I couldn't just let the worst breakout ever live on without a visit to the dermatologist, so I went to BeautyRx founder Dr. Neal Schultz. He gave me this incredible "Z Stick" spot treatment that contains mild cortisone (the same substance derms use to inject pimples to make them die down in 24 to 48 hours), and Clindamycin, an antibiotic. I applied this every morning and evening to all my spots and it acted like an extra layer of armor against further inflammation. Sadly, it's prescription-only and/or only available through Dr. Schultz's practice in New York—but he's working on making one for consumers.
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.
"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.
Lasers: Dermatologists often remodel collagen using lasers, "which do not completely eliminate acne scars but can improve them by 30% or more," according to Dr. Woolery-Lloyd. "These can be helpful in reducing the redness associated with acne marks and scars. I use a pulse-dye laser called the V-Beam for red scars. When treating older scars that are no longer red, I like to use the Fraxel laser. When lasers are used to treat acne scars, the results can differ dramatically based on two things: how many treatments you have done, and how much social downtime you're willing to accept as part of the recovery process," says Dr. Bowe. "Erbium laser resurfacing is also another option and it's more aggressive than Fraxel," says Dr. Shah. "It's a minimal burning of surrounding tissues and has fewer side effects like less swelling and redness, but it's won't work for those with darker skin tones."
The best way to fix them: This is where the classic zit treatments come into play. "Topical medications are the best way to treat a lesion like this," says Jennifer Chwalek, M.D., a dermatologist at Union Square Laser Dermatology in NYC. "Benzoyl peroxide-, salicylic acid-, or sulfur-based products can help to dry it up." She prefers salicylic acid over benzoyl peroxide for these, since the latter can cause irritation, dryness, and even post-inflammatory hyperpigmentation (a.k.a. dark spots) in those with darker skin tones. Retinol works well for these, too.
Cocoa butter is a fat and an excellent moisturizer as well as emollient. It can quickly melt due to the body temperature. This quality makes it easily absorbable into the skin. In fact, it not only penetrates the top layer of your skin but it goes deep into the skin into the dermis. Thus, it reaches the site where your skin can retain the moisture for the longest time. A well-moisturized skin is a skin that makes spots and scars less visible!
To get rid of acne, wash your face with a pH balanced cleanser twice a day to eliminate acne-causing bacteria. You should also exfoliate your face at least once a week with a physical or chemical exfoliant which will remove dead skin cells that clog pores. Applying a benzoyl peroxide cream to your acne before you go to bed can also help get rid of breakouts.
In order to treat acne marks and scars, it's helpful to learn how to distinguish between the two. "What many people don’t realize is that a dark or pink mark on the skin is not actually an acne scar. Inflammation in the skin often leaves behind a stain as part of the natural healing process. The inflammation revs up pigment production, creating the mark that fades on its own over several weeks to months," says dermatologist and 2018 Acne Awards judge Dr. Joshua Zeichner. Unlike scars, these are smooth to the touch (AKA, not raised or indented), and signify that there is no permanent collagen damage to the skin.
Exfoliating cleansers and masks: A variety of mild scrubs, exfoliants, and masks can be used. These products may contain salicylic acid in a concentration that makes it a very mild peeling agent. These products remove the outer layer of the skin and thus open pores. Products containing glycolic or alpha hydroxy acids are also gentle skin exfoliants.