It starts when greasy secretions from the skin's sebaceous glands (oil glands) plug the tiny openings for hair follicles (plugged pores). If the openings are large, the clogs take the form of blackheads: small, flat spots with dark centers. If the openings stay small, the clogs take the form of whiteheads: small, flesh-colored bumps. Both types of plugged pores can develop into swollen, tender inflammations or pimples or deeper lumps or nodules. Nodules associated with severe cases of acne (cystic acne) are firm swellings below the skin's surface that become inflamed, tender, and sometimes infected.
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.
Blackheads are, essentially, open comedones. "Comedone refers to plugging of the follicular opening," explains NYC dermatologist Elizabeth Hale, M.D., referring to hair follicles that technically cover your entire face and body (hi, peach fuzz). "Every hair follicle appears in a sebaceous gland." So a blackhead is the mixture of dead cells, bacteria, and grime that builds up and hardens in the follicular opening—but it's open to the world, which is why blackheads are so easy (read: tempting) to push out.

"Hyperpigmentation is an increase of melanin, which is the substance that colors the skin," says Dr. Sobel. Hyperpigmentation often clears up on its own. However if you want to speed up the process, you can use topical treatments with ingredients like retinol, vitamin C, and kojic acid, which can help brighten skin overall. We like Sunday Riley Sleeping Night Oil ($105, sephora.com) and InstaNatural Vitamin C Serum ($17, amazon.com). The most important thing is to stay out of the sun to keep the dark spots from getting even deeper in color.


People who escaped their teen years almost pimple-free may develop persistent adult-onset acne as they get older. Despite the normal increase in androgen levels during puberty, some doctors believe that flare-ups of acne have less to do with androgen levels than with how a person's skin responds to an increase in sebum production or to the bacteria that causes acne. The bacteria Propionibacterium acnes occurs naturally in healthy hair follicles. If too many of them accumulate in plugged follicles, they may secrete enzymes that break down sebum and cause inflammation. Some people are simply more sensitive than others to this reaction. Sebum levels that might cause a pimple or two in one person may result in widespread outbreaks -- or even acute cystic acne -- in another person.
This formula gently and effectively treats visible acne overnight using a skin-recovery complex that blends salicylic acid, vitamin B3, azelaic acid, caffeine, and other complexion clearers. The formula helps fight redness and unclog pores while calming and soothing post-breakout skin. The result is a clarified, glowing complexion free of redness, dark spots, and hyperpigmentation.
Whether your acne has persisted since your teenage years or has appeared as a new skin problem in later life, consider seeing a dermatologist if you're looking for treatment options. A specialist can help you determine the factors which may be triggering your acne and can help you with prescription medications to help regulate hormones or treat your breakouts without drying or otherwise irritating your aging skin.
When you have true scars that have changed the texture of your skin, you’ll need a medical procedure to see improvement. We use a laser specifically approved by the FDA for treating laser scars. Some people try chemical peels, which aren’t very effective. Others try dermabrasion, a technique like a sanding wheel on your skin, but there’s a high risk of permanent scarring. A laser gets much better results without the same risk.
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.
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).
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.
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.
Extraction reactions: When performed correctly, extractions can be very helpful in getting rid of whiteheads, blackheads, and even pimples. But that’s when they’re performed correctly. Getting extractions from anyone other than an experienced aesthetician or dermatologist can lead to facial scarring and severe inflammatory acne. Some believe that all extractions lead to larger pores, and a larger likelihood of developing more severe acne, however many aestheticians refute the claim.
Retinol is a vitamin A derivative, which the skin absorbs and converts to retinoic acid. Retin-A is the prescription form. "Topical retinoids are fortunately one of the most effective treatments for acne, and also happens to be a highly effective antiaging ingredient, because of its collagen-building properties," Dr. Tzu notes. The biggest downside is they're harsh and can sometimes be too much for sensitive skin. For an elegant OTC option, try Dr. Dennis Gross Skincare Ferulic Acid + Retinol Brightening Solution.
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.
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.
Understanding why you break out requires consideration of a variety of aspects. There are many underlying reasons for acne breakouts, but most pimples are caused by fluctuations in hormone levels. During puberty, the increase in androgens (male hormones) causes the adrenal glands to go into overdrive. This triggers the production of sebum within the sebaceous glands. The more sebum produced, the easier it is for hair follicles to become clogged. When the follicle becomes blocked, oil can’t leave the pore, collecting dead skin cells that would have otherwise sloughed off and hanging onto bacteria called p. acnes. These hormonal fluctuations can arise at other times in life, including menstruation, pregnancy, and menopause.
The Center for Young Women’s Health (CYWH) is a collaboration between the Division of Adolescent and Young Adult Medicine and the Division of Gynecology at Boston Children’s Hospital. The Center is an educational entity that exists to provide teen girls and young women with carefully researched health information, health education programs, and conferences.

Even if battling zits is a distant memory, filed away with high-school gym class and algebra tests, acne marks and scars can annoyingly linger long after pimples are gone. “If someone gets a very large pimple or cyst, the natural healing process of the skin will create a scar,” says David Avram, M.D., of Heights Dermatology and Laser. “The more intense the inflammation, the more likely it will leave a scar.”
A healthy diet can only prevent 90% of your acne. The other 10% of your acne has to do with external factors. External factors are cleanser, cream, lotion and moisturizer that you apply to your face. During the course of my acne treatment with my doctor, 4 main ingredients appeared on all my topical prescriptions. You should look for these ingredients in your external acne treatment products. They are as follows:
Yet another study took a look at the difference in rates of acne in first-degree relatives between patients and controls. The study used 204 acne patients, and 144 non-acne controls. Their study determined that having a first-degree relative who suffers from acne increases the risk of getting acne by four times. Genes play a role in several ways: firstly, they contribute to skin sensitivity. Acne-prone skin is more susceptible to oil production, and tends to shed and regenerate skin cells faster. Those prone to acne also exhibit strong inflammatory responses to skin irritants and bacteria in comparison to those who don’t have issues with acne.
Acne scars, on the other hand, are formed when there is damage to the skin which leads to abnormal collagen production, and usually appear raised or bumpy. "There are two types of acne scars: depressed and raised. Depressed scars may look like pits or craters, and raised scars may be firm and tender," explains Dr. Zeichner, who notes that unfortunately, these are permanent.
Wondering how to get rid of acne fast? While you can't get rid of a pimple overnight, there are plenty of doctor-approved acne treatments that can shrink zits significantly—and zap redness and irritation—in a mere 24 hours (which should make it much easier to cover up. We talked to top dermatologists to get the scoop on what actually works when it comes to banishing blemishes. Read on for 11 ways to get rid of acne, plus learn about the different types of acne and what each type responds to best when it comes to treatment.
Temporary skin fillers have been used for years for acne scar treatment, but a permanent dermal filler was approved for use by the FDA just last summer. Designed to remove moderate to severe acne scarring, Bellafill is made up of 80% collagen to replace lost volume and 20% polymethylmethacrylate, which helps your body heal by boosting protein production.
Dermal fillers: "Certain scars can be filled with a substance that elevates the depressed areas, like hyaluronic acid. This can make the surface of the skin more even and get rid of shadows," says Dr. Bowe. Until recently, fillers weren't a lasting solution. But now, if you're over 21 years old, Bellafill is the first FDA-approved dermal filler designed for permanently correcting moderate to severely dented acne scars. Unlike other fillers, it contains two different ingredients to help improve acne scarring. "It's 20% polymethylmethacrylate (PMMA), which helps your body make more protein to allow itself to heal," says Dr. Shah. "PMMA are tiny balls that sort of act as a scaffolding. Most fillers degrade over time, but since PMMA cannot be absorbed into the body, this offers a permanent result," she says. The other 80% is collagen. The procedure takes about 20-30 minutes, and while you may need a touchup a couple months later, some people just need the single treatment, says Dr. Shah.
Comedo (whiteheads or blackheads) or papules. The comedo is the basic acne lesion, which is a plugged pore. If the plugged pore stays under the skin, it's called a closed comedo and forms a white bump or whitehead. Blackheads are comedos that open up and appear blackish on the surface of the skin. This black color is not due to dirt, but because the air reacts with the excess oil.
Some individuals have absolutely no symptoms, and rosacea doesn't bother them. They may enjoy perfectly healthy normal lives without any effect from this benign skin condition. Some patients really like the pink glow to their cheeks and find it gives them a pleasant color without having to use blush. They may not even know they have rosacea. They usually do not want to use any treatment.
Photodynamic therapy (PDT) is one of the newly available treatments. PDT uses a topical photosensitizer liquid that one applies to the skin and a light to activate the sensitizer. Levulan (aminolevulinic acid) and blue light, commonly used to treat pre-cancers (actinic keratosis) and acne vulgaris, can treat some rosacea patients. The use of PDT in rosacea is off-label, since it is primarily designed for regular acne. PDT works at reducing the inflammation; PDT is performed in a physician's office. The treatment takes anywhere from one to one and a half hours to complete. Strict sun avoidance for approximately one to three days is required after the treatment. Mild discomfort during the treatment and a mild to moderate sunburn appearance after the treatment is common. Some patients have experienced remissions (disease-free periods) of several months to years from these types of treatments. Other patients may not notice significant improvement.
The best way to fix them: This is where the classic zit treatments come into play. "Topical medications are the best way to treat a lesion like this," says Jennifer Chwalek, M.D., a dermatologist at Union Square Laser Dermatology in NYC. "Benzoyl peroxide-, salicylic acid-, or sulfur-based products can help to dry it up." She prefers salicylic acid over benzoyl peroxide for these, since the latter can cause irritation, dryness, and even post-inflammatory hyperpigmentation (a.k.a. dark spots) in those with darker skin tones. Retinol works well for these, too.
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.
Understanding why you break out requires consideration of a variety of aspects. There are many underlying reasons for acne breakouts, but most pimples are caused by fluctuations in hormone levels. During puberty, the increase in androgens (male hormones) causes the adrenal glands to go into overdrive. This triggers the production of sebum within the sebaceous glands. The more sebum produced, the easier it is for hair follicles to become clogged. When the follicle becomes blocked, oil can’t leave the pore, collecting dead skin cells that would have otherwise sloughed off and hanging onto bacteria called p. acnes. These hormonal fluctuations can arise at other times in life, including menstruation, pregnancy, and menopause.
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