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.
Wrap your index finger with cotton, and gently start removing black heads and white heads starting from one side of the face until the skin is clean. For stubborn black heads and white heads, make sure you hold the skin tight with the left hand while using a lancet in the right hand to gently poke the blemish. Using the lancet will make it easier for the white head to come out without bruising the skin; especially with a product like BD Ultrafine. This takes about 10-20 minutes depending on the severity of the acne.

What you can do differently: Gently wash and moisturize your face with a gentle yet effective system (cleanser, toner, moisturizer) that contains pore-clearing ingredients, like alpha hydroxy acids and glycolic and lactic acids. That way you keep the scrubbing to a minimum. Wright recommends Obagi Foaming Gel, Toner and Exfoderm Lotion, her favorite system to suggest for Dangene's acne-prone clients.


Some acne marks and scars are completely within your control while others are pre-determined. Aside from genetics, there are several lifestyle habits that can make dark marks and scars worse. Spending time in the sun is a big one, and, to reiterate one last time, every dermatologist agrees that picking or squeezing pimples creates further inflammation and can ultimately lead to more damage.
"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.

It's best to consult a primary care physician or dermatologist if an individual is unable to adequately control his or her acne. The goal of treatment should be the prevention of scarring (not a flawless complexion) so that after the condition spontaneously resolves there is no lasting sign of the affliction. Here are some of the options available:


If you have scarring, your dermatologist may suggest surgery to help heal acne lesions and remove scarring. A laser can reshape scar tissue and reduce redness. Dermabrasion is a type of surgery that can remove surface scars and reduce the depth of deep scars. Another option is to transfer fat from one part of the body to the face. In some cases, a single treatment can help scarring. But for lasting results, several are often needed. There are also topical treatments for acne scarring.
It starts out as a powder (a blend of raw cacao, bamboo charcoal, soil nutrients, and spices), only releasing its potent healing elements when mixed with water. The resulting mousse heals blemishes, fights inflammation, encourages circulation, and visibly tightens pores pretty much instantly. Use Lindstrom’s facial treatment bowl and brush to mix the paste.
Smoking, spicy foods, hot drinks, and alcohol may cause flushing and should be avoided. Exposure to sunlight and to extreme hot and cold temperatures should be limited as much as possible. Red wine and chocolate are two well-known rosacea triggers. Some listed foods may have no effect on one patient's rosacea but severely affect someone else. Individual reaction patterns vary greatly in rosacea. Therefore, a food diary may help to elucidate one's special triggers.
Use a toner after cleansing. After you wash your face, exfoliate, or apply a face mask, apply a toner to the entirety of your face. Toners work to tighten pores making it less likely that dirt and oil will become trapped in them. Buy acne toners at a local drugstore, or use witch hazel or apple cider vinegar dabbed on with a cotton ball. Don’t rinse toners after application - allow them to stay on your skin.
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.
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.

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.
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