Smoking, spicy foods, hot drinks, and alcohol may cause flushing and should be avoided. Exposure to sunlight and to extreme hot and cold temperatures should be limited as much as possible. Red wine and chocolate are two well-known rosacea triggers. Some listed foods may have no effect on one patient's rosacea but severely affect someone else. Individual reaction patterns vary greatly in rosacea. Therefore, a food diary may help to elucidate one's special triggers.

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.


Your doctor might recommend an injectable treatment called a filler. "Mainly, I treat acne scars with hyaluronic acid fillers, such as Restylane, but not all acne scars respond to this sort of treatment," Schlessinger says. "Additionally, I personally find that Accutane has a remarkable effect on acne scars if it is prescribed early on in the course of a scarring acne."

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.
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Scars that are indented aren't going to go away on their own and most likely need professional treatment. Talk to your derm about laser options, as well as subcision and microneedling—all proven methods to get rid of scarring. But those brown spots left behind once a zit goes away? You can treat them at home if you're diligent. Dr. Schultz says you have to stick to a regimen of daily sunscreen use, exfoliation, and application of a bleaching product that will help remove the excess pigmentation in the skin. Try Murad Rapid Age Spot and Pigment Lightening Serum.
There are several low-level light devices designed as at-home acne remedies on the market — but do they really work? Some, like the Zeno electronic "zit-zapper" are FDA-approved as acne remedies, but reviews with these products are typically mixed. Even the best acne treatment won't work for everyone, as the severity of the acne, types of acne and quality of the device are all factors. Ask your dermatologist for a recommendation if you're considering purchasing an at-home light device to treat your acne.
A benzoyl peroxide cream (2.5 percent strength) is a good choice for adolescents experiencing red or inflamed breakouts that aren't getting better with medicated cleansers. Benzoyl peroxide is a very common and inexpensive acne treatment cream that can be found over-the-counter in the skin care aisle. Benzoyl peroxide kills the bacteria that cause pimples and is highly successful in treating mild cases of acne.

As mentioned above, genetics are thought to play a major role in your susceptibility to acne. However, using the best acne products and taking good care of your skin can help you prevent worsening acne and scars later in life. Check out these other known acne causes and aggravators and see how to prevent acne by cutting some of these out of your life:
Acne appears when a pore in our skin clogs. This clog begins with dead skin cells. Normally, dead skin cells rise to surface of the pore, and the body sheds the cells. When the body starts to make lots of sebum (see-bum), oil that keeps our skin from drying out, the dead skin cells can stick together inside the pore. Instead of rising to the surface, the cells become trapped inside the pore.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
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