Pimples are raised red spots with a white center that develop when blocked hair follicles become inflamed or infected with bacteria. Blockages and inflammation that develop deep inside hair follicles produce cystlike lumps beneath the surface of your skin. Other pores in your skin, which are the openings of the sweat glands, aren't usually involved in acne.
Like microneedling, fractionated skin resurfacing sends skin a signal to respond to damage. Specifically, microscopic columns of injury are created causing minute perforations in the treatment area, while leaving healthy surrounding tissue intact and untouched. "The specific zones of injury trigger the patient's natural neocollagenesis (collagen rebuilding process)," explains Engelman, who characterizes the treatment as both revolutionary and non-invasive. This new collagen rejuvenates the skin and improves its appearance. "Improvements continue over time (up to six months post-procedure) as new collagen continues to rebuild," she says.
Drink plenty of water and follow a balanced diet. Although eating healthily and staying hydrated isn't going to magically make acne scars disappear, it will allow your body to perform at its best and help skin to heal itself. Water will flush toxins from the body and keep skin looking plump and firm, so you should aim to drink 5 to 8 glasses a day. Vitamins such as A, C and E will also help to feed the skin and keep it hydrated.
There are simple things you can do on your own to help prevent adult acne and keep it from getting worse. First, wash your skin once or twice a day with a non-drying, non-comedogenic cleanser that won't clog your pores. Look for cosmetic products labeled oil-free, non-comedogenic and non-acnegenic (unlikely to cause acne breakouts). In addition, avoid heavy skin creams or hair products which may aggravate your skin condition.
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.
So if popping pimples doesn't cause scarring, what does? Long-lasting scars typically turn up after a recurring bout with cystic acne. Cystic acne is a breakout that burrows deep into the skin. These red, painful nodules occur when clogged pores are filled with pus and bacteria, which causes inflammation. Cystic breakouts are often tied to an internal fluctuation of hormones like testosterone (that's why they're common during puberty, monthly menstruation, and perimenopause). "If there is a cyst in the skin, it's going to cause a scar the longer it sits there because pus or bacteria deeper inside the pores cause surrounding inflammation," says Dr. Karolak. And as a result, the inflammation affects the collagen production as well as the fat stores under the skin, creating a visible scar on the surface.
If you really must do something about your pimple beyond washing your face and spot treating, ice or a cold compress can help reduce swelling. Wrap an ice cube or the compress in a soft tissue or cloth and apply it to your zit for 20-30 seconds at a time, a few times a day. In case of an emergency (like, prom), you can also see a dermatologist for a cortisone injection, which can help shrink the cyst down quickly in a day or two.
You've probably seen those tiny glass jars filled with liquid and some solid sediment at the bottom—sometimes it's pink, sometimes it's white, and (in the case of my favorite product) sometimes it's flesh-tone. The solid in the jar is usually a mix of drying ingredient like camphor, sulfur, and zinc oxide, but many brands throw in a few little extras. Cult-favorite Mario Badescu Drying Lotion adds calming calamine and exfoliating salacylic acid to their formula, while my favorite, End-Zit Acne Control Drying Lotion, keeps it simple, but comes in several shades so that it conceals your breakout while it treats it.
Shower twice a day. Take a shower or bath in the morning and at night. Alternatively, take a shower in the morning and then again after physical activity, like exercise, or sweating. Wash your entire body with a mild cleanser and use shampoos that limit oil production in your hair. Be sure to always shower after exercising to remove the dead skin cells your body has sloughed off through sweating.
Your body is capable of taking care of your scars and they will get lighter with time. However, if you expose them to the sun, their healing process will slow down and the scars will get darker. So, avoid the sun. If it’s essential to go out in sun, use sunscreen to guard your skin and also cover yourself with hat, umbrella, clothes- whatever you can lay hands on.
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.
Unwashed sheets and pillowcases lead to cross contamination which leads to pimples. Aim to wash your bedding once or twice a week to prevent bacteria from building up and affecting your complexion, suggests Dr. Papantoniou. If that seems overboard, at least aim to wash your pillowcase once a week since that's where your face rests while you snooze (and dream of flawless skin).
"Acne scars are very challenging to treat and are even more challenging to treat once they've been given time to age," says Joel Schlessinger, M.D., a board-certified dermatologist in Omaha, Nebraska. Although he says the best option is prevention (but if you just can't resist popping your pimples, do it the doctor-approved way!), there are ways to treat acne scars to drastically reduce their appearance.
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.
Treating acne requires patience and perseverance. Any of the treatments listed above may take two or three months to start working (even isotretinoin). Unless there are side effects such as excessive dryness or allergy, it is important to give each regimen or drug enough time to work before giving up on it and moving on to other methods. Using modern methods, doctors can help clear up the skin of just about everyone.