Cysts, which are also called blind pimples, are the very worst kind of acne. Basically, cysts are made up of sebaceous content (again, a gross combination of oil, dirt, and bacteria) that's trapped beneath the skin and has no way out—so they just live and grow under the skin, causing both a bump and, in some cases, pain. "These take longer to resolve on their own, are less responsive to topical treatments, and over time may lead to scarring," says Dr. Chwalek. Um, no thanks.
This treatment is performed by dermatologists and combines two different technologies — microneedling and radio frequency — for big results in eliminating acne scars. First, a topical numbing gel is applied. Then the doctor uses the microneedling device to penetrate the skin and, simultaneously, radiofrequency is delivered right to the dermis. Downtime is usually around 24 hours and then you can resume wearing makeup to cover any lasting redness.
"Jessner Peels help to reduce acne lesions overnight by drying them out. They also help to remove the top layers of the skin that cause dry skin and acne flareups. It's important to note that the use of retin-A may cause the acids in the peel to intensify, so if you are using a prescription retin-A it's important to stop using it one week prior to getting the peel," says Dr. Bank. For those with less severe acne or occasional breakouts, there are other types of chemical peels your derm can give you to exfoliate your skin, dry up acne, and help create an instant glow (great for if you're trying to remove a few lingering pimples before a big event in a few days).
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.
Do a Google search for “how to get rid of acne fast" and you'll see plenty of websites telling you to eat better for clear skin. But are there really foods that cause acne, or is that an old wives' tale? Dermatologist Hilary Baldwin, MD, of the Acne Treatment and Research Centre in Morristown, New Jersey, says the answer isn't really simple at all. "The simple answer is, we don't know. So far studies have suggested that high-glycemic index diets (those with lots of white foods like potatoes, pasta, bread, rice and sweets), as well as diets high in skim-milk dairy products and whey protein supplements might be associated with worsening of existing acne but are less likely to cause acne," Baldwin says.
The process involves first removing makeup with an emollient formula—I use her Soothing Aloe Cleansing Milk, which looks and feels like lotion—on dry skin for 30 seconds, then rinsing and follow with another cleanser. Rouleau's AHA/BHA Blemish Control Cleanser has been my lifesaver, it's a blend of salicylic, lactic, and glycolic acids, plus jojoba beads for physical exfoliation. It sloughs away residue and oil and targets pimples, blackheads, and leftover scarring. I always followed this with Rouleau's Balancing Skin Tonic before applying any other layers.
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.
While over-the-counter products don’t treat the hormonal component of acne, salicylic acid—a.k.a. willow bark, a.k.a. what aspirin is made of—addresses all other aspects involved in a breakout. “It works,” says Anolik, who recommends using salicylic acid-based products in conjunction with benzoyl peroxide preparations that target acne bacteria with greater strength. Benzoyl peroxide can definitely cause dryness and irritation; if you decide not to use it, know that you’ve got to be even more vigilant about the bacteria on your skin, so cleanse and treat more often. Tea-tree oil preparations like Tammy Fender’s Clarifying Dermagel ($72, goop.com) help. Burt’s Bees Natural Solutions Acne Spot Treatment ($10, burtsbees.com) combines tea tree and salicylic acid for powerful (yet easy on skin) results.
Acne refers to pimples, blemishes, blackheads, zits or whiteheads. While this problem is commonly associated with teenagers, many adults suffer from acne as well. Stress, hormones, environmental factors and more can lead to acne problems, causing individuals embarrassment and slashing their confidence. Outlined below are tips for eliminating acne once and for all so you can have healthy, glowing skin.
Prescription Medications. Medications that affect hormones, like birth control pills, can help control acne. You might also discuss antibiotic pills and prescription retinoids with your dermatologist. There are also antibiotics that are effective. Doctors may prescribe Aldactone (spironolactone), which was first made to treat high blood pressure, to treat acne. "That works miracles but it can take three months to kick in," Day says. Isotretinoin is another prescription drug for acne, but you can't take it if you're pregnant or planning to get pregnant.
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.
Antibiotics are an acne treatment used to kill acne-causing bacteria. They may be applied directly on the skin (topical) or taken by mouth (oral). Topical antibiotics kill bacteria in the upper portion of your pores, while oral antibiotics can reach to the lower depths of the pores. Antibiotics used for acne treatment include, clindamycin, or tetracyclines like doxycycline or minocycline. These antibiotics are the most effective for treating acne because they both kill bacteria and act as anti-inflammatory agents to calm down the skin.
Some people swear by the disinfecting power of tea tree oil for acne treatment. It can be applied either full strength or slightly diluted with water directly onto pimples. Use a small amount on a clean cotton swab or cotton pad and dab on the affected areas immediately after cleansing. Because tea tree oil can be drying, you might choose to use both tea tree oil and coconut oil for acne as part of your clear skin regimen.
Hormone changes as an adult. The menstrual cycle is one of the most common acne triggers. Acne lesions tend to form a few days before the cycle begins and go away after the cycle is completed. Other hormone changes, such as pregnancy and menopause, improve acne in some women. But some women have worse acne during these times. Stopping use of birth control pills can play a role as well.
Treatments like radiofrequency microneedling, lasers, and fillers can be effective to treat acne scars, but they can run you hundreds of dollars per treatment. And Hellman says you'll need six to eight treatments and a good amount of time before seeing results. "The process takes a good part of a year," she says. (Her office does offer some package options to help offset some of the cost.)
Treatment of acne scars: For those patients whose acne has gone away but left them with permanent scarring, several options are available. These include surgical procedures to elevate deep, depressed acne scars and laser resurfacing to smooth out shallow acne scars. Newer forms of laser resurfacing ("fractional resurfacing") are less invasive and heal faster than older methods, although results are less complete and the procedures may need to be repeated three or more times. These treatments can help, but they are never completely successful at eliminating acne scars.