Caused by a bacteria that lives on our skin, acne comes to life at any age when our hormones cue our body to produce excess oil, essentially throwing fuel on the fire. “Our skins’ oils are a wonderful environment for acne bacteria to thrive in, unfortunately,” says Dr. Robert Anolik, clinical assistant professor of dermatology at the NYU School of Medicine. Add dead skin cells, dirt, stress, irritation from everything from diet to skin products, and a breakout is going to result unless you (constantly) work to prevent it.
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.
A quick primer on light therapy: red light is known to promote circulation and reduce inflammation while blue light targets acne-causing bacteria and makes oil glads produce less sebum. What this mask helped me most with was preventing new breakouts from forming on top of the cluster already invading my chin. It stopped what was previously a never-ending cycle of acne.
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.
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.
Laser treatment may cause some discomfort. While most patients are able to endure the procedure, ice packs and topical anesthetic cream can help alleviate the discomfort. Multiple treatments are typically necessary, and most insurances do not cover the procedure. Doctors recommend treatments in three- to six-week intervals; during this time, sun avoidance is necessary. Review risk, benefits, and alternatives with a physician prior to treatment. Combine laser treatments with photodynamic therapy (light-activated chemical using Levulan) for more noticeable results.
11. You need to clean your phone, too. If you're seeing pimples on your cheeks or anywhere near the area where you hold your phone, they may be from those hour-long convos with your crush. Your phone picks up lots of dirt and bacteria (from your hands, your bag, the kitchen counter), which can then get transferred to your face when you're chatting on the phone. Wipe your screen with an anti-bacterial wipe often to get rid of dirt and germs.
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.
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.
5. You're scrubbing your skin too hard. A lot of people with acne think that the more you scrub your skin with a washcloth, rough exfoliants (like crushed apricot seeds), or cleansing brushes, the smoother your skin will be, but in reality, the problem will only inevitably get worse. What happens when you do that is you scrub the active acne and the blemish bacteria gets spread across the skin, worsening the condition.
Some skin advocates suggest foregoing this method. The pH of baking soda is 7.0, which is far too basic for skin's pH. Optimal skin pH occurs between 4.7 and 5.5, which is an inhospitable environment for p. acne (the bacteria responsible for causing most acne). By raising the pH to a more basic level, p. acne is able to survive longer and cause more infection and inflammation. So try this method with care, and stop using it if it's not effective for you.
"Acne scars are very challenging to treat and are even more challenging to treat once they've been given time to age," says Joel Schlessinger, M.D., a board-certified dermatologist in Omaha, Nebraska. Although he says the best option is prevention (but if you just can't resist popping your pimples, do it the doctor-approved way!), there are ways to treat acne scars to drastically reduce their appearance.
20. Know your options. Benzoyl peroxide products are great at fighting pimples, but can be drying to your skin, so use them only once a day (or every other day). If it's drying out or irritating your skin, switch out your cleanser for a gentle formula. (Keep up your regular acne spot treatment, but use just a dab!) It will clear away dirt and oil without stripping your skin of moisture. Salicylic acid (in creams, gels, astringents, or masks) dries less than benzoyl peroxide, so it can be used with more-drying cleansers.
Oral contraceptives: Oral contraceptives (birth control pills), which are low in estrogen to promote safety, have little effect on acne one way or the other. Some contraceptive pills have been shown to have modest effectiveness in treating acne. Those that have been U.S. FDA approved for treating acne are Estrostep, Ortho Tri-Cyclen, and Yaz. Most dermatologists work together with primary care physicians or gynecologists when recommending these medications.