As the name suggests, ice pick scars are very deep acne scars that look like the skin has been punctured with… an ice pick. When the body produces too little collagen in response to an injury, depressed scars such as ice picks can form. “Ice pick scars represent the result of infected sebaceous gland openings on the skin. They are usually the most difficult to correct,” says New York City plastic surgeon Gerald Imber, MD.
With its natural inflammation-fighting properties, a 5 percent solution of tea tree oil is less harsh than a 5 percent benzoyl peroxide solution and can be just as effective against acne, though it may clear up a little less quickly. Mix a few drops of tea tree oil with between 20 and 40 drops of witch hazel, then use a cotton swab to apply. Try this remedy up to twice a day; more could dry your skin and make the acne worse.
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.
Acne is reported to be less common in people that have a diet with lower glycaemic index, eg, natives from Kitava and Papua New Guinea, the Ache people of Paraguay, Inuits and rural residents of Kenya, Zambia and Bantu. These people tend to become sexually mature at a later age than in the cities where higher glycaemic index foods are consumed. Early puberty is associated with earlier onset and more severe acne that tends to peak at the time of full maturity (age 16 to 18).

Punch excisions: "This procedure is best for those with icepick scars, which aren't as wide as rolling or boxcar scars," says Dr. Shah. "If you use a punch excision on a scar that's wide at the surface, you're making a bigger punch and trading in one scar for another," she says. "Your dermatologist will numb up the area and use a tiny cookie-cutter like device to cut out the scar, and then sew it closed with a tiny stitch. The stitch is removed in less than a week," says Dr. Bowe. However, Dr. Idriss cautions against this method for those with darker skin or undertones who are prone to hyperpigmentation.
Another potential skin saboteur is sugar, because it raises your insulin level. More and more evidence shows that insulin may boost those oil-triggering male hormones, Dr. Schultz explains. Stick to low-glycemic foods—ones that have complex carbs like whole grains, which break down slower in the body and cause less of an insulin spike. Your health will be better for it, too.
11. You're wearing a lot of hats or constantly touching your face. Anything that can trap sweat and bacteria against your skin and clog your pores, like the lining of a tight hat, can cause zits to crop up. Also, touching your face or resting your chin in your hand while you're sitting at your desk can transfer bacteria from your hand onto your face and brew blemishes. (Tip via Dr. Downie.)

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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. 
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.
Hypo-pigmentation is characterized by the light spots that result from a lack of melanin. With this type of skin damage, melanocytes are depleted from the injured area or lose their ability to produce melanin. This occurs when healthy skin has been replaced with scar tissue. Because scar tissue has a light pink color, it’s more noticeable on people with darker skin tones.
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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