No one factor causes acne. Acne happens when oil (sebaceous) glands are activated at puberty, stimulated by male hormones from the adrenal glands in both boys and girls. Oil is a natural substance which lubricates and protects the skin. Under certain circumstances, cells that are close to the surface block the openings of sebaceous glands and cause a buildup of oil underneath. This oil stimulates bacteria, which live in everyone's skin and generally cause no problems, to multiply and cause surrounding tissues to become inflamed.

Acne scar treatment: “Treatment may include excising the scar with a small ‘punch,’ and suturing the defect closed, but this only works for isolated ice pick scars,” he says. New York City dermatologist Judy Hellman, MD, adds: “We can also do skin grafts and take skin from behind the ear to fill the scar, and then we can use a laser or radiofrequency device to smooth it out.”
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.
"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.
Inflammation is the single greatest gauge of scar development. The greater the inflammation on the skin, the more likely scarring is to occur. Deep breakouts that take a long time to heal also increase the chance of scarring. Blackheads, whiteheads, and other non-inflamed blemishes typically don't cause scarring because these types of lesions don't injure skin tissue.
Chemical peels: "A chemical peel is a treatment that uses the application of mild solutions for skin refinement and regeneration. Products containing glycolic acid promote cell turnover, which is the process where new skin cells form and help even out your skin tone," says Dr. Bowe. You can try an at-home peel like Peter Thomas Roth 40% Triple Acid Peel, which uses both glycolic and salicylic acids to help fade spots by exfoliating dead skin cells and smoothing out skin texture. "Or, your dermatologist can prescribe you a stronger peel based on your skin type and treatment goals," says Dr. Bowe.
What you can do differently: Instead of dousing your zit with a spot treatment, apply a dab of OTC 1 percent hydrocortisone cream, like Aveeno One Percent Hydrocortisone Anti-Itch Cream, onto the spot two to three times during the day to take down the inflammation and redness. Then conceal it by simply covering it up with a concealer, like Clinique Even Better Compact Makeup, which has antibacterial ingredients to keep the formula bacteria-free and your face clear.
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."
Some teens who have acne can get help from a doctor or dermatologist (a doctor who specializes in skin problems). A doctor may treat the acne with prescription medicines. Depending on the person's acne, this might mean using prescription creams that prevent pimples from forming, taking antibiotics to kill the bacteria that help create pimples, or if the acne is severe, taking stronger medicines such as isotretinoin, or even having minor surgery. Some girls find that birth control pills help to clear up their acne.
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.
When it comes to acne scars — especially difficult to treat indented or raised ones — the best offense is a good defense. If you’re still struggling with active acne and want to avoid future scarring, Avram likes this drugstore-staple Neutrogena wash because it contains salicylic acid, a beta-hydroxy acid that he says “exfoliates the skin, softens the appearance of the acne itself, and has some antibacterial properties.”
This powerful, medicated cleanser delivers a luxuriously whipped texture and three percent sulfur to address acne and blemishes, draw out impurities, and target congested pores. Honey and rice bran extracts calm redness, while natural oat extract addresses excess sebum. With continued use, this gentle, yet effective daily cleanser leaves skin clearer with visibly minimized pores.
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.
Skin-care geeks rejoiced when the formerly Rx-only Differin gel became available over the counter, in 2016. A prescription-strength retinoid, Differin also affects cell turnover faster than OTC retinols to prevent the formation of new acne. Avram recommends it for those dealing with a lot of small pimples and only the occasional monster cyst. Because Nagler says retinoids “encouraging collagen remodeling,” a well-tolerated formula like Differin can also reduce the appearance of deeper scars.
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.
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