If you’ve made a concerted effort with over-the-counter regimens and/or diet and still aren’t seeing results, a dermatologist is absolutely worth it. There are many levels of care: Prescription retinoids (Retin A, Tazorac, Differin et al) and/or topical antibiotics are the mildest, along with blue-light treatments like Isolaze, which kill bacteria and clear pores, with virtually no downtime. Light lasers like Clear and Brilliant can clear pores and treat the red and brown tones left by old acne lesions. “Some patients think they’ve got a severe problem, when they really only have a few pimples, surrounded by red and brown marks from old breakouts,” notes Anolik. Oral antibiotics represent a more aggressive (and unsustainable long-term) solution; birth control pills and hormone-mitigating medications like Spironalactone and Deldactone can get many more-severe patients’ acne under control. Most aggressive is Accutane; while it can be severely drying and can cause birth defects if taken during pregnancy, it represents a cure for truly-severe acne cases, says Anolik. “Used correctly, it is something of a miracle for people who’ve tried everything and failed,” he says.
Hormones are ruthless, and all the topical treatments in the world won't make a difference if yours are seriously out of whack. In that case, you need to fix things internally first. "Medications that manipulate hormonal levels, such as oral contraceptives and spironolactone, are helpful in curbing hormonal chin and lower face outbreaks," Dr. Tzu says. Ask your derm about what might work for you.
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.
If you look in the mirror and see a pimple, don't touch it, squeeze it, or pick at it. This might be hard to do — it can be pretty tempting to try to get rid of a pimple. But when you play around with pimples, you can cause even more inflammation by popping them or opening them up. Plus, the oil from your hands can't help! More important, though, picking at pimples can leave tiny, permanent scars on your face.
Antibiotics are an acne treatment used to kill acne-causing bacteria. They may be applied directly on the skin (topical) or taken by mouth (oral). Topical antibiotics kill bacteria in the upper portion of your pores, while oral antibiotics can reach to the lower depths of the pores. Antibiotics used for acne treatment include, clindamycin, or tetracyclines like doxycycline or minocycline. These antibiotics are the most effective for treating acne because they both kill bacteria and act as anti-inflammatory agents to calm down the skin.
Hypo-pigmentation is characterized by the light spots that result from a lack of melanin. With this type of skin damage, melanocytes are depleted from the injured area or lose their ability to produce melanin. This occurs when healthy skin has been replaced with scar tissue. Because scar tissue has a light pink color, it’s more noticeable on people with darker skin tones.
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.
Good Genes All-In-One Lactic Acid Treatment is formulated with high potency, purified grade lactic acid that immediately exfoliates dull, pore-clogging dead skin cells, revealing smoother, fresher, younger-looking skin. Fine lines appear visually plumped while the skin looks more radiant. With continued use, the appearance of stubborn hyperpigmentation and the visible signs of aging are reduced for a healthier-looking complexion. Perfect for all skin types and all ages, this treatment is enhanced with licorice for brightening, Good Genes clarifies, smooths, and retexturizes for instant radiance.
If you wear tight clothing when working out or don heavy equipment for sporting purposes, you may have experienced Acne Mechanica. This type of acne is prevalent among athletes, students, and soldiers, and is directly caused by excessive heat, pressure, and covered skin. It also may be triggered by consistent rubbing of different materials against the skin. This type of acne can be alleviated by changing out of sweaty gear and clothing and showering immediately after a workout. It’s also important to clean gear of acne bacteria and prevent friction by ensuring a comfortably tight fit. If you believe your acne flare up has been caused by a tight or heavy uniform, wearing a clean, cotton t-shirt underneath can help absorb the sweat and keep your skin protected.
Since there is some overlap between acne and rosacea, some of the medications may be similar. Acne and rosacea have in common several possible treatments, including (but not limited to) oral antibiotics, topical antibiotics, sulfa-based face washes, isotretinoin, and many others. It is important to seek a physician's advice before using random over-the-counter acne medications since they can actually irritate skin that is prone to rosacea. Overall, rosacea skin tends to be more sensitive and easily irritated than that of common acne.
If you’re dealing with an acne breakout, avoid touching your face or popping any pimples to prevent the acne from spreading. Wash your face no more than twice a day and moisturize regularly in order to clear your skin up. Make sure you're eating plenty of fruits, vegetables, fish, and nuts, and stay away from sugary drinks and fast food. You can also try treating stubborn acne with benzoyl peroxide cream, salicylic acid, and tea tree oil. For tips on how to treat acne with vitamins, astringents, and natural antihistamines, read on!
You can apply all the topicals you want, but unfortunately, most treatments you'll find at the drugstore won't help with acne scars, Hellman says. However, she notes that derma rollers (at-home microneedling devices) may help with acne scarring. If you're on a tight budget, that should be your first stop. You can get one on Amazon for less than $20. (Use yours once a week followed by a Vitamin C serum for best results—here's how to pick the best ones.)
Treatments like radiofrequency microneedling, lasers, and fillers can be effective to treat acne scars, but they can run you hundreds of dollars per treatment. And Hellman says you'll need six to eight treatments and a good amount of time before seeing results. "The process takes a good part of a year," she says. (Her office does offer some package options to help offset some of the cost.)
Scars are varied and complex, and learning how to get rid of acne marks requires trial and error. There are a variety of ways to get rid of acne scars and each corner has a different proponent. However, before you go jumping on the bandwagon for the latest cure-all, we suggest breaking down the various treatments methods into their disparate parts.
Isotretinoin (previously known as Accutane) is the most effective form of acne therapy and the only one that can actually result in a cure for your acne. After finishing a course 80% of people never see acne again. It works so well because it unclogs pores, kills bacteria, reduces oil production and reduces inflammation. It is taken as a daily pill. Isotretinoin has numerous rare and potential side effects that has made it a controversial choice, but for patients with severe acne there is often no other option. Patients taking isotretinoin must also be on highly effective birth control as the drug can cause birth defects. Isotretinoin can only be taken under close medical supervision.
Blackheads are, essentially, open comedones. "Comedone refers to plugging of the follicular opening," explains NYC dermatologist Elizabeth Hale, M.D., referring to hair follicles that technically cover your entire face and body (hi, peach fuzz). "Every hair follicle appears in a sebaceous gland." So a blackhead is the mixture of dead cells, bacteria, and grime that builds up and hardens in the follicular opening—but it's open to the world, which is why blackheads are so easy (read: tempting) to push out.
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.