You may have been told that what you eat affects your skin and that it can be the cause of pimples and outbreaks, but the debate about diet playing a role in acne frequency still rages on. Many dermatologists will vehemently dismiss the claims that food and acne are linked, as so much of the research surrounding this aspect of skin care has been inconclusive. Studies either yielded weak results, or were flawed with too few subjects or lack of control groups. 
Because I'm constantly testing out new products, I don't often end up with "empties" (as in, products so good you've emptied out the bottle). However, I loved Sunday Riley's Good Genes so much I literally twisted the pump off and stuck my finger in it to try and get every last bit. The magic potion's main ingredient is lactic acid, which exfoliates away dead skin cells — key for clearing pores, fading scars, and revealing fresh skin on the surface.
I tried many different products from over-the-counter acne treatments to expensive prescription medications. Price ranged from $5 to over $100. I even have books on “How to Clear Acne in 24 Hours”, “How to Clear Pimples in a Week”, or even “How to Clear Break Outs through Hypnosis”. I was an acne treatment junkie! I would buy anything for a clear complexion.
Acne occurs when the small pores on the surface of the skin become blocked with oil, dead skin cells, and bacteria. Each individual pore on the skin opens up to a follicle beneath the epidermis. Within these follicles lie a singular hair and a sebaceous gland. The sebaceous gland produces sebum, an oil designed to keep your skin lubricated and soft. However, when hormonal changes and other factors cause the gland to produce an excess of sebum, the oil will be pumped through the follicle, and may pick up dead skin cells and P. acnes bacteria on its way out. Should these substances clump together, a plug will form. As this plug starts to press up against the surface of the skin, the body responds with an accumulation of red and white blood cells to combat any infection, and this results in inflammation and redness. Acne can occur on the face, back, neck, chest, arms, and buttocks, and any other skin area with a saturation of sebaceous pores.
Isotretinoin: Accutane was the original brand name; there are now several generic versions in common use, including Sotret, Claravis, and Amnesteem. Isotretinoin is an excellent treatment for severe, scarring, persistent acne and has been used on millions of patients since it was introduced in Europe in 1971 and in the U.S. in 1982. It should be used for people with severe acne, chiefly of the cystic variety, that has been unresponsive to conventional therapies like those listed above. If taken in sufficient dosage, it should eliminate the need to continue the use of prescription drugs in most patients. The drug has many potential serious side effects and requires a number of unique controls before it is prescribed. This means that isotretinoin is not a good choice for people whose acne is not that severe but who are frustrated and want "something that will knock acne out once and for all." In order to use the drug, the prescribing physician, the patient, and the supplying pharmacy must be enrolled in the online "iPLEDGE PROGRAM." Used properly, isotretinoin is safe and produces few side effects beyond dry lips and occasional muscle aches. This drug is prescribed for five to six months at a dosage that has a high likelihood of preventing the return of acne. Fasting blood tests are monitored monthly to check liver function and the level of triglycerides, substances related to cholesterol, which often rise a bit during treatment but rarely to the point at which treatment has to be modified or stopped.
Topical treatments on their own may not be enough to give you clear skin, especially in those with complicated, inflammatory cystic acne. There are several acne medication options approved for use by the FDA, but which one is best for you is a question for your dermatologist and/or general practitioner. Baldwin says if you have insurance and you have acne, a prescription may be the best step because "it makes no sense to try to handle the condition yourself or to use over the counter products that are always less effective than prescriptions meds." Here are a few of the acne medications you'll want to ask about:
Acne scar treatment: Energy-based skin resurfacing with a laser, radiofrequency, or an ultrasound device can help treat boxcar scars, according to Nada Elbuluk, MD, an assistant professor at the Ronald O. Perelman Department of Dermatology at New York University Langone Medical Center in New York City. “They all work by creating new collagen beneath the surface of the skin.” A series of treatments is likely needed based on the extent of scarring, she says. Chemical peels can also help but to a lesser extent. With either procedure, using a retinoid to increase cell turnover and further boost collagen can help improve results, Dr. Elbuluk adds.

Laser resurfacing involves directing concentrated pulsating beams of light at irregular skin. This procedure may be used to reduce wrinkles, blemished, or acne scars. There are two types of lasers commonly used in laser resurfacing: carbon dioxide and erbium. Treated areas heal in 10-21 days. Possible complications include milia, hyperpigmentation, and swelling.


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.

Acne scar treatment: “Treatment may include excising the scar with a small ‘punch,’ and suturing the defect closed, but this only works for isolated ice pick scars,” he says. New York City dermatologist Judy Hellman, MD, adds: “We can also do skin grafts and take skin from behind the ear to fill the scar, and then we can use a laser or radiofrequency device to smooth it out.”


"Fluctuation in hormones, such as before one's menstrual cycle, is the main cause," explains dermatologist Julia Tzu, M.D., of Wall Street Dermatology. Specifically, androgens (male hormones) like testosterone. This usually rears its ugly head in the form of deep (painful) cystic acne around the chin, neck, and back, says dermatologist Rebecca Kazin, M.D., F.A.A.D., of the Washington Institute of Dermatologic Laser Surgery and the Johns Hopkins Department of Dermatology.
Sunscreen: "Sun exposure during an active breakout can lead to darkening of inflammatory lesions, prolonging their appearance on your skin and making them harder to fade over time," says Dr. Shereene Idriss from Union Square Dermatology, which means it's important to lather on the sunscreen daily — even when it's cloudy. And don't worry about breaking out from a pore-clogging sunscreen; the latest formulas are more innovative and acne-friendly than ever. Elta MD UV Clear Broad-Spectrum SPF 46 is a top derm-approved favorite. It contains niacinamide, which is an anti-inflammatory that helps reduce redness.
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.

When it comes to acne scars — especially difficult to treat indented or raised ones — the best offense is a good defense. If you’re still struggling with active acne and want to avoid future scarring, Avram likes this drugstore-staple Neutrogena wash because it contains salicylic acid, a beta-hydroxy acid that he says “exfoliates the skin, softens the appearance of the acne itself, and has some antibacterial properties.”
Acne scars are most often the product of an inflamed lesion, such as a papule, pustule, or cyst. Inflamed blemishes occur when the follicle, or pore, becomes engorged with excess oil, dead skin cells, and bacteria. The pore swells, causing a break in the follicle wall. If the rupture occurs near the skin's surface, the lesion is usually minor and heals quickly. More serious lesions arise when there is a deep break in the follicle wall. The infected material spills out into the dermis and destroys healthy skin tissue.
Sometimes it seems like pimples sprout up overnight, but the process of pimple formation is a bit more complex. So what are the most common causes of pimples? A variety of factors can result in an acne blemish. Pimples can develop on anyone at any age, but tend to be most common amongst teens. Why do teenagers get the brunt of breakouts? Hormone fluctuations. When hormone levels increase, the sebaceous glands found within the skin’s hair follicles produce an excess of sebum. Sebum is a waxy substance that the body produce to keep the skin soft and moisturized. However, when hormonal changes cause an increase in sebum production, the pores can become clogged. This sticky substance can collect dead skin cells, debris, and bacteria, forming a plug in the follicle. Blackheads, whiteheads, pimples, and pustules all begin the same way. Preventing pimples means discovering the reasons you’re breaking out and doing all you can to combat these factors. There is no single answer to the age old question of how to get rid of pimples.
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.
If you're looking for suggestions on how to get rid of acne overnight, using toothpaste for acne spot treatment has probably come up. But does it work? Toothpaste contains ingredients like baking soda, alcohol, hydrogen peroxide and menthol that can dry out acne. However, some experts warn that using toothpaste for acne can actually cause over-drying and even skin peeling, so it should be used with caution. Here's how:
The nose is typically one of the first facial areas affected in rosacea. It can become red and bumpy and develop noticeable dilated small blood vessels. Left untreated, advanced stages of rosacea can cause a disfiguring nose condition called rhinophyma (ryno-fy-ma), literally growth of the nose, characterized by a bulbous, enlarged red nose and puffy cheeks (like the classic comedian W.C. Fields). There may also be thick bumps on the lower half of the nose and the nearby cheek areas. Rhinophyma occurs mainly in men. Severe rhinophyma can require surgical correction and repair.
It’s the end of the line for adult acne with this new powerful treatment that jump-starts acne clearing and helps prevent acne well beyond the treatment.  A deep-cleansing is followed by professional exfoliation to remove pore-clogging skin cells and extractions to help clear current breakouts without spreading acne-causing bacteria.  The application of our soothing professional masque system detoxifies skin while calming irritation and redness.
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:
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."
12. Step away from your hands. You know how you rest your face on your hand while you're studying? That might be the reason for those blemishes on your cheek or jaw. You're constantly touching things that have germs—anything from your phone to your locker—so putting your hands on your face for a long period of time can cause dirt and bacteria from anything you touch to get into your pores.
Toning. After you wash and exfoliate you should apply a toner to the face that will help tighten the pores so oil and dirt cannot become trapped and create a home for harmful bacteria. Toners designed for acne sufferers are readily available at drugstores, but you can also apply products like apple cider vinegar or witch hazel. Apply toners with cotton balls and allow them to sit on the skin rather than rinsing them away.
Many theories about diet and acne abound; Anolik is most convinced by the ones surrounding sugar and dairy. “Dermatologists really didn’t believe in all the dietary restrictions for acne, but studies in the past ten years have convinced us a bit,” he says. “Dairy and high-glycemic foods do seem to play a part.” High-sugar diets are known to feed bacteria; any diet that increases overall inflammation in the body doubtlessly plays a part. Specific diets—from Ayurveda to low-carb to veganism—definitely work for some people.
Acne scar treatment: “Rolling scars can be treated with microfat injections followed by microneedling with platelet-rich plasma (PRP),” says Dr. Imber. Microneedling creates tiny wounds or pinpricks in the skin. The body’s natural, controlled healing process then kicks in to boost internal collagen production. Microneedling is also a great acne scar treatment because it opens up channels within the skin that give PRP—the healing factors in your own blood—and skin care products direct access to deeper layers of the skin where they’re needed most. PRP is created by taking some of your blood, isolating the platelet-rich plasma, which contains proteins and other growth factors, and injecting it back into the scar. “The objective is to build up the collagen layer under the depression in order to raise it to the level of the surrounding skin,” Dr. Imber says. You’ll likely need multiple treatments, but the results are worth it. This approach is backed up by a new study in the January 2017 issue of Aesthetic Plastic Surgery, which found that fat plus PRP improve depressed scars alone and in combination with laser skin resurfacing. What’s more, the treatment improved the social life and relationships of people with scarring, the study showed. These are the innocent habits that practically guarantee your acne will scar.

Best used for treating hyperpigmentation, these products — packed with glycolic acid — promote cellular turnover to remove the top layers of the skin revealing a brighter, fresh complexion, says New York City-based dermatologist Dendy Engelman. "Glycolic acid is the smallest acid in size," she says. (This means it can get deep into the skin.) "It is very effective in breaking down skin cells and removing dead particles," says Engleman. "It boosts collagen production and elastin production with the removal of waste and dead skin cells." Bottom line: By removing these dead cells, healthy, glow-y skin is revealed.
Acne (acne vulgaris, common acne) is a disease of the hair follicles of the face, chest, and back that affects almost all teenagers during puberty -- the only exception being members of a few primitive Neolithic tribes living in isolation. It is not caused by bacteria, although bacteria play a role in its development. It is not unusual for some women to develop acne in their mid- to late-20s.
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