Moderate to moderately severe acne. This type of acne consists of several whiteheads, blackheads, papules and pustules that cover from ¼ to ¾ of the face and/or other parts of the body. It can be treated with antibiotic lotions or gels, as well as retinoic acid. Retinoic acid is an altered form of vitamin A. It helps prevent whiteheads and blackheads. Your doctor may also prescribe an antibiotic pill, such as erythromycin. If you take birth control pills to prevent pregnancy, antibiotics can affect how well they work. Be sure to use a second method of birth control with the pill, such as a condom. Retinoic acid and antibiotic pills can make the skin sensitive to the sun. So, wear sunscreen and stay in the shade while using them.


Glycolic acid: A true magic maker, glycolic acid is the smallest acid in size, meaning it’s able to penetrate deeply into the skin’s pores to do its work. It breaks apart the cellular glue holding dead skin cells together to reveal a fresher, brighter complexion. It also promotes cellular turnover by boosting collagen and elastin, helping your skin regenerate and repair itself.

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.


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.
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.
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.
The first and most important rule isn't groundbreaking: Remember to wash your face! Cleansing and treating your skin twice a day is the best way to keep breakouts away. For those emergencies when you're just too tired to wash your face, keep a stash of face wipes in the drawer of your nightstand. This way if you get home super late and don’t feel like going all the way to the sink, you can still go to bed with clean skin!
Whether your acne has persisted since your teenage years or has appeared as a new skin problem in later life, consider seeing a dermatologist if you're looking for treatment options. A specialist can help you determine the factors which may be triggering your acne and can help you with prescription medications to help regulate hormones or treat your breakouts without drying or otherwise irritating your aging skin.

Over-the-Counter Creams and Lotions. Retinoid creams or lotions can help clear your skin and also lessen wrinkles. Products made with sulfur can be good for the occasional spot treatment. Benzoyl peroxide is another acne fighter. Use benzoyl peroxide products only occasionally, because they can dry out your skin, Day says. You could also try a milder benzoyl peroxide product.
"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.
You can help keep rosacea under control by keeping a record of things that cause it to flare up. Try to avoid or limit these triggers as much as you can. Antibiotic lotions or gels can also help. Sometimes, you may need to take antibiotic pills. Your dermatologist may treat you with laser surgery. If you think you have rosacea, talk with your doctor about these treatments.
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.

Your dermatologist may prescribe Accutane®, if other treatments have not worked. This is a strong medicine that can help prevent scarring and treat active disease. But, Accutane also can cause birth defects. It is important that you are not pregnant and do not plan to get pregnant while taking this medicine. You must use two methods of birth control at the same time. This is done for one month before treatment begins, during treatment, and for a full month after stopping the drug. Talk with your dermatologist about when it's safe to get pregnant. Other side effects of this drug may include dry eyes, itching, mood changes, and changes in the blood and liver. You and your dermatologist can decide whether this medicine is right for you based on the pros and cons. Use any prescribed medicine exactly as you are advised. Taking more medicine than you are supposed to take may make acne or your general health worse. Ask your doctor what to do if you miss a dose.
Sometimes, your gynecologist can share insight into your acne, especially when it comes to deciding if birth control could help your breakouts. The FDA approves of Estrostep, Ortho Tri-Cyclen and Yaz to combat acne, but the trick is to be patient, as it can take up to four months to start seeing results. "This plan of attack works best when paired with whatever topical treatments you’re already using to treat your acne, like Proactiv, benzoyl peroxide, salicylic acid, etc," advises dermatologist Dr. Elizabeth Tanzi.
Over-the-counter retinol or vitamin A can also help. Anolik says retinols can be incredibly effective, especially higher-strength prescription retinoids: “They’re the gold standard in acne and aging treatments.” The prescription versions, from Tazorac to Differin, are usually covered by insurance in the case of acne. Vitamin C can also treat pores and exfoliate; Tammy Fender’s System ($165, tammyfender.com) comes with a vitamin C toner.

Worried moisturizer will make your acne worse? Think again — it can actually help improve your skin. “If the skin surface is dry and dehydrated, the oil glands tend to overproduce oil and this can make acne worse,” Dr. Weiser says. “Hydrating the skin surface can re-balance oil glands and help control acne and improve healing.” When buying a moisturizer, she recommends looking for a lightweight, oil-based product that won’t clog your pores. Dr. Levin likes Differin Soothing Moisturizer because it's "a great lightweight pH balanced moisturizer you can use in combination with acne topical treatments."
If you have this, you’re not alone – it can affect many people! Like face acne, bacne can form when your pores get clogged by excess oil and dead skin cells, allowing bacteria to grow. Sometimes, wearing tight clothes and using heavy backpacks can irritate the skin and make bacne worse. You can treat it the same way you would treat acne on your face.
In dermatology, PDT with the photosensitizer Levulan Kerastick (20% delta-aminolevulinic acid HCl) is used for the treatment of very early, thin skin cancers called actinic keratoses (AK). The initial approval was specifically for the treatment of actinic keratosis of the face and scalp with a combination of an application of the photosensitizer followed by a timed exposure to a special blue light source. PDT is also used for acne, rosacea, skin cancer, sun damage, cosmetic skin improvement, oily skin, enlarged sebaceous glands, wrinkles, rejuvenation (anti-aging), warts, hidradenitis suppurativa, psoriasis, and many other skin conditions.
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.
With the proper treatment, patients can control rosacea symptoms and signs. Popular methods of treatment include topical (skin) medications applied by the patient once or twice a day. Topical antibiotic medication such as metronidazole (Metrogel) applied one to two times a day after cleansing may significantly improve rosacea. Azelaic acid (Azelex cream, Finacea gel 15%) is another effective treatment for patients with rosacea. Both metronidazole and azelaic acid work to control the redness and bumps in rosacea.
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.

New to glycolic acid peels? Cane + Austin recommends starting here with their introductory glycolic daily facial treatment. These easy-to-use, one-step daily treatment peels contain 10 percent pharmaceutical grade glycolic acid to reveal a healthy-looking glow. Great for all skin types including dry and sensitive, they reduce the appearance of fine lines, wrinkles, and age spots, even pigmentation, and restore skin’s luminosity and vitality.
Try some benzoyl peroxide. Benzoyl peroxide is used to kill the bacteria that contribute to acne. Benzoyl peroxide comes in different concentrations, but benzoyl peroxide with a 2.5% concentration is just as effective as 5-10% solutions, and it's less irritating to the skin to boot. Benzoyl peroxide also helps peel away layers of dead skin, leaving brighter, more rejuvenated skin in its place.
Exfoliate dead skin cells that can clog pores and lead to breakouts with the power of salicyclic acid. Mario Badescu's Acne Facial Cleanser was specially formulated to effectly target acne-prone or acne-erupted skin. A soothing blend of botanical extracts including aloe, chamomile, and thyme help to improve the look and feel of troubled skin, while leaving skin thoroughly refreshed.
3. You're eating spicy foods. Spicy foods often contain tomatoes and peppers, which contain acidic lycopene that can be an irritant to some people, throwing off their skin's pH levels and triggering breakouts. However, it isn't just spicy foods that can irritate your skin. Some people have an aversion to dairy, bread, or other types of foods — how your skin reacts to what you eat just depends on your own personal make-up. (Tip via Dr. Downie.)
If you use hair sprays or gels, try to keep them away from your face, as they also can clog pores. If you have long hair that touches your face, be sure to wash it often enough to keep oil away. And if you have an after-school job that puts you in contact with oil — like in a fast-food restaurant or gas station, for example — be sure to wash your face well when you get home. It also can help to wash your face after you've been exercising.
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.
Sometimes, your gynecologist can share insight into your acne, especially when it comes to deciding if birth control could help your breakouts. The FDA approves of Estrostep, Ortho Tri-Cyclen and Yaz to combat acne, but the trick is to be patient, as it can take up to four months to start seeing results. "This plan of attack works best when paired with whatever topical treatments you’re already using to treat your acne, like Proactiv, benzoyl peroxide, salicylic acid, etc," advises dermatologist Dr. Elizabeth Tanzi.
Sometimes even though they wash properly and try lotions and oil-free makeup, people get acne anyway — and this is totally normal. In fact, some girls who normally have a handle on their acne may find that it comes out a few days before they get their period. This is called premenstrual acne, and about 7 out of 10 women get it from changes in hormones in the body.
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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