Isotretinoin: Accutane was the original brand name; there are now several generic versions in common use, including Sotret, Claravis, and Amnesteem. Isotretinoin is an excellent treatment for severe, scarring, persistent acne and has been used on millions of patients since it was introduced in Europe in 1971 and in the U.S. in 1982. It should be used for people with severe acne, chiefly of the cystic variety, that has been unresponsive to conventional therapies like those listed above. If taken in sufficient dosage, it should eliminate the need to continue the use of prescription drugs in most patients. The drug has many potential serious side effects and requires a number of unique controls before it is prescribed. This means that isotretinoin is not a good choice for people whose acne is not that severe but who are frustrated and want "something that will knock acne out once and for all." In order to use the drug, the prescribing physician, the patient, and the supplying pharmacy must be enrolled in the online "iPLEDGE PROGRAM." Used properly, isotretinoin is safe and produces few side effects beyond dry lips and occasional muscle aches. This drug is prescribed for five to six months at a dosage that has a high likelihood of preventing the return of acne. Fasting blood tests are monitored monthly to check liver function and the level of triglycerides, substances related to cholesterol, which often rise a bit during treatment but rarely to the point at which treatment has to be modified or stopped.

Laser resurfacing involves directing concentrated pulsating beams of light at irregular skin. This procedure may be used to reduce wrinkles, blemished, or acne scars. There are two types of lasers commonly used in laser resurfacing: carbon dioxide and erbium. Treated areas heal in 10-21 days. Possible complications include milia, hyperpigmentation, and swelling.

So if popping pimples doesn't cause scarring, what does? Long-lasting scars typically turn up after a recurring bout with cystic acne. Cystic acne is a breakout that burrows deep into the skin. These red, painful nodules occur when clogged pores are filled with pus and bacteria, which causes inflammation. Cystic breakouts are often tied to an internal fluctuation of hormones like testosterone (that's why they're common during puberty, monthly menstruation, and perimenopause). "If there is a cyst in the skin, it's going to cause a scar the longer it sits there because pus or bacteria deeper inside the pores cause surrounding inflammation," says Dr. Karolak. And as a result, the inflammation affects the collagen production as well as the fat stores under the skin, creating a visible scar on the surface.


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.

If you wear tight clothing when working out or don heavy equipment for sporting purposes, you may have experienced Acne Mechanica. This type of acne is prevalent among athletes, students, and soldiers, and is directly caused by excessive heat, pressure, and covered skin. It also may be triggered by consistent rubbing of different materials against the skin. This type of acne can be alleviated by changing out of sweaty gear and clothing and showering immediately after a workout. It’s also important to clean gear of acne bacteria and prevent friction by ensuring a comfortably tight fit. If you believe your acne flare up has been caused by a tight or heavy uniform, wearing a clean, cotton t-shirt underneath can help absorb the sweat and keep your skin protected.
There have been rumblings about the connection between eating chocolate and acne conditions for years, but a 2014 study showed some promising research that unfortunately does indicate chocolate as a cause of acne flare ups. This study, published in The Journal of Clinical and Aesthetic Dermatology, took a group of 14 men aged 18 to 35 to examine the effects of cocoa on the skin. On days that followed chocolate consumption, the number of both non-inflammatory and inflammatory pimple lesions grew exponentially.
Acne scars are usually the result of inflamed blemishes caused by skin pores engorged with excess oil, dead skin cells and bacteria. The pore swells, causing a break in the follicle wall. Shallow lesions are usually minor and heal quickly. But if there is a deep break in the wall of the pore, infected material can spill out into surrounding tissue, creating deeper lesions. The skin attempts to repair these lesions by forming new collagen fibers. These repairs usually aren't as smooth and flawless as the original skin.
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.
Alcoholism is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law. It can cause myriad health problems, including cirrhosis of the liver, birth defects, heart disease, stroke, psychological problems, and dementia. Counseling and a few medications can be effective for alcoholism treatment.
See Your Doctor If You Get Large, Deep Breakouts or Acne Cysts: While smaller blemishes can still scar the skin, it's the big guys that usually do the damage. Because they extend deeper into the skin, deep nodular breakouts or cystic breakouts are more likely to destroy skin tissue and leave scars. Over-the-counter acne products just won't help these types of breakouts. Get an appointment with a dermatologist. Quick, effective treatment can help lessen the chance of developing deep scars.

Use gentle skincare products. A lot of the time, people are so desperate to get rid of acne scars and skin discolorations that they will use all manner of abrasive products and methods which can irritate the skin and make the situation worse. Try to listen to your skin -- if it's reacting badly to a particular product, you should stop using that product immediately. Stick to gentle facial cleansers, make-up removers, moisturizers and scrubs that soothe your skin rather than inflame it.


Topical (external) applications: Antibacterial cleansers come in the form of gels, creams, and lotions that are applied to the affected area. The active ingredients that kill surface bacteria include benzoyl peroxide, sulfur, and resorcinol. Some brands promoted on the Internet and cable TV (such as ProActiv) are much more costly than identical and sometimes more potent products one can buy in the drugstore.
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