But, sometimes a particularly aggressive blemish is truly on a mission to leave its permanent mark. "Acne scars occur when normal tissue in the skin is destroyed and replaced with fibrous tissue. You can think of an acne lesion as a wound. When the damage caused by acne is severe, the body can respond by creating too much tissue or too little tissue. The production of too much tissue forms a keloid or a hypertrophic scar, and too little tissue leads to that depression in the skin, or atrophic scar. The deeper and more inflamed the acne lesion, or the more that it is picked or squeezed, the more likely it is to scar," says Dr. Bowe.

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.
2. You're OD'ing on spot treatments. Overusing topical salicylic acid, benzoyl peroxide, or sulphur over-the-counter treatments can dry out your skin, causing it to produce more oil and possibly blemishes. Those ingredients can actually make the appearance of your pimples look worse, since the active ingredients can slightly burn the top layer of your skin if used too often, making the pimple appear even redder and harder to conceal than if you had just left it alone. (Tip via Samantha Wright, a licensed aesthetician and Skinovator at the Dangene Institute.)
As you go about treating acne, it's important to remember that all acne isn't the same. What works really well for one kind of pimple might not work at all for another. You want to use the type of acne treatment that targets your particular kind of acne. If you use the wrong treatment you might even make your breakouts worse. The first step in how to get rid of acne is understanding what kind of acne you have—read on to learn about blackheads, white heads, small red bumps, hormonal acne and cystic acne, and how to best treat each.
The bad news: There's no secret ingredient or miracle gadget that makes scars totally disappear. Don't get discouraged, though. A lot of what you think is acne scarring is really just hyperpigmentation or erythema (brown or red spots) rather than an actual change in the texture of the skin. Plus, there's a bevy of gels, creams, and treatments that can bring that discoloration down. We asked top dermatologists to recommend the most effective of the bunch.
Instead, you’ll want to talk to your dermatologist about what can be done about your scarring. There are professional procedures that can smooth the skin and minimize scars. Laser treatments are often used to treat acne scars. Your dermatologist might also suggest dermal fillers to “plump up” the depressed area leaving the skin, albeit temporarily, more smooth and even.

If you really must do something about your pimple beyond washing your face and spot treating, ice or a cold compress can help reduce swelling. Wrap an ice cube or the compress in a soft tissue or cloth and apply it to your zit for 20-30 seconds at a time, a few times a day. In case of an emergency (like, prom), you can also see a dermatologist for a cortisone injection, which can help shrink the cyst down quickly in a day or two.
Rosacea, although distinct from acne, does have some similarities. Unlike common acne, rosacea occurs most often in adults (30-50 years of age). Unlike acne vulgaris, rosacea is devoid of blackheads and characteristically does not resolve after puberty. Rosacea strikes both sexes and potentially all ages. It tends to be more frequent in women but more severe in men. It is very uncommon in children, and it is less frequent in people with dark skin.
The hair follicles, or pores, in your skin contain sebaceous glands (also called oil glands). These glands make sebum, which is an oil that lubricates your hair and skin. Most of the time, the sebaceous glands make the right amount of sebum. As the body begins to mature and develop, though, hormones stimulate the sebaceous glands to make more sebum.
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As you go about treating acne, it's important to remember that all acne isn't the same. What works really well for one kind of pimple might not work at all for another. You want to use the type of acne treatment that targets your particular kind of acne. If you use the wrong treatment you might even make your breakouts worse. The first step in how to get rid of acne is understanding what kind of acne you have—read on to learn about blackheads, white heads, small red bumps, hormonal acne and cystic acne, and how to best treat each.
While SPF is a must, some sunscreens can trigger breakouts. You want to look for oil-free and non-comedogenic formulas that won't clog pores,” says Karen Hammerman, MD, from Schweiger Dermatology. Options from brands like Elta MD and Peter Thomas Roth, which are recommended by the pros, are specifically tested on acneic skin so you can get your dose of SPF without having to worry about clogged pores.
Like microneedling, fractionated skin resurfacing sends skin a signal to respond to damage. Specifically, microscopic columns of injury are created causing minute perforations in the treatment area, while leaving healthy surrounding tissue intact and untouched. "The specific zones of injury trigger the patient's natural neocollagenesis (collagen rebuilding process)," explains Engelman, who characterizes the treatment as both revolutionary and non-invasive. This new collagen rejuvenates the skin and improves its appearance. "Improvements continue over time (up to six months post-procedure) as new collagen continues to rebuild," she says.

"Overwashing your face can make acne worse," Dr. Kazin explains. Cleansing more than twice a day is too much and can just dry out skin, "which can cause [it] to produce more oil to overcompensate." Your Clarisonic addiction may not be helping either. "It helps remove all makeup and helps your cleanser work better, but I worry about the coarse ones. It's almost like giving yourself microdermabrasion twice a day, which can cause a breakout," says Dr. Kazin. Dr. Schultz seconds that: "Anything that rubs skin will, to a small extent, promote acne." That includes a grainy or gritty cleanser, too. Try these two gentle face washes instead: Phace Bioactive Detoxifying Gel Cleanser or Frank Body Creamy Face Cleanser.

26. Get your SPF on. Sunscreen isn't just for summer—your skin needs protection every day, even in winter. There are now sunscreens for every skin type imaginable—even ones that help make your skin less oily, so your face stays matte and pimple-free! Look for a daily moisturizer with SPF that says it's "lightweight," "oil-free," or "oil-controlling." For the highest level, look for a PA++ rating, it covers both UVA and UVB rays, so you're guarded against everything from burns to future wrinkles!
2. You're OD'ing on spot treatments. Overusing topical salicylic acid, benzoyl peroxide, or sulphur over-the-counter treatments can dry out your skin, causing it to produce more oil and possibly blemishes. Those ingredients can actually make the appearance of your pimples look worse, since the active ingredients can slightly burn the top layer of your skin if used too often, making the pimple appear even redder and harder to conceal than if you had just left it alone. (Tip via Samantha Wright, a licensed aesthetician and Skinovator at the Dangene Institute.)

When you think about it, consistently reaching for your go-to face towel every day is like reusing a dinner napkin over and over again. Using dirty towels can harbor bacteria, and they can even introduce new bacteria to your skin, which may lead to more pimples. Thankfully, this doesn't mean you need to reach for a new towel every single time you wash your face, according to Dr. Melissa Kanchanapoomi Levin, board-certified NYC dermatologist and clinical instructor at NYU Langone and Mount Sinai Hospital. As long as you're truly washing off all of your makeup, you can stick to switching out your towels on a weekly basis.
Chemical peels: "A chemical peel is a treatment that uses the application of mild solutions for skin refinement and regeneration. Products containing glycolic acid promote cell turnover, which is the process where new skin cells form and help even out your skin tone," says Dr. Bowe. You can try an at-home peel like Peter Thomas Roth 40% Triple Acid Peel, which uses both glycolic and salicylic acids to help fade spots by exfoliating dead skin cells and smoothing out skin texture. "Or, your dermatologist can prescribe you a stronger peel based on your skin type and treatment goals," says Dr. Bowe.
EradiKate™ Mask Foam-Activated Acne Treatment gently exfoliates dead skin cells and helps unclog pores while sulfur reduces the appearances and helps prevent pimples, zits, and future breakouts. Within minutes Kate’s unique foam-activated technology penetrates to help dissolve impurities and dirt, and address oily skin. An advanced botanical complex of boswellia serrata, honey extracts, and rice bran work to calm and soothe skin. Use this mask with Kate Somerville’s bestselling EradiKate Acne Treatment for an acne regimen that promotes a clearer complexion.
Understanding why you break out requires consideration of a variety of aspects. There are many underlying reasons for acne breakouts, but most pimples are caused by fluctuations in hormone levels. During puberty, the increase in androgens (male hormones) causes the adrenal glands to go into overdrive. This triggers the production of sebum within the sebaceous glands. The more sebum produced, the easier it is for hair follicles to become clogged. When the follicle becomes blocked, oil can’t leave the pore, collecting dead skin cells that would have otherwise sloughed off and hanging onto bacteria called p. acnes. These hormonal fluctuations can arise at other times in life, including menstruation, pregnancy, and menopause.
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. 

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."
Steroids have long been known to cause acne. These drugs are generally taken without a prescription in order to gain muscle, but there are instances in which women are prescribed steroids for rare conditions. Steroids cause hormonal changes, and as the androgen hormones increase, so too does oil production. The more sebum, the greater chance of clogged pores. Steroids might also accelerate the growth of P. acnes, which can make pimples and inflammation worse.

17. Less is more. Too many products can irritate and too many steps may tempt you to skip. When it comes to your skin, more is definitely NOT more. In other words, trying a bunch of different remedies at once won't boost your chances of making the zit disappear — more likely, it'll just wreak havoc on your skin and turn a teeny-tiny pimple into a red, blotchy mess.
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:

Can’t use the good stuff: The best medications for clearing acne include topical retinoids like Differin and Retin-A. The strong chemicals that are used in exfoliants can cause severe inflammation and sun irritation when combined with these medications. This means that you will have to choose between facials or proper medications. The choice is yours.
15. Try the 3-step solution. If you have acne, dermatologists recommend fighting it with a three-step regimen: a salicylic acid cleanser, a benzoyl peroxide spot treatment, and a daily moisturizer. Benzoyl peroxide works by fighting the bacteria that causes acne. It causes an exfoliating effect that might cause some slight peeling and can dry out your skin. It's great for mild cases of acne, and you can get it without a prescription — many drugstore acne washes, creams and gels contain benzoyl peroxide. Prescriptions creams that contain higher doses of benzoyl peroxides such can also be prescribed by a doctor for more severe cases. Salicylic acid dries out the skin and helps exfoliate it to make dead skin cells fall away faster. It's good for mild cases of acne, and is available without a prescription. Many drugstore acne creams, washes, and gels contain salicylic acid, but stronger versions are also available in prescription form. It can dry up your skin and cause redness and peeling.
The exact cause of rosacea is still unknown. The basic process seems to involve dilation of the small blood vessels of the face. Currently, health researchers believe that rosacea patients have a genetically mediated reduction in the ability to dampen facial inflammation that is incited by environmental factors such as sunburn, demodicosis (Demodex folliculorum in the hair follicles), flushing, and certain medications. Rosacea tends to affect the "blush" areas of the face and is more common in people who flush easily. Additionally, a variety of triggers is known to cause rosacea to flare. Emotional factors (stress, fear, anxiety, embarrassment, etc.) may trigger blushing and aggravate rosacea. Changes in the weather, like strong winds, or a change in the humidity can cause a flare-up. Sun exposure and sun-damaged skin is associated with rosacea. Exercise, alcohol consumption, smoking, emotional upsets, and spicy food are other well-known triggers that may aggravate rosacea. Many patients may also notice flares around the holidays, particularly Christmas and New Year's holidays.
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
Aqua (Water, Eau), Glycerin, Triethanolamine, Sodium Laureth Sulfate, Propylene Glycol, Isopropyl Alcohol, Salicylic Acid, Dimethicone, Aloe Barbadensis Leaf Juice, Chamomilla Recutita (Matricaria) Flower Extract, Thymus Vulgaris (Thyme) Leaf Extract, Sodium Hyaluronate, Carbomer, Parfum (Fragrance), Diazolidinyl Urea, Methylparaben, Propylparaben, Benzyl Benzoate, Benzyl Salicylate, Eugenol, Linalool.
I can't disagree with much of this. I was almost half expecting some wild remedy. :) When I was younger I had very bad cystic acne. I took tetracycline, minocycline, doxicycline, I used topicals like Retin-A, Cleocin-T, salicylic acid, benzoyl peroxide. I began using the Citrus Clear products on a regular, daily basis. Also I never touch my hands to my face, and the result has been acne free. NOt even an occasional pimple.
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While you’re waiting on all those active ingredients to kick in, Tzu says it’s best to use “makeup or foundation with a green tint to neutralize the redness.” She likes the Clinique Redness Solutions line, designed to color-correct red marks or spots. While this foundation includes SPF, it’s still best to layer over a dedicated sunscreen for maximum protection.

"Leafy green vegetables and other brightly-colored fruit and vegetables which are rich in antioxidants and nutrients dampen inflammation and improve skin quality (studies have shown acne patients have higher oil production and lower antioxidant levels)," says Dr. Weiser. "Limit intake of dairy products, which can contain hormones and antibiotics that can worsen acne breakouts." Other skin-boosting superfoods include eggs, nuts, legumes, and quinoa.
Oil-free soaps or washes won’t clog your pores or cause blackheads, acne, and whiteheads. Choose products that are labeled "oil free," "nonacnegenic” (which means it won’t cause acne) or "noncomedogenic” (which means it won’t clog your pores). Some also have ingredients recommended by dermatologists, such as benzoyl peroxide and salicylic acid. Make sure your washcloths are soft -- you can use one made for babies -- and use a clean one every time, too.

13. You're still a sun-worshipper. You're probably already aware that lying out in the sun and going to tanning beds cause skin cancer, but if that still hasn't stopped you from hitting the beach without sunscreen or the proper protective gear (aka that chic sun hat), perhaps this will. Contrary to popular belief, the sun isn't healing your acne, it's actually making it worse. What happens is, as your face gets red from the sun, it makes any breakouts you might already have blend in, creating the appearance of clearer skin. But what's really going on is the sun causing your skin to dry out and triggering more oil production, which can lead to more zits.

“After sweating, immediately use an exfoliating cleanser to help keep your pores clear and remove excess oil,” says Dr. Zein Obagi of ZO Skin Health. Try keeping Neutrogena Rapid Clear Treatment Pads in your gym bag or locker for those times you need an on-the-go cleanse. These will remove any leftover dirt while treating your skin with acne-fighting salicylic acid.


Helicobacter pylori (H. pylori) is a bacteria that causes chronic inflammation (gastritis) of the inner lining of the stomach, and also is the most common cause of ulcers worldwide. About 50% of people in the world carries or is infected with H. pylori. Common symptoms of H. pylori infection are occasional abdominal discomfort, bloating, belching or burping, and nausea and vomiting. H. pylori infection is difficult to erdicate, and treatment is with two or more antibiotics.

Ablative lasers deliver an intense wavelength of light to the skin, removing thin outer layers of the skin (epidermis). In addition, collagen production is stimulated in the underlying layer (the dermis). Patients are typically numbed with local anesthetic and the ablation is done as an outpatient procedure. CO2 and erbium are the ablative lasers most often used for acne scar treatment.


"I have terrible cystic acne but I don't want to take prescription medication!" she whines. Puh-leeze! You are given treatment, have access to products other than cleansers, but won't use them. This is a ridiculous article. I cleared my skin with soap, water, alcohol, and a complete dietary adjustment. Zero sugar, starch, breads, oils, fried and processed foods. I eat broccoli, greens (lots of greens), steamed and poached veggies, broiled or canned salmon, tofu, quinoa, brown rice, half a lemon a day over food or in unsweetened green tea, and blueberries. Someone else mentioned the sugar/insulin/hormonal imbalance link. You have to take responsibility for your lifestyle, as well as your treatment.
Post-inflammatory hyperpigmentation is not an acne scar, but a red, pink, brown or tan skin discoloration where acne has previously flared up. It will usually disappear on its own in a year or so. Many skin lightening products claim to help reduce the visibility of these acne “scars." Their active ingredient, hydroquinone, works to slow melanin production and can reduce dark brown marks, but melanin isn't the cause of red and pink acne discolorations. A better option is to use the best foundation for acne prone skin you can find to hide the marks until they naturally fade away.
Some people swear by the disinfecting power of tea tree oil for acne treatment. It can be applied either full strength or slightly diluted with water directly onto pimples. Use a small amount on a clean cotton swab or cotton pad and dab on the affected areas immediately after cleansing. Because tea tree oil can be drying, you might choose to use both tea tree oil and coconut oil for acne as part of your clear skin regimen.
Some teens who have acne can get help from a doctor or dermatologist (a doctor who specializes in skin problems). A doctor may treat the acne with prescription medicines. Depending on the person's acne, this might mean using prescription creams that prevent pimples from forming, taking antibiotics to kill the bacteria that help create pimples, or if the acne is severe, taking stronger medicines such as isotretinoin, or even having minor surgery. Some girls find that birth control pills help to clear up their acne.
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.

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."
Our second primary treatment, the Icon Laser, offers patients the best results for smoother skin. Laser therapy breaks up the scar with laser light. It punches holes in the collagen without ever piercing the skin. Because it doesn’t break the skin, recovery tends to be quicker after this treatment. Also, lasers penetrate deep into the skin causing long-lasting results.
Rosacea may affect the eyes. Not everyone with rosacea has eye problems. A complication of advanced rosacea, known as ocular rosacea, affects the eyes. About half of all people with rosacea report feeling burning, dryness, and irritation of the tissue lining of the eyes (conjunctivitis). These individuals may also experience redness of the eyelids and light sensitivity. Often the eye symptoms may go completely unnoticed and not be a major concern for the individual. Many times, the physician or ophthalmologist may be the first one to notice the eye symptoms. Untreated, ocular rosacea may cause a serious complication that can damage the cornea permanently damaging vision, called rosacea keratitis. An ophthalmologist can assist in a proper eye evaluation and prescribe rosacea eyedrops. Oral antibiotics may be useful to treat skin and eye rosacea.
Use a toner after cleansing. After you wash your face, exfoliate, or apply a face mask, apply a toner to the entirety of your face. Toners work to tighten pores making it less likely that dirt and oil will become trapped in them. Buy acne toners at a local drugstore, or use witch hazel or apple cider vinegar dabbed on with a cotton ball. Don’t rinse toners after application - allow them to stay on your skin.
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.

No one factor causes acne. Acne occurs when sebaceous (oil) glands attached to the hair follicles are stimulated at the time of puberty or due to other hormonal changes. Sebum (oil) is a natural substance that lubricates and protects the skin. Associated with increased oil production is a change in the manner in which the skin cells mature, predisposing them to plug the follicular pore. The plug can appear as a whitehead if it is covered by a thin layer of skin, or if exposed to the air, the darker exposed portion of the plug is called a "blackhead." The plugged hair follicle gradually enlarges, producing a bump. As the follicle enlarges, the wall may rupture, allowing irritating substances and normal skin bacteria access into the deeper layers of the skin, ultimately producing inflammation. Inflammation near the skin's surface produces a pustule; deeper inflammation results in a papule (pimple); if the inflammation is deeper still, it forms a cyst.
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