Genetics can also have an effect on acne breakouts, and may be the reason some people are acne-prone while others are not. One of the top cited studies took a look at 458 pairs of identical twins and 1099 pairs of fraternal twins to study acne prevalence. They found that genes explained a significant 81 percent of the difference in acne prevalence, while the other 19 percent was explained by non-shared environmental factors. 
"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.

A healthy diet can only prevent 90% of your acne. The other 10% of your acne has to do with external factors. External factors are cleanser, cream, lotion and moisturizer that you apply to your face. During the course of my acne treatment with my doctor, 4 main ingredients appeared on all my topical prescriptions. You should look for these ingredients in your external acne treatment products. They are as follows:


Doxycycline is another of the tetracyclines that is equally effective in treating acne. It comes in generic versions and also as the branded Doryx and Acticlate which are easier on the stomach. Originally FDA approved for the treatment of rosacea, Oracea is a non antibiotic dose of doxycycline that is often used as an acne treatment, as well. Taken orally, it can be used as solo therapy or in combination with a topical acne treatment regimen. More severe cases of acne might need higher doses of doxycycline, but since Oracea is not an antibiotic, many patients can be “down-graded" to Oracea after improvement and it is suitable for longterm use as it does not cause antibiotic resistance.

Acne is usually a temporary problem, but acne scars can be permanent. However unwelcome they may be, scars are part of the skin's normal healing process after it has been damaged by a wound or injury. Most superficial wounds heal without scarring. It's when the dermis is damaged that scars form on the skin. Learn what causes acne scars and how you can prevent them.
The exact cause of rosacea is still unknown. The basic process seems to involve dilation of the small blood vessels of the face. Currently, health researchers believe that rosacea patients have a genetically mediated reduction in the ability to dampen facial inflammation that is incited by environmental factors such as sunburn, demodicosis (Demodex folliculorum in the hair follicles), flushing, and certain medications. Rosacea tends to affect the "blush" areas of the face and is more common in people who flush easily. Additionally, a variety of triggers is known to cause rosacea to flare. Emotional factors (stress, fear, anxiety, embarrassment, etc.) may trigger blushing and aggravate rosacea. Changes in the weather, like strong winds, or a change in the humidity can cause a flare-up. Sun exposure and sun-damaged skin is associated with rosacea. Exercise, alcohol consumption, smoking, emotional upsets, and spicy food are other well-known triggers that may aggravate rosacea. Many patients may also notice flares around the holidays, particularly Christmas and New Year's holidays.
Unfortunately, subtype 2 rosacea was historically referred to as “acne rosacea,” reflecting the belief that the two conditions were related. Although it is now known that there is no connection between acne and rosacea, the term can still be found in older literature about the disease, as well as in occasional reports today. This has often led to confusion by the public, and rosacea sufferers with bumps and pimples may mistakenly self-diagnose themselves as having acne. The two disorders require different treatment, however, and acne medications may cause rosacea symptoms to get worse.
Glycolic Acid is an alpha-hydroxy acid and an exfoliating ingredient that targets both acne and wrinkles at the same time. "The same way it helps acne, it helps wrinkles—by removing dead cells on surface. If you have effective exfoliation, you're stimulating collagen and hyaluronic acid," Dr. Schultz explains. This will help improve skin's texture and reduce fine lines and wrinkles while also clearing up breakouts.
Photodynamic therapy (PDT) is one of the newly available treatments. PDT uses a topical photosensitizer liquid that one applies to the skin and a light to activate the sensitizer. Levulan (aminolevulinic acid) and blue light, commonly used to treat pre-cancers (actinic keratosis) and acne vulgaris, can treat some rosacea patients. The use of PDT in rosacea is off-label, since it is primarily designed for regular acne. PDT works at reducing the inflammation; PDT is performed in a physician's office. The treatment takes anywhere from one to one and a half hours to complete. Strict sun avoidance for approximately one to three days is required after the treatment. Mild discomfort during the treatment and a mild to moderate sunburn appearance after the treatment is common. Some patients have experienced remissions (disease-free periods) of several months to years from these types of treatments. Other patients may not notice significant improvement.
Eat healthily. Foods that are highly processed and contain a lot of oils greatly increase the amount of acne on your body. Getting the proper amount of nutrients from whole grains, fruits, vegetables, and protein help your skin to regenerate faster and limit unnecessary oil production. When at all possible, avoid foods that are processed or contain a lot of sugar (think junk foods).[11]
Oral antibiotics: Doctors may start treatment with tetracycline (Sumycin) or one of the related "cyclines," such as doxycycline (Vibramycin, Oracea, Adoxa, Atridox, and others) and minocycline (Dynacin, Minocin). Other oral antibiotics that are useful for treating acne are cefadroxil (Duricef), amoxicillin (Amoxil, DisperMox, Trimox), and the sulfa drugs.
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