Light treatments: Recent years have brought reports of success in treating acne using special lights and similar devices, alone or in conjunction with photosensitizing dyes. It appears that these treatments are safe and can be effective, but it is not clear that their success is lasting. At this point, laser treatment of acne is best thought of as an adjunct to conventional therapy, rather than as a substitute.
“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.
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."
"I often recommend PCA Skin Pigment Gel to patients looking to treat scars left behind from acne," explains Rebecca Kazin, a dermatologist at Washington Institute of Dermatologic Laser Surgery and Johns Hopkins department of dermatology. "This gel contains 2 percent hydroquinone blended with other skin brighteners, like kojic acid, resorcinol, and azeleic acid, which work to lighten the pigmentation without irritating the skin," she says. The addition of lactic acid helps maintain moisture to prevent overdrying, which can worsen pigmentation.
21. You might try a prescription. Topical antibiotics are available only with a prescription and work by killing the bacteria on your skin that cause acne, and by reducing inflammation. Some examples of topical antibiotics are erythromycin and clindamycin. Your doctor may prescribe you them in conjunction with another topical treatment such as one containing benzoyl peroxide or a retinoid such as Retin-A.
Both Avram and Tzu recommend looking for products with mark-fading hydroquinone. Ambi Fade Cream includes 2 percent hydroquinone, the highest concentration allowed without a prescription. “It also contains soy, which is well known for treating pigmentation issues, and vitamin E which helps with scarring,” says Tzu. While the FDA considers hydroquinone safe, it is banned in Europe and can potentially cause irritation or further discoloration, so remember to patch-test and check with a dermatologist whether it’s right for you.
Spot treatments are key for treating a pimple ASAP. Benzoyl peroxide is often vilified for being harsh, but when it comes to really zapping a zit, it should be your best friend. Just dab it on the trouble spot to dry it out and kill bacteria. For heavy-duty action, try Neutrogena Rapid Clear Stubborn Acne Spot Gel; for something gentler, we like Arithmetic Acne Control Complex, which has soothing ingredients to counter the drying effects and is made with adult skin in mind.
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.
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.
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.
8. You can't stop picking at your pimples. It's tempting in the moment, but it's never a good idea to play dermatologist, because it's impossible to pick your own pimple and not make a red mark that could turn into a scar. Even worse, when you try to press the plug or oil or puss out of your pore, you run the risk of pushing the bacteria deeper or spreading it around underneath your skin, multiplying your pimples.
Birth controls can affect hormone levels, and some women may be finding that their birth control is causing acne due to increases in sebum production. This rise in sebum can affect the skin, clogging up pores and leading to acne. According to The Huffington Post, birth control pills that contain androgen-based progestin have been indicated as the most likely offender.
Doctors infrequently prescribe isotretinoin for severe and resistant rosacea. Often physicians prescribe it after multiple other therapies have been tried for some time and have failed. Patients take a daily capsule of istotretinoin for four to six months. Typically, isotretinoin is most commonly used in the treatment of severe, common acne called acne vulgaris. Close physician monitoring and blood testing are necessary while on isotretinoin. Generally, at least two forms of birth control are required for females using this medication, as pregnancy is absolutely contraindicated while on isotretinoin.
Rena Levi is known for her sensitivity towards clients with severe acne and problem skin. In 1968 she moved from Israel to the U.S. and studied with Christine Valmy at the European Esthetic Skincare Institute. In 1975, she opened the Rena Levi Skin Care Salon in New York City. In 1980, she moved to Albuquerque, NM, where she managed the skin care center for Eleganza Salon and further developed and refined her practice. It was there that she became well known for her ability to treat what many considered impossible skin, while also teaching budding estheticians and skin practitioners at the same time, including the then-president of the New Mexico Board of Cosmetology. Here, Levi shares with us one of her most popular facial protocol treatments for treating clients with moderate to severe acne.
Experiment with aloe vera. The sap of the aloe vera plant is a soothing natural substance which can be used to relieve many ailments, from burns to wounds to acne scars. Aloe vera helps to rejuvenate and moisturize the skin, encouraging acne scars to fade. It is possible to buy aloe vera products in the drugstore, but the best thing to do is buy an aloe vera plant and use the sap from a broken leaf. This gel-like sap can be applied directly on the scarring, and there is no need to wash off.
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.
The facialist, Tanya Eubanks, first exfoliates and steams my face. Then she uses her gloved fingers and a medical needle to perform extractions. And it is as painful as it sounds. The worst part is when I hear the noise of the needle pricking each cyst. It sounds like a tiny burst of air, which might not seem bad, but all I can think about is all the gunk coming out each time, and it makes me cringe. By the time she applies a mask to reduce redness, I've lost all feeling in my face.
If you have scarring, your dermatologist may suggest surgery to help heal acne lesions and remove scarring. A laser can reshape scar tissue and reduce redness. Dermabrasion is a type of surgery that can remove surface scars and reduce the depth of deep scars. Another option is to transfer fat from one part of the body to the face. In some cases, a single treatment can help scarring. But for lasting results, several are often needed. There are also topical treatments for acne scarring.
Treatment of acne scars: For those patients whose acne has gone away but left them with permanent scarring, several options are available. These include surgical procedures to elevate deep, depressed acne scars and laser resurfacing to smooth out shallow acne scars. Newer forms of laser resurfacing ("fractional resurfacing") are less invasive and heal faster than older methods, although results are less complete and the procedures may need to be repeated three or more times. These treatments can help, but they are never completely successful at eliminating acne scars.