Doctors can treat telangiectasias with a small electric needle, a laser, intense pulsed light, or minor surgery to close off the dilated blood vessels. Usually, multiple treatments are required for best results, and only a portion of the blood vessels improve with each treatment. Not everyone responds the same to these types of treatments, and a physician can help someone decide which treatment is best for his or her skin type, condition, and size of blood vessels.
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.
It's best to consult a primary care physician or dermatologist if an individual is unable to adequately control his or her acne. The goal of treatment should be the prevention of scarring (not a flawless complexion) so that after the condition spontaneously resolves there is no lasting sign of the affliction. Here are some of the options available:
If you look in the mirror and see a pimple, don't touch it, squeeze it, or pick at it. This might be hard to do — it can be pretty tempting to try to get rid of a pimple. But when you play around with pimples, you can cause even more inflammation by popping them or opening them up. Plus, the oil from your hands can't help! More important, though, picking at pimples can leave tiny, permanent scars on your face.
You may have heard the age old question, "does makeup cause acne?". While wearing makeup can exacerbate acne flare ups, it is not necessarily the case. Some support the fact that that cosmetics can fill up your pores, worsen pimples, and prevent your skin from “breathing”. The truth is, whether or not makeup worsens acne is highly individualized. While excessive use of foundations, concealers, and other cosmetics can work their way into and block up your pores, making sure to clean your face of such products before working out or going to bed lessens the likelihood of makeup blockages.
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.”
So if popping pimples doesn't cause scarring, what does? Long-lasting scars typically turn up after a recurring bout with cystic acne. Cystic acne is a breakout that burrows deep into the skin. These red, painful nodules occur when clogged pores are filled with pus and bacteria, which causes inflammation. Cystic breakouts are often tied to an internal fluctuation of hormones like testosterone (that's why they're common during puberty, monthly menstruation, and perimenopause). "If there is a cyst in the skin, it's going to cause a scar the longer it sits there because pus or bacteria deeper inside the pores cause surrounding inflammation," says Dr. Karolak. And as a result, the inflammation affects the collagen production as well as the fat stores under the skin, creating a visible scar on the surface.
Steroid injections: If you feel a stress pimple rearing its ugly head, a steroid shot can be administered the same day you call your derm because the process is very fast. Not only does it immediately reduce the inflammation of an existing zit, but cortisone can also help thick scars (keloids) appear softer and flatter. "These are specifically for raised scars, however," says Dr. Shah. "It'll help flatten out the scar, but it won't do anything to any discrepancies in the texture."
Those big, painful zits will leave a scar if you pick and prod at them—"the only way to reduce it quickly is to drain it, and that's not a DIY deal," Dr. Schultz warns. The reason they're painful is because quick expansion stretches the nerves. "Drinking good red wine is often helpful [to numb the pain]," he jokes. Take Advil, apply a warm or cold compress (whichever feels better to you), and go see your derm. "Cortisone shots are the true 'spot treatments' for painful cystic acne lesions," Dr. Tzu says.
Drugs: Some medications may cause or worsen acne, such as those containing iodides, bromides, or oral or injected steroids (either the medically prescribed prednisone [Deltasone, Orasone, Prednicen-M, Liquid Pred] or the steroids that bodybuilders or athletes sometimes take). Other drugs that can cause or aggravate acne are anticonvulsant medications and lithium (Eskalith, Lithobid). Most cases of acne, however, are not drug related.