"I have seen many patients develop a tolerance to prescription acne treatments, and when they stop working, it’s devastating. Treating acne demands a more holistic approach that includes lifestyle, nutrition, and advances in topical skincare. I developed Outsmart Acne™ Clarifying Treatment to be used as part of a whole-person regimen to help skin stay consistently clear."—Howard Murad, M.D., FAAD
As far as combination scars go, Dr. Levine’s go-to acne scar treatment for combination-type scars include a series of treatments with picosecond lasers such as the Picosure or use of the FRAX 1550* Fractional non-ablative laser. “These are newer technologies, and they have less downtime than older lasers, so for me this means I can be more aggressive and see results with fewer treatments.” Older ablative lasers blast off the skin’s top layers, which requires significant downtime, but these newer non-ablative lasers pass through the skin’s upper layers to harmlessly heat the deeper tissues, stimulating collagen and smoothing the scar’s appearance.
Fillers. A substance such as collagen, hyaluronic acid, or fat can be used to "fill out" certain types of acne scars, especially those that have resulted in a depressed appearance of the skin. Since fillers are eventually absorbed into your skin, you will have to repeat filler injections, usually every few months, depending on the type of product used. There is no downtime for recovery from this treatment.

People trying to lose weight or build muscle are often encouraged to take photos along their journey—there's nothing more motivating than visible progress. I applied the same logic to my breakout. I took a photo of it at its worst to start, then continued. The second photo you see is one week after doing all of the above—you definitely see remnants of the breakout but they are not as active nor as inflamed (they're also flat and easy to cover up with my BFF, concealer). The last photo is four weeks later after me following these tips religiously—all clear.


Bellafill is a dermal filler approved for the correction of moderate to severe, atrophic, distensible facial acne scars on the cheeks in patients over the age of 21. This injection provides immediate improvement — like, your skin is improved by the time you leave the office. Once it's injected, the collagen goes to work immediately, adding natural-looking volume and lift to soften acne scars. Over time, your body naturally metabolizes the collagen — but the results remain intact. In fact, Z. Paul Lorenc, a New York City-based plastic surgeon, explains, “90 percent of patients who used Bellafill to treat their acne scars were still satisfied with the results at the one-year mark." The best part? There is no downtime and you can return to normal activities right away.

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.


Minocycline is available in generic form or the branded formulation, Solodyn. The most-prescribed oral antibiotic acne medication for moderate to severe inflammatory acne like cystic acne, Solodyn is a minocycline like those mentioned above. However, it comes in an extended release formula that allows it to work to clear skin over the course of the day with just one daily dose.

As you go about treating acne, it's important to remember that all acne isn't the same. What works really well for one kind of pimple might not work at all for another. You want to use the type of acne treatment that targets your particular kind of acne. If you use the wrong treatment you might even make your breakouts worse. The first step in how to get rid of acne is understanding what kind of acne you have—read on to learn about blackheads, white heads, small red bumps, hormonal acne and cystic acne, and how to best treat each.


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.
You can apply all the topicals you want, but unfortunately, most treatments you'll find at the drugstore won't help with acne scars, Hellman says. However, she notes that derma rollers (at-home microneedling devices) may help with acne scarring. If you're on a tight budget, that should be your first stop. You can get one on Amazon for less than $20. (Use yours once a week followed by a Vitamin C serum for best results—here's how to pick the best ones.)
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Other concerns include inflammatory bowel disease and the risk of depression and suicide in patients taking isotretinoin. Recent evidence seems to indicate that these problems are exceedingly rare. Government oversight has resulted in a highly publicized and very burdensome national registration system for those taking the drug. This has reinforced concerns in many patients and their families have that isotretinoin is dangerous. In fact, large-scale studies so far have shown no convincing evidence of increased risk for those taking isotretinoin compared with the general population. It is important for those taking this drug to report changes in mood or bowel habits (or any other symptoms) to their doctors. Even patients who are being treated for depression are not barred from taking isotretinoin, whose striking success often improves the mood and outlook of patients with severe disease.
26. Get your SPF on. Sunscreen isn't just for summer—your skin needs protection every day, even in winter. There are now sunscreens for every skin type imaginable—even ones that help make your skin less oily, so your face stays matte and pimple-free! Look for a daily moisturizer with SPF that says it's "lightweight," "oil-free," or "oil-controlling." For the highest level, look for a PA++ rating, it covers both UVA and UVB rays, so you're guarded against everything from burns to future wrinkles!
A U.K. survey found that on average single men only change their sheets four times a year. And while we certainly hope you are swapping out your linens much more frequently, dirty pillowcases can lead to clogged pores. Nasty as is sounds, bacteria can build up on your bed and your face rubs around on it for a good eight hours a night. Well, that just can’t be good. If your skin is oily, change those sheets (or at least your pillowcases) twice a week. It might be a pain, but isn’t a clear complexion worth it?

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.


Laser resurfacing involves directing concentrated pulsating beams of light at irregular skin. This procedure may be used to reduce wrinkles, blemished, or acne scars. There are two types of lasers commonly used in laser resurfacing: carbon dioxide and erbium. Treated areas heal in 10-21 days. Possible complications include milia, hyperpigmentation, and swelling.
You’ll need more than one: Facials can clear away comedonal acne and reduce breakouts for the following month, but your skin is an organ which continues to grow new cells and shed dead ones every day. Most aestheticians recommend getting a facial every 4 to 6 weeks to continue your clear complexion. Considering that most facials cost upwards of $80 each and take at least an hour, this can become very expensive and time consuming.

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.
Avoid picking at spots and scars. Though it may be tempting, picking at your scars interrupts the process by which your skin naturally heals and can worsen their appearance. Picking at existing pimples, meanwhile, can cause your skin to scar in the first place, as bacteria from your hands may be transferred onto your face, causing it to become inflamed and infected. Therefore, picking should be avoided at all costs.
The birth control pill is another option for women suffering hormonal acne. Four types of birth control pills have been approved by the FDA for use as acne treatment, and all four are combination pills that contain both estrogen and progesterone. Talk to your doctor about how to get rid of acne using birth control and keep in mind that Ortho Tri-cyclen, Estrostep YAZ and Beyaz are the only four brands specifically FDA approved as acne remedies.
Topical (external) applications: Antibacterial cleansers come in the form of gels, creams, and lotions that are applied to the affected area. The active ingredients that kill surface bacteria include benzoyl peroxide, sulfur, and resorcinol. Some brands promoted on the Internet and cable TV (such as ProActiv) are much more costly than identical and sometimes more potent products one can buy in the drugstore.
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