your skin is an organ which continues to grow new cells and shed dead ones every day. Most aestheticians recommend getting a facial every 4 to 6 weeks to continue your clear complexion. Considering that most facials cost upwards of $80 each and take at least an hour, this can become very expensive and time consuming.
You’re a typical hormonal-acne patient if, well past puberty, you’re breaking out around your period, usually in the jawline area, says Anolik. A consistent routine is key—as is enduring a waiting period of two to three months for said routine to work, he continues: “Even powerful prescription treatments can take a few months to really clear things up, and that’s our biggest challenge. People who get frustrated and don’t stick to their treatments get stuck in a cycle of trying and quitting too early, and feeling like nothing works.”
Do not—we repeat, do not—even think about attempting to get this out yourself. "With deep zits, there’s no exit strategy, so if you’re pushing on it to try to get rid of it, it could actually leak sebum into the dermis and cause more lesions," explains Dr. Hale. Instead, this is the time to visit your dermatologist for a cortisone injection, which should take care of it in 24 hours. If you're sitting here wondering why doctors don't just shoot all of your zits up with cortisone, that's because that it can actually lead to scarring or even a depression in your skin, especially with smaller zits, says Dr. Chwalek. That's why cortisone shops reserved for the oversize monsters like these.
The path to clear skin is often one of trial and error; you might need to try several acne remedies before you find the right treatment for the types of acne affecting your skin. Before trying acne medication, you may prefer to give different natural acne treatment options a chance. While there is no research supporting the effective use of natural acne treatments, here are two popular options that you may want to try.

Experiment with aloe vera. The sap of the aloe vera plant is a soothing natural substance which can be used to relieve many ailments, from burns to wounds to acne scars. Aloe vera helps to rejuvenate and moisturize the skin, encouraging acne scars to fade. It is possible to buy aloe vera products in the drugstore, but the best thing to do is buy an aloe vera plant and use the sap from a broken leaf. This gel-like sap can be applied directly on the scarring, and there is no need to wash off.
If a pore gets clogged up and closes but bulges out from the skin, you're left with a whitehead. If a pore gets clogged up but stays open, the top surface can darken and you're left with a blackhead. Sometimes the wall of the pore opens, allowing sebum, bacteria, and dead skin cells to make their way under the skin — and you're left with a small, red bump called a pimple (sometimes pimples have a pus-filled top from the body's reaction to the bacterial infection).
There are breakouts, and then there are breakouts so bad that make me, a grown woman, literally hide under a blanket. The latter happened over a month ago and, as much as I'm here for the growing skin positivity movement, I have to admit my confidence hit an all-time low. I cancelled plans. I stared unhealthily often at a mirror, examining the damage: a colony of seemingly multiplying cystic zits invaded my chin and jawline like never before. How did I get here?
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"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.
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.
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Not for those with moderate to severe acne: Facials are effective in removing comedones (whiteheads and blackheads), but aren’t for those with many pimples, or inflammatory acne. Exfoliants help reduce comedones, but they frequently irritate pimples — causing them to become more inflamed and noticeable. Also, extracting inflammatory acne, like nodules and cysts, can be very challenging and when done improperly, can lead to scarring or further inflammation.
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 occurs when the small pores on the surface of the skin become blocked with oil, dead skin cells, and bacteria. Each individual pore on the skin opens up to a follicle beneath the epidermis. Within these follicles lie a singular hair and a sebaceous gland. The sebaceous gland produces sebum, an oil designed to keep your skin lubricated and soft. However, when hormonal changes and other factors cause the gland to produce an excess of sebum, the oil will be pumped through the follicle, and may pick up dead skin cells and P. acnes bacteria on its way out. Should these substances clump together, a plug will form. As this plug starts to press up against the surface of the skin, the body responds with an accumulation of red and white blood cells to combat any infection, and this results in inflammation and redness. Acne can occur on the face, back, neck, chest, arms, and buttocks, and any other skin area with a saturation of sebaceous pores.
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