Retinoids: Retin-A (tretinoin) has been in use for years, and preparations have become milder and gentler while still maintaining its effectiveness. Newer retinoids include adapalene (Differin) and tazarotene (Tazorac). These medications are especially helpful for unclogging pores. Side effects may include irritation and a mild increase in sensitivity to the sun. Adapalene 0.1% is now available without a prescription. With proper sun protection, however, they can be used even during sunny periods. The combination medication known as Epiduo gel -- which contains the retinoid, adapalene, along with the antibacterial, benzoyl peroxide -- is applied once a day.
But, sometimes a particularly aggressive blemish is truly on a mission to leave its permanent mark. "Acne scars occur when normal tissue in the skin is destroyed and replaced with fibrous tissue. You can think of an acne lesion as a wound. When the damage caused by acne is severe, the body can respond by creating too much tissue or too little tissue. The production of too much tissue forms a keloid or a hypertrophic scar, and too little tissue leads to that depression in the skin, or atrophic scar. The deeper and more inflamed the acne lesion, or the more that it is picked or squeezed, the more likely it is to scar," says Dr. Bowe.

Unfortunately, if you have a scar on the skin then it will for lifelong but the good news is that you can reduce its size, color and appearance on the skin by lightening them up to the point of undetectable. In general, there are 5 types of acne scars like an ice pick, boxcar, rolling, hyperpigmentation, and keloid scars. So, consult your dermatologist for proper treatment.
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The hair follicles, or pores, in your skin contain sebaceous glands (also called oil glands). These glands make sebum, which is an oil that lubricates your hair and skin. Most of the time, the sebaceous glands make the right amount of sebum. As the body begins to mature and develop, though, hormones stimulate the sebaceous glands to make more sebum.
Hormones are ruthless, and all the topical treatments in the world won't make a difference if yours are seriously out of whack. In that case, you need to fix things internally first. "Medications that manipulate hormonal levels, such as oral contraceptives and spironolactone, are helpful in curbing hormonal chin and lower face outbreaks," Dr. Tzu says. Ask your derm about what might work for you.

"Retinoids work over time by continuously increasing cell turnover which in turn helps fade hyperpigmentation," says Dr. Idriss. Dr. Shah agrees, noting that Retin-A helps with acne marks by causing your skin cells to "divide more rapidly and pushing out cells with discolored pigments." Since retinoids make your skin super-sensitive to the sun, it's best to not only wear SPF, but to also apply a treatment like RoC Retinol Correxion Sensitive Night Cream before you go to bed.
There are breakouts, and then there are breakouts so bad that make me, a grown woman, literally hide under a blanket. The latter happened over a month ago and, as much as I'm here for the growing skin positivity movement, I have to admit my confidence hit an all-time low. I cancelled plans. I stared unhealthily often at a mirror, examining the damage: a colony of seemingly multiplying cystic zits invaded my chin and jawline like never before. How did I get here?
Potentially the easiest and cheapest option, "Clay masks help draw out impurities such as dirt and oil at the surface level of the skin which helps with acne breakouts. It will help to dry up the acne," says Dr. Bank. You can usually find a large tube (meant for your entire face) at the drugstore, and using it as a spot treatment will make it last forever. Just look for a mask with kaolin or bentonite clay as the primary ingredient.

Coconut oil is all the rage, with uses ranging from hair conditioning to cooking. But some swear by it as a natural acne treatment. To use coconut oil as an acne treatment, you can include it as part of a healthy diet. The fatty acids like lauric acid caprylic acid are metabolized into antibacterial agents in the body. Or, you can apply a very small amount and rub directly onto your skin after cleansing for an extra hydrating boost.
12. Step away from your hands. You know how you rest your face on your hand while you're studying? That might be the reason for those blemishes on your cheek or jaw. You're constantly touching things that have germs—anything from your phone to your locker—so putting your hands on your face for a long period of time can cause dirt and bacteria from anything you touch to get into your pores.
Clean your skin gently with a mild soap or cleanser twice a day — once in the morning and once at night. You should also gently clean the skin after heavy exercise. Avoid strong soaps and rough scrub pads. Harsh scrubbing of the skin may make acne worse. Wash your entire face from under the jaw to the hairline and rinse thoroughly. Remove make-up gently with a mild soap and water. Ask your doctor before using an astringent.
It's a myth that tanning clears up your skin. UV rays put you at risk for skin cancer, premature aging, and wrinkles. Don't lie in the sun or use a tanning booth. Also, some commonly prescribed acne medications, including retinoids that go on your skin, can make you more sensitive to damage from UV rays. So always wear sunscreen and limit how much sun you get.

"I have terrible cystic acne but I don't want to take prescription medication!" she whines. Puh-leeze! You are given treatment, have access to products other than cleansers, but won't use them. This is a ridiculous article. I cleared my skin with soap, water, alcohol, and a complete dietary adjustment. Zero sugar, starch, breads, oils, fried and processed foods. I eat broccoli, greens (lots of greens), steamed and poached veggies, broiled or canned salmon, tofu, quinoa, brown rice, half a lemon a day over food or in unsweetened green tea, and blueberries. Someone else mentioned the sugar/insulin/hormonal imbalance link. You have to take responsibility for your lifestyle, as well as your treatment.


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.
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.
Scars (permanent): People who get acne cysts and nodules often see scars when the acne clears. You can prevent these scars. Be sure to see a dermatologist for treatment if you get acne early — between 8 and 12 years old. If someone in your family had acne cysts and nodules, you also should see a dermatologist if you get acne. Treating acne before cysts and nodules appear can prevent scars.
Lin says he recommends applying egg whites directly to a pimple to shrink a breakout. “The protein in the egg will help dry out the pimple,” he says. “You can also apply honey to a breakout to calm redness. Honey is a naturally soothing ingredient with anti-inflammatory properties that helps heal the skin. Leave it on for five to 10 minutes, then wipe away with a damp cloth.”
lThis at-home skin peel available at Sephora tightens pores, reduces oil, helps retexturize skin and diminishes dark spots. It's paraben and sulfate free, non-comedogenic, and is not tested on animals. Use this peel each week as part of your clear skin regimen to help even out skin tone and gently remove unhealthy top skin layers, revealing new, healthier skin underneath.
Severe acne. Severe acne consists of deep cysts, redness, swelling, extreme damage to the skin and scarring. You should see a dermatologist to care for this type of acne. Scarring can be prevented with appropriate treatments. Your dermatologist can prescribe oral antibiotics and oral contraceptives. Large inflamed cysts can be treated with an injection of a drug that lessens the redness, swelling, and irritation, and promotes healing.
The redness in rosacea, often aggravated by flushing, may cause small blood vessels in the face to enlarge (dilate) permanently and become more visible through the skin, appearing like tiny red lines (called telangiectasias). Continual or repeated episodes of flushing and blushing may promote inflammation, causing small red bumps, or papules, that often resemble teenage acne. Acne rosacea and adult acne are other names for rosacea. One of the most unpleasant aspects of rosacea is the overgrowth of dermal tissues producing a "phymatous" change in the skin. This appears as a thickening and permanent swelling of the facial tissues. A bulbous nose called rhinophyma is an example of this change.
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).
There are a number of mild chemical peels available over the counter, but acne scar removal requires a stronger peel typically administered by a doctor or dermatologist. Trichloroacetic acid (TCA) peels are slightly stronger than alpha hydroxy acid (AHA) peels and may be used for acne scar treatment. The strongest type, phenol peels, may cause significant swelling and require up to two weeks of recovery time at home. Neither are recommended for people with active severe acne.
Contrary to popular belief, acne isn't caused by a harmful diet, poor hygiene, or an uncontrolled sex drive. The simple truth is that heredity and hormones are behind most forms of acne. Swearing off chocolate or scrubbing your face 10 times a day won't change your predisposition to this unsightly, sometimes painful, and often embarrassing skin problem.

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.
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.
If you’ve made a concerted effort with over-the-counter regimens and/or diet and still aren’t seeing results, a dermatologist is absolutely worth it. There are many levels of care: Prescription retinoids (Retin A, Tazorac, Differin et al) and/or topical antibiotics are the mildest, along with blue-light treatments like Isolaze, which kill bacteria and clear pores, with virtually no downtime. Light lasers like Clear and Brilliant can clear pores and treat the red and brown tones left by old acne lesions. “Some patients think they’ve got a severe problem, when they really only have a few pimples, surrounded by red and brown marks from old breakouts,” notes Anolik. Oral antibiotics represent a more aggressive (and unsustainable long-term) solution; birth control pills and hormone-mitigating medications like Spironalactone and Deldactone can get many more-severe patients’ acne under control. Most aggressive is Accutane; while it can be severely drying and can cause birth defects if taken during pregnancy, it represents a cure for truly-severe acne cases, says Anolik. “Used correctly, it is something of a miracle for people who’ve tried everything and failed,” he says.
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).

EradiKate™ Mask Foam-Activated Acne Treatment gently exfoliates dead skin cells and helps unclog pores while sulfur reduces the appearances and helps prevent pimples, zits, and future breakouts. Within minutes Kate’s unique foam-activated technology penetrates to help dissolve impurities and dirt, and address oily skin. An advanced botanical complex of boswellia serrata, honey extracts, and rice bran work to calm and soothe skin. Use this mask with Kate Somerville’s bestselling EradiKate Acne Treatment for an acne regimen that promotes a clearer complexion.
"I have terrible cystic acne but I don't want to take prescription medication!" she whines. Puh-leeze! You are given treatment, have access to products other than cleansers, but won't use them. This is a ridiculous article. I cleared my skin with soap, water, alcohol, and a complete dietary adjustment. Zero sugar, starch, breads, oils, fried and processed foods. I eat broccoli, greens (lots of greens), steamed and poached veggies, broiled or canned salmon, tofu, quinoa, brown rice, half a lemon a day over food or in unsweetened green tea, and blueberries. Someone else mentioned the sugar/insulin/hormonal imbalance link. You have to take responsibility for your lifestyle, as well as your treatment.
Many people use beaten egg whites as a facial acne mask. The mask is applied to the face for about 15 minutes, then it is washed off and the skin is GENTLY patted dry with a soft cloth. Eggs have potent healing properties (due to the protein contained within) which makes this a great method for healing and clearing away acne. This is by no means an overnight acne cure, so don't get upset when you find out you have to use this technique for a matter of weeks before the effects begin to show.
Shower twice a day. Take a shower or bath in the morning and at night. Alternatively, take a shower in the morning and then again after physical activity, like exercise, or sweating. Wash your entire body with a mild cleanser and use shampoos that limit oil production in your hair. Be sure to always shower after exercising to remove the dead skin cells your body has sloughed off through sweating.
This article was medically reviewed by Hilary Baldwin, MD. Baldwin, medical director of the Acne Treatment Research Center, is a board-certified dermatologist with nearly 25 years of experience. Her area of expertise and interest are acne, rosacea and keloid scars. Baldwin received her BA and MA in biology from Boston University. She became a research assistant at Harvard University before attending Boston University School of Medicine. She then completed a medical internship at Yale New Haven Hospital before becoming a resident and chief resident in dermatology at New York University Medical Center.
Yes, it’s another pricey SkinCeuticals serum, but dermatologists absolutely love their products for treating acne marks. You’ll get more bang for your buck with the inclusion of glycolic and lactic acids, two alpha-hydroxy acids that Avram says help fade marks by exfoliating the top surface of the skin. Nagler says “vitamin C is helpful as an adjunct in preventing free radical damage, which helps with pigmentation.” It’s also worth investing in a high-quality serum since, according to Nagler, vitamin C isn’t stable — and is therefore less effective — in some other products.

Over-the-counter retinol or vitamin A can also help. Anolik says retinols can be incredibly effective, especially higher-strength prescription retinoids: “They’re the gold standard in acne and aging treatments.” The prescription versions, from Tazorac to Differin, are usually covered by insurance in the case of acne. Vitamin C can also treat pores and exfoliate; Tammy Fender’s System ($165, tammyfender.com) comes with a vitamin C toner.

Acne scars take many different forms. You might see tiny pockmarks, a swollen keloid, or a discolored area on the skin. And just like the types of scars vary, there isn't a one-size-fits-all fix. Your dermatologist can use a combination of treatments including lasers, chemical peels, or fillers to minimize the spots. "Once there is scarring you can't get the skin back to the way it was before," says Dr. Karolak. "But we can get it to look significantly better, so that [clients] feel more comfortable in social environments."

"Other good over-the-counter options are benzoyl peroxide-containing agents," says Dr. Engelman. "I like La Roche-Posay Effaclar Duo. Benzoyl peroxide is anti-microbial, attacking the bacteria that is associated with acne. The La Roche Posay product also contains Lipohydroxy acid (LHA), which serves as an exfoliator to smooth roughness and even out skin texture."


Unwashed sheets and pillowcases lead to cross contamination which leads to pimples. Aim to wash your bedding once or twice a week to prevent bacteria from building up and affecting your complexion, suggests Dr. Papantoniou. If that seems overboard, at least aim to wash your pillowcase once a week since that's where your face rests while you snooze (and dream of flawless skin).
Rosacea (ro-zay-sha) is a common, acne-like benign inflammatory skin disease of adults, with a worldwide distribution. Rosacea affects an estimated 16 million people in the United States alone and approximately 45 million worldwide. Most people with rosacea are Caucasian and have fair skin. The main symptoms and signs of rosacea include red or pink facial skin, small dilated blood vessels, small red bumps sometimes containing pus, cysts, and pink or irritated eyes. Many people who have rosacea may just assume they have very sensitive skin that blushes or flushes easily.
See Your Doctor If You Get Large, Deep Breakouts or Acne Cysts: While smaller blemishes can still scar the skin, it's the big guys that usually do the damage. Because they extend deeper into the skin, deep nodular breakouts or cystic breakouts are more likely to destroy skin tissue and leave scars. Over-the-counter acne products just won't help these types of breakouts. Get an appointment with a dermatologist. Quick, effective treatment can help lessen the chance of developing deep scars.
Treating acne requires patience and perseverance. Any of the treatments listed above may take two or three months to start working (even isotretinoin). Unless there are side effects such as excessive dryness or allergy, it is important to give each regimen or drug enough time to work before giving up on it and moving on to other methods. Using modern methods, doctors can help clear up the skin of just about everyone.
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