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.)
Cysts, which are also called blind pimples, are the very worst kind of acne. Basically, cysts are made up of sebaceous content (again, a gross combination of oil, dirt, and bacteria) that's trapped beneath the skin and has no way out—so they just live and grow under the skin, causing both a bump and, in some cases, pain. "These take longer to resolve on their own, are less responsive to topical treatments, and over time may lead to scarring," says Dr. Chwalek. Um, no thanks.
Those big, painful zits will leave a scar if you pick and prod at them—"the only way to reduce it quickly is to drain it, and that's not a DIY deal," Dr. Schultz warns. The reason they're painful is because quick expansion stretches the nerves. "Drinking good red wine is often helpful [to numb the pain]," he jokes. Take Advil, apply a warm or cold compress (whichever feels better to you), and go see your derm. "Cortisone shots are the true 'spot treatments' for painful cystic acne lesions," Dr. Tzu says.
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.
Rolling scars can look like little saucers, giving the skin a wavy texture. Lasers that resurface the skin are Dr. Karolak's top treatment pick for this type of scar, and Dr. Sobel agrees. "Many scars can be improved with lasers such as the matrix CO2, which remove the outer layers of skin, burning away the scar tissue and stimulate new collagen production," he says. "Non-ablative lasers such as the Fraxel can help activate the production of collagen without damaging the surface of the skin." Keep in mind, that these laser treatments can take a bit of recovery time and require multiple treatments to see results. For a quicker solution, your dermatologist can plump the bowl-like scar with fillers like Juvederm, Restylane, or Bellafill.
Everything you need to know about blackheads Blackheads are small lesions that often appear on the face or neck. They are a feature of mild acne, and handling blackheads in the right way can help to prevent the acne from becoming more severe. We look at ways to reduce and treat breakouts. Learn more about what causes blackheads and how to get rid of them here. Read now
Lasers. Your dermatologist can use a laser to remove the outer layer of your skin, contour areas of acne scars, or lighten redness around healed acne lesions. Various types of lasers are used, depending on whether the acne scar is raised or flat. More than one laser treatment may be required and, depending on the laser used, you may need to several days to heal.
Stress: Being under stress can boost the production of male hormones called androgens. These hormones, which naturally occur in both men and women, stimulate oil production and can worsen acne. Experts believe that an excessive amount of androgens, a condition called hyperandrogenism, may be a significant cause of late-onset acne in women who didn't have acne as adolescents.
Dermal fillers: "Certain scars can be filled with a substance that elevates the depressed areas, like hyaluronic acid. This can make the surface of the skin more even and get rid of shadows," says Dr. Bowe. Until recently, fillers weren't a lasting solution. But now, if you're over 21 years old, Bellafill is the first FDA-approved dermal filler designed for permanently correcting moderate to severely dented acne scars. Unlike other fillers, it contains two different ingredients to help improve acne scarring. "It's 20% polymethylmethacrylate (PMMA), which helps your body make more protein to allow itself to heal," says Dr. Shah. "PMMA are tiny balls that sort of act as a scaffolding. Most fillers degrade over time, but since PMMA cannot be absorbed into the body, this offers a permanent result," she says. The other 80% is collagen. The procedure takes about 20-30 minutes, and while you may need a touchup a couple months later, some people just need the single treatment, says Dr. Shah.
Some patients elect combination therapies and notice an improvement by alternating metronidazole and azelaic acid: using one in the morning and one at night. Sodium sulfacetamide (Klaron lotion) helps reduce inflammation. Other topical antibiotic creams include erythromycin and clindamycin (Cleocin). Topical ivermectin cream (Soolantra Cream, 1%) is also available.
Moderation and regularity are good things, but not everyone can sleep eight hours, eat three healthy meals per day, and drink plenty of water a day. Probably the most useful lifestyle changes one can make is to never to pick or squeeze pimples. Playing with or popping pimples, no matter how careful and clean one is, nearly always makes bumps stay redder and bumpier longer. People often refer to redness as "scarring," but fortunately, it usually isn't permanent. It's just a mark that takes months to fade if left entirely alone.