Lowering stress levels can have an immediate beneficial effect on the appearance and frequency of acne breakouts. It’s important to maintain a regular exercise routine, get enough sleep every night, and practice stress control methods. Meditation has been shown to alleviate the effects of various skin conditions like eczema and psoriasis, and could have a positive effect on the symptoms of acne.

A recent study has found a difference between strains of acne bacteria, which could have a significant impact on acne treatment down the road. This study, published in the Journal of Investigative Dermatology, found that these strains play a role in the severity and frequency of developing pimples. One particular strain of P. acnes was found among study participants that exhibited few symptoms of acne. Researchers came to the conclusion that this “good” strain of bacteria features a natural defense mechanism that fights back bacteria which might infect the cell. Researchers are hopeful that this discovery will help dermatologists better and more accurately prescribe effective acne treatment in the future, and reduce the severity of acne by ridding the skin of bad acne bacteria while preserving the good. 


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.
Acne scars take many different forms. You might see tiny pockmarks, a swollen keloid, or a discolored area on the skin. And just like the types of scars vary, there isn't a one-size-fits-all fix. Your dermatologist can use a combination of treatments including lasers, chemical peels, or fillers to minimize the spots. "Once there is scarring you can't get the skin back to the way it was before," says Dr. Karolak. "But we can get it to look significantly better, so that [clients] feel more comfortable in social environments."
Alcohol-based toners have been an anti-acne step since forever, but are so harsh and drying on skin that they can cause skin to produce even more oil, and they can irritate; as with benzoyl peroxide or any other irritant, they can further inflame a case of acne. But dabbing skin with witch hazel or non-alcohol toner (we love S.W. Basics’ toner with witch hazel and raw apple cider vinegar, $9.99, swbasicsofbk.com) can serve as a mild exfoliant, to unclog pores and deposit ingredients like tea tree oil or salicylic acid. Tea Tree Oil Facial Cleansing pads from Desert Essence ($7.99, desertessence.com) are particularly brilliant, combining both ingredients.
Rena Levi is known for her sensitivity towards clients with severe acne and problem skin. In 1968 she moved from Israel to the U.S. and studied with Christine Valmy at the European Esthetic Skincare Institute. In 1975, she opened the Rena Levi Skin Care Salon in New York City. In 1980, she moved to Albuquerque, NM, where she managed the skin care center for Eleganza Salon and further developed and refined her practice. It was there that she became well known for her ability to treat what many considered impossible skin, while also teaching budding estheticians and skin practitioners at the same time, including the then-president of the New Mexico Board of Cosmetology. Here, Levi shares with us one of her most popular facial protocol treatments for treating clients with moderate to severe acne.
Spot treatments are key for treating a pimple ASAP. Benzoyl peroxide is often vilified for being harsh, but when it comes to really zapping a zit, it should be your best friend. Just dab it on the trouble spot to dry it out and kill bacteria. For heavy-duty action, try Neutrogena Rapid Clear Stubborn Acne Spot Gel; for something gentler, we like Arithmetic Acne Control Complex, which has soothing ingredients to counter the drying effects and is made with adult skin in mind.
All three dermatologists suggested that the best solution for boxcar or rolling scars are in-office procedures. Dr. Day, for instance, suggestedEndyMed Intensif, which uses microneedle radio frequency to remodel the skin by delivering heat into the skin to stimulate collagen and elastin production. For at-home treatments, however, Dr. Day turns to Olay's DIY microdermabrasion kit. It comes with both a foam head and crystal polisher, which claims to exfoliate 7 times better than a typical scrub and thoroughly cleanses the face to prevent future breakouts.
Another study focused in on dairy. In 2005, an article in the Journal of the American Academy of Dermatology took on milk and milk products. By examining the diets of 47,355 women, researchers observed a significant connection between milk and dairy intake and breakouts. Some researchers believe this is caused by high levels of hormones found in our milk products. Much of the milk consumed is produced by pregnant cows, who pump out progesterone, IGF-1, and other compounds that are then passed into the milk. We may also be subject to Bovine Growth Hormone (BGH). These hormones can signal the oil glands to start producing more sebum, which can affect acne. Unfortunately, switching to organic milk doesn’t seem to make a difference, and neither do skim milk options. In fact, skim milk has been observed to worsen the skin, which researches have attributed to lower levels of estrogen and different processing activities. Milk is also known to contain a number of vitamins, some good and some not so beneficial to your skin. Research has shown a correlation between acne and vitamin A in milk. 
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.

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.


Make sandalwood paste. Sandalwood is known for its skin healing properties, and is easy to prepare at home. Just mix one tablespoon of sandalwood powder with a few drops of rosewater or milk to form a paste. Apply this paste to the affected area and leave it on for at least 30 minutes before rinsing. Repeat this process daily until your scars have vanished.

A recent study has found a difference between strains of acne bacteria, which could have a significant impact on acne treatment down the road. This study, published in the Journal of Investigative Dermatology, found that these strains play a role in the severity and frequency of developing pimples. One particular strain of P. acnes was found among study participants that exhibited few symptoms of acne. Researchers came to the conclusion that this “good” strain of bacteria features a natural defense mechanism that fights back bacteria which might infect the cell. Researchers are hopeful that this discovery will help dermatologists better and more accurately prescribe effective acne treatment in the future, and reduce the severity of acne by ridding the skin of bad acne bacteria while preserving the good. 
According to dermatologist Dr. Whitney Bowe, some scars are thick, raised hypertrophic scars that stick out above the skin; others are keloid, which are scars that have over-healed, and manifest as dense, rubbery skin tissue. Then, there are atrophic scars that appear as depressions in the skin — they're the most challenging to treat. The three main categories of atrophic scars are:
Inflammatory Acne: Inflammatory acne is red bumps and pustules, not whiteheads, blackheads and comedones. It does not necessarily start as them, either. It arises on its own. Whiteheads, blackheads or comedones that become inflamed can be painful and unsightly. Persistent inflammatory acne may require treatment by a physician or dermatologist, in addition to over-the-counter acne remedies.
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.
Acne is a condition of the skin that shows up as different types of bumps. These bumps can be blackheads, whiteheads, pimples, or cysts. Teens get acne because of the hormonal changes that come with puberty. If your parents had acne as teens, it's more likely that you will, too. The good news is that, for most people, acne goes away almost completely by the time they are out of their teens.
What you can do differently: For starters, stop going to tanning beds. Period. And if you are in the sun, make sure to slather on a titanium dioxide- or zinc-based sunscreen (these are natural sun protectants and their formulations usually contain fewer chemicals, so they won't break you out as easily), and wear a sun hat or ball cap to shield your facial skin from harsh rays.
"You want to calm the inflammation right away," Chiu says of treating newly popped pimples prone to scarring. She suggested asking your dermatologist to prescribe an anti-inflammatory acne medication like Aczone Gel. For a prescription-free solution, dermatologist Ronald Moy suggests treating newer scars with a product containing innovative growth factors that "stimulate collagen production immediately" and "should prevent any new scars from becoming old scars." This serum from Moy's product line, DNA EGF, uses growth factors clinically proven to speed up the growth of healthy skin cells. Both hyperpigmentation (not true scarring, but the spotty aftermath of a breakout) and atrophic scars (those crater marks more deep and sunken) benefit from a stimulating collagen boost because thickening the skin leads to less visibility of existing scars, Moy says.
When you're feeling anxious, your body produces more of the stress hormone cortisol. Excess levels can signal acne to worsen, explains Lauren Eckert Ploch, a dermatologist with Georgia Dermatology and Skin Cancer Center in Augusta, GA. Light an aromatherapy candle. The dim flickering light, plus the soothing scents of eucalyptus and mint, instantly creates a chill environment.
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.

I wear a full face of full coverage makeup every weekday for work. To get it all off, I used to rely on makeup wipes before face wash. I later realized the wipes, while convenient for nights you're ready to PTFO and must, were kind of just sliding product around my face instead of truly cleaning it. Thankfully, a facial with celebrity esthetician Renée Rouleau introduced me to the idea of double cleansing.


Even if you have amazing willpower—like the willpower of a Girl Scout with a full inventory of Thin Mints under her bed—and never, ever mess with your acne, you can still scar. "Acne scars result from damage to the skin following repeated inflammation from acne cysts," says Judith Hellman, M.D., a board-certified dermatologist in New York City. "Pimple popping can make the process worse, but acne can cause scarring even without pimple popping."


Who likes scars and that too on the face! Getting rid of acne scars is a little tougher than eliminating acne actually. Pimples can be naturally treated with many ingredients having anti-inflammatory or antibacterial properties which are in abundance in nature. However, pimple scars are a little stubborn as they don’t go easily. However, as the saying goes, nothing is impossible. It may take some time but your regular efforts using certain natural bleaching agents as well as other ingredients may lighten your acne scars and gradually remove them permanently.
If you have body acne, taking a shower as soon as possible after working out is also key. It turns out that standing around in tight, sweaty workout clothes puts you at the greatest risk for body acne and rashes. “The whole idea is that the bacteria that live on the skin can get trapped in the hair follicles and cause inflammation,” says dermatologist Dr. Elizabeth Hale. “The more you work out in the heat the more likely this is.” Dr. Levin agrees that showering right after a workout is your best defense against body acne. But in a pinch, body wipes like the Yuni Shower Sheets will do the trick.
Ugh, I know. This is the first piece of advice every dermatologist, esthetician, and nutritionist has told me time and time again, yet I've resisted. I'm aware that dairy is known to cause inflammation and increased sebum production, but I just love cheese (and ice cream, and milk chocolate) so damn much, okay? Because I was at my most desperate, I decided to swallow my cravings and go dairy-free for a very doable three weeks. After just one week into the experiment, my cystic bumps died down significantly, and I cursed everyone for being right.
7. You smoke. Every time you light up a cigarette, you decrease the amount of oxygen that goes to your face. This not only predisposes you to cancer, and causes the breakdown of collagen and elastin that leads to wrinkles and increased pore size, but the carcinogens in the smoke also irritates your skin and dries it out, triggering your skin to produce more oil and possibly more breakouts. (Tip via Dr. Downie.)
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.)
Rosacea is considered an incurable auto-inflammatory skin condition that waxes and wanes. As opposed to traditional or teenage acne, most adult patients do not "outgrow" rosacea. Rosacea characteristically involves the central region of the face, mainly the forehead, cheeks, chin, and the lower half of the nose. It commonly appears in people with light skin and particularly in those of English, Irish, and Scottish backgrounds. Some famous people with rosacea include the former U.S. President Bill Clinton and W.C. Fields. Alcohol intake does not directly cause rosacea, but it can be aggravated by it. Rosacea is not contagious or infectious.

Doctors can treat telangiectasias with a small electric needle, a laser, intense pulsed light, or minor surgery to close off the dilated blood vessels. Usually, multiple treatments are required for best results, and only a portion of the blood vessels improve with each treatment. Not everyone responds the same to these types of treatments, and a physician can help someone decide which treatment is best for his or her skin type, condition, and size of blood vessels.


This article was medically reviewed by Hilary Baldwin, MD. Baldwin, medical director of the Acne Treatment Research Center, is a board-certified dermatologist with nearly 25 years of experience. Her area of expertise and interest are acne, rosacea and keloid scars. Baldwin received her BA and MA in biology from Boston University. She became a research assistant at Harvard University before attending Boston University School of Medicine. She then completed a medical internship at Yale New Haven Hospital before becoming a resident and chief resident in dermatology at New York University Medical Center.
Bacteria. Excess sebum clogs the openings to hair follicles -- especially those on the face, neck, chest, and back. Bacteria grow in these clogged follicles. This makes blackheads or whiteheads, also known as ''comedones,'' form on the skin's surface. Sometimes, this clogging causes the follicle wall to break under the pressure of this buildup. When this happens, sebum leaks into nearby tissues and forms a pustule or a papule -- this is called inflammatory acne. Larger, tender pustules are called nodules.
Cocoa butter is a fat and an excellent moisturizer as well as emollient. It can quickly melt due to the high body temperature. This quality makes the butter easily absorbable into the skin. In fact, it not only penetrates the top layer of the skin but it goes deep within the skin into the dermis. Thus, it enters the site where the skin can retain the moisture for a longer time. A well moisturized skin is the skin that makes spots and scars less visible!
"You want to calm the inflammation right away," Chiu says of treating newly popped pimples prone to scarring. She suggested asking your dermatologist to prescribe an anti-inflammatory acne medication like Aczone Gel. For a prescription-free solution, dermatologist Ronald Moy suggests treating newer scars with a product containing innovative growth factors that "stimulate collagen production immediately" and "should prevent any new scars from becoming old scars." This serum from Moy's product line, DNA EGF, uses growth factors clinically proven to speed up the growth of healthy skin cells. Both hyperpigmentation (not true scarring, but the spotty aftermath of a breakout) and atrophic scars (those crater marks more deep and sunken) benefit from a stimulating collagen boost because thickening the skin leads to less visibility of existing scars, Moy says.

Comedo (whiteheads or blackheads) or papules. The comedo is the basic acne lesion, which is a plugged pore. If the plugged pore stays under the skin, it's called a closed comedo and forms a white bump or whitehead. Blackheads are comedos that open up and appear blackish on the surface of the skin. This black color is not due to dirt, but because the air reacts with the excess oil.

"You want to calm the inflammation right away," Chiu says of treating newly popped pimples prone to scarring. She suggested asking your dermatologist to prescribe an anti-inflammatory acne medication like Aczone Gel. For a prescription-free solution, dermatologist Ronald Moy suggests treating newer scars with a product containing innovative growth factors that "stimulate collagen production immediately" and "should prevent any new scars from becoming old scars." This serum from Moy's product line, DNA EGF, uses growth factors clinically proven to speed up the growth of healthy skin cells. Both hyperpigmentation (not true scarring, but the spotty aftermath of a breakout) and atrophic scars (those crater marks more deep and sunken) benefit from a stimulating collagen boost because thickening the skin leads to less visibility of existing scars, Moy says.


Temporary skin fillers have been used for years for acne scar treatment, but a permanent dermal filler was approved for use by the FDA just last summer. Designed to remove moderate to severe acne scarring, Bellafill is made up of 80% collagen to replace lost volume and 20% polymethylmethacrylate, which helps your body heal by boosting protein production.


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.
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