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.
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.
Consider exfoliating with baking soda. Baking soda can be used to exfoliate the skin and minimize the appearance of acne scars. All you need to do is mix one teaspoon of baking soda with two teaspoons of water to form a liquid paste. Apply this paste all over your face and use gentle circular motions to rub the baking soda into the skin, concentrating on the scarred areas, for about two minutes. Rinse off with warm water and pat the skin dry. 
Other concerns include inflammatory bowel disease and the risk of depression and suicide in patients taking isotretinoin. Recent evidence seems to indicate that these problems are exceedingly rare. Government oversight has resulted in a highly publicized and very burdensome national registration system for those taking the drug. This has reinforced concerns in many patients and their families have that isotretinoin is dangerous. In fact, large-scale studies so far have shown no convincing evidence of increased risk for those taking isotretinoin compared with the general population. It is important for those taking this drug to report changes in mood or bowel habits (or any other symptoms) to their doctors. Even patients who are being treated for depression are not barred from taking isotretinoin, whose striking success often improves the mood and outlook of patients with severe disease.
As mentioned above, genetics are thought to play a major role in your susceptibility to acne. However, using the best acne products and taking good care of your skin can help you prevent worsening acne and scars later in life. Check out these other known acne causes and aggravators and see how to prevent acne by cutting some of these out of your life:
Mild rosacea may not necessarily require treatment if the individual is not bothered by the condition. Situations that are more resistant may require a combination approach, using several of the treatments at the same time. A combination approach may include prescription sulfa facial wash twice a day, applying an antibacterial cream morning and night, and taking an oral antibiotic for flares. A series of in-office laser, intense pulsed light, or photodynamic therapies may also be used in combination with the home regimen. It is advisable to seek a physician's care for the proper evaluation and treatment of rosacea.
"Acne scars are very challenging to treat and are even more challenging to treat once they've been given time to age," says Joel Schlessinger, M.D., a board-certified dermatologist in Omaha, Nebraska. Although he says the best option is prevention (but if you just can't resist popping your pimples, do it the doctor-approved way!), there are ways to treat acne scars to drastically reduce their appearance.
For women who break out mainly around their menstrual cycle, some birth control pills can help. Research shows that these pills can clear acne by slowing down overactive oil glands in the skin. Sometimes, birth control pills are used along with a drug called spironolactone to treat acne in adult females. This medication lowers levels of the hormone androgen in the body. Androgen stimulates the skin's oil glands. Side effects of this drug include irregular menstruation, breast tenderness, headache and fatigue. Spironolactone is not appropriate therapy for all patients.
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.
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.
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