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.


Sometimes it seems like pimples sprout up overnight, but the process of pimple formation is a bit more complex. So what are the most common causes of pimples? A variety of factors can result in an acne blemish. Pimples can develop on anyone at any age, but tend to be most common amongst teens. Why do teenagers get the brunt of breakouts? Hormone fluctuations. When hormone levels increase, the sebaceous glands found within the skin’s hair follicles produce an excess of sebum. Sebum is a waxy substance that the body produce to keep the skin soft and moisturized. However, when hormonal changes cause an increase in sebum production, the pores can become clogged. This sticky substance can collect dead skin cells, debris, and bacteria, forming a plug in the follicle. Blackheads, whiteheads, pimples, and pustules all begin the same way. Preventing pimples means discovering the reasons you’re breaking out and doing all you can to combat these factors. There is no single answer to the age old question of how to get rid of pimples.

The two laser treatment options above are great for acne scar removal, but aren't generally recommended as acne treatment. If you're still experiencing active acne breakouts and wondering how to get rid of acne with laser treatments, check out photodynamic therapy. It combats active moderate to severe acne while also diminishing older acne scars by using light energy to activate a powerful acne-fighting solution. Patients may require 2 or 3 treatments over several weeks and should expect some redness, peeling, and sun sensitivity. This treatment will cost between $2000 to $3500 per series. 

"Put it this way: It is so common that pimples are meeting wrinkles," dermatologist Neal Schultz, M.D., creator of Beauty Rx Skincare, tells SELF. "For the last 10 to 20 years, adult acne has been increasing. It can even go into your 50s, right to menopause." If you had acne as a teen, chances are, you've got oily skin that's prone to breakouts. But even if you didn't, it's still possible you'll end up with adult acne.
Patients first receive a topical anesthetic, which works for about an hour before the device goes on. "When you’re done," she explains, "it looks like your skin has tiny holes — almost pixelated or grid-like — and I follow with SkinCeuticals CE Ferulic Acid, a hyaluronic acid serum, and Luxamend (a prescription wound-healing cream that speeds up healing). Finally, we apply Aquaphor to create a barrier for the skin." Depending on the intensity of the laser, patients can expect anywhere from a few days of ruddiness to up to 10 to 14 for very high-intensity treatment. There is a risk of bleeding, infection, or scarring. As always, you'll need to consult with your dermatologist about whether this treatment is right for you.

In unusual cases, a skin biopsy may be required to help confirm the diagnosis of rosacea. Occasionally, a dermatologist may perform a noninvasive test called a skin scraping in the office to help exclude a skin mite infestation by Demodex, which can look just like rosacea (and may be a triggering factor). A skin culture can help exclude other causes of facial skin bumps like staph infections or herpes infections. Blood tests are not generally required but may help exclude less common causes of facial blushing and flushing, including systemic lupus, other autoimmune conditions, carcinoid, and dermatomyositis.

It may take time, but discovering how to get rid of pimple scars isn’t as impossible as you think; solutions ranging from natural, DIY home remedies to professional-grade procedures are available at your fingertips. So what works best? In the end, only your unique skin can say, but we do have a few suggestions (hint: they don’t involve expensive fillers or lasers). If you want to learn how to get rid of acne marks effectively and affordably, keep reading and start saying sayonara to unsightly scars.
The spots that linger after a pimple has healed are caused by inflammation that has disrupted the skin's natural healing process. "When your skin is opened up (like when you pop a pimple) and then closes back together, you can get abnormal pigmentation, texture, and tone that looks different from the rest of your skin. Sometimes the broken blood vessels that remain after an acne lesion fades can result in a mark," says Dr. Bowe. For a number of people who are able to refrain from picking, inflamed pimples or blemishes can still leave a dark brown or red mark — but these naturally fade over the course of a few months, notes dermatologist Heather C. Woolery-Lloyd, MD.
Inflammatory Acne: Inflammatory acne is red bumps and pustules, not whiteheads, blackheads and comedones. It does not necessarily start as them, either. It arises on its own. Whiteheads, blackheads or comedones that become inflamed can be painful and unsightly. Persistent inflammatory acne may require treatment by a physician or dermatologist, in addition to over-the-counter acne remedies.
Wear sunscreen everyday and do not tan. Ultraviolet Radiation is the number one cause of premature aging. It also leads to skin cancer in high enough doses. Treat the sun like the death ray that it is. Exposing your skin to harmful UVA and UVB rays damages skin and prolongs post inflammatory erythema(PIE)--red acne marks, as the sunlight stimulates pigment-producing cells.
Isotretinoin has a high risk of inducing birth defects if taken by pregnant women. Women of childbearing age who take isotretinoin need two negative pregnancy tests (blood or urine) before starting the drug, monthly tests while they take it, and another after they are done. Those who are sexually active must use two forms of contraception, one of which is usually the oral contraceptive pill. Isotretinoin leaves the body completely when treatment is done; women must be sure to avoid pregnancy for one month after therapy is stopped. There is, however, no risk to childbearing after that time.
"Leafy green vegetables and other brightly-colored fruit and vegetables which are rich in antioxidants and nutrients dampen inflammation and improve skin quality (studies have shown acne patients have higher oil production and lower antioxidant levels)," says Dr. Weiser. "Limit intake of dairy products, which can contain hormones and antibiotics that can worsen acne breakouts." Other skin-boosting superfoods include eggs, nuts, legumes, and quinoa.
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.
A BHA product often cited includes salicylic acid, it must be between a pH between 3 and 4 to work. A BHA works to slough (to get rid of) off dead skin cells and encourage new skin growth. As a result, you may experience dry skin and scaliness around your acne, but this will dissipate over time as your skin begins to regenerate faster. Use this in a cleanser or spot treatment daily on the acne-affected areas of your skin.[6]

Laser resurfacing. This procedure can be done in the doctor's or dermatologist's office. The laser removes the damaged top layer of skin and tightens the middle layer, leaving skin smoother. It can take anywhere from a few minutes to an hour. The doctor will try to lessen any pain by first numbing the skin with local anesthesia. It usually takes between 3 and 10 days for the skin to heal completely.
Since the UV rays and visible light from the sun can further darken acne marks, all the dermatologists agree it’s essential to wear sunscreen daily. “Sun protection can make a big difference in whether or not these marks remain permanent,” says Nagler, so much so that she’ll often recommend patients wait and see what their scars look like after a year of careful sun protection before opting for an expensive or invasive procedure. This CeraVe oil-free sunscreen is ideal for acne-prone skin, and also contains niacinamide, which is known to help brighten skin and fight inflammation.
Acne scar treatment: Energy-based skin resurfacing with a laser, radiofrequency, or an ultrasound device can help treat boxcar scars, according to Nada Elbuluk, MD, an assistant professor at the Ronald O. Perelman Department of Dermatology at New York University Langone Medical Center in New York City. “They all work by creating new collagen beneath the surface of the skin.” A series of treatments is likely needed based on the extent of scarring, she says. Chemical peels can also help but to a lesser extent. With either procedure, using a retinoid to increase cell turnover and further boost collagen can help improve results, Dr. Elbuluk adds.
For UVA protection, a sunscreen with a high UVA protection of PA+++ or higher of PA++++ as recommended, especially to treat PIE. PPD is the UVA equivalent of SPF; use a sunscreen with a minimum of PPD20. The PA+ system has a + that corresponds to a tier of PPD protection. Of note, different countries use different PA systems. Japan and Taiwan changed their PA system to a 4+ tier system while Korea uses a 3+ tier system.
This lightweight, all-over acne treatment clears acne with two percent salicylic acid—the highest percentage allowed. It also contains retinol, which helps smooth the look of skin texture and even the look of skin tone while a blend of soothing ingredients helps balance the skin’s microbiome. This hydrating formula also contains sodium PCA and sodium hyaluronate, which moisturize skin and help offset dryness that could be caused by salicylic acid and/or retinol.
Zinc sulfate: This is one of the ultimate minerals for those wondering how to get rid of acne scars. Zinc’s anti-inflammatory properties can reduce the swelling and redness of your bumps and blemishes. It also promotes faster wound healing, in addition to aiding vitamin A transportation throughout the bloodstream. Find it in your fruits and veggies or listed as an ingredient in a potent product.
Another potential skin saboteur is sugar, because it raises your insulin level. More and more evidence shows that insulin may boost those oil-triggering male hormones, Dr. Schultz explains. Stick to low-glycemic foods—ones that have complex carbs like whole grains, which break down slower in the body and cause less of an insulin spike. Your health will be better for it, too.
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).

What you can do differently: Make sure all the skin care products you're using are labeled "noncomedogenic," which means your makeup or skin care has been specifically formulated not to clog your pores. That said, even if the product is "noncomedogenic," if you're using it continuously and your breakouts continue to get worse, make an appointment with your dermatologist, as you could be allergic to another ingredient in the product that is causing your issues.


Rouleau also enlightened me about another culprit making my skin care routine less effective: using oil-based products at the beginning of my skin care routine. As Rouleau explained, oils have a large molecule size and, therefore, should go at the end of a skin care routine because it almost acts like a sealant. When you use a cleansing oil or balm first (as I used to do along with makeup wipes), you're basically creating a barrier that makes it more difficult for other skin care products to penetrate and do their job.
"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.
Dermarolling: Those little needle rollers you've been seeing all over social media? Turns out, they're good for more than just a cute Instagram video. "Microneedling works by creating a small 'injury' to the skin, which in turn can increase collagen and elastin production, improving scars and fine wrinkles and reducing hyperpigmentation," explains dermatologist and founder of Curology, David Lortscher, MD. Use the microneedler a few times a week as a part of your nighttime routine after cleansing and before toning. "It’s particularly important to pay attention to sterility, and remember that overdoing can damage the skin and incite inflammation, so proceed with caution if you are considering home treatments. Consider a consultation with a dermatologist to explore in-office options," says Dr. Lortscher.
Acne can be a painful and embarrassing skin condition, and the scars it leaves behind are an unwelcome reminder of that. A dermatologist can help remove raised or pitted scars. While hyper-pigmented blemishes may fade after several months, you can help speed up the process. Realistically, you will not be able to make acne scars disappear in a single night, but the remedies, products, treatments, and skincare tips outlined below will certainly produce a noticeable difference over time. You just need to find the right method for your individual skin type.

"Cortisone injections help treat painful acne flareups and are good for getting rid of it quickly. However, they should not be administered regularly," cautions Dr. Bank. "Cortisone shots contain an antiinflammatory steroid medication called triamcinolone, which helps reduce the swelling of a glaring pimple or cyst, normally within 24 to 48 hours."
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Many theories about diet and acne abound; Anolik is most convinced by the ones surrounding sugar and dairy. “Dermatologists really didn’t believe in all the dietary restrictions for acne, but studies in the past ten years have convinced us a bit,” he says. “Dairy and high-glycemic foods do seem to play a part.” High-sugar diets are known to feed bacteria; any diet that increases overall inflammation in the body doubtlessly plays a part. Specific diets—from Ayurveda to low-carb to veganism—definitely work for some people.
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.
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.
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