Sunscreen: "Sun exposure during an active breakout can lead to darkening of inflammatory lesions, prolonging their appearance on your skin and making them harder to fade over time," says Dr. Shereene Idriss from Union Square Dermatology, which means it's important to lather on the sunscreen daily — even when it's cloudy. And don't worry about breaking out from a pore-clogging sunscreen; the latest formulas are more innovative and acne-friendly than ever. Elta MD UV Clear Broad-Spectrum SPF 46 is a top derm-approved favorite. It contains niacinamide, which is an anti-inflammatory that helps reduce redness.
Ablative lasers deliver an intense wavelength of light to the skin, removing thin outer layers of the skin (epidermis). In addition, collagen production is stimulated in the underlying layer (the dermis). Patients are typically numbed with local anesthetic and the ablation is done as an outpatient procedure. CO2 and erbium are the ablative lasers most often used for acne scar treatment.
You've probably seen those tiny glass jars filled with liquid and some solid sediment at the bottom—sometimes it's pink, sometimes it's white, and (in the case of my favorite product) sometimes it's flesh-tone. The solid in the jar is usually a mix of drying ingredient like camphor, sulfur, and zinc oxide, but many brands throw in a few little extras. Cult-favorite Mario Badescu Drying Lotion adds calming calamine and exfoliating salacylic acid to their formula, while my favorite, End-Zit Acne Control Drying Lotion, keeps it simple, but comes in several shades so that it conceals your breakout while it treats it.
Because I'm constantly testing out new products, I don't often end up with "empties" (as in, products so good you've emptied out the bottle). However, I loved Sunday Riley's Good Genes so much I literally twisted the pump off and stuck my finger in it to try and get every last bit. The magic potion's main ingredient is lactic acid, which exfoliates away dead skin cells — key for clearing pores, fading scars, and revealing fresh skin on the surface.
Rena Levi is known for her sensitivity towards clients with severe acne and problem skin. In 1968 she moved from Israel to the U.S. and studied with Christine Valmy at the European Esthetic Skincare Institute. In 1975, she opened the Rena Levi Skin Care Salon in New York City. In 1980, she moved to Albuquerque, NM, where she managed the skin care center for Eleganza Salon and further developed and refined her practice. It was there that she became well known for her ability to treat what many considered impossible skin, while also teaching budding estheticians and skin practitioners at the same time, including the then-president of the New Mexico Board of Cosmetology. Here, Levi shares with us one of her most popular facial protocol treatments for treating clients with moderate to severe acne.
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.
This article was medically reviewed by Hilary Baldwin, MD. Baldwin, medical director of the Acne Treatment Research Center, is a board-certified dermatologist with nearly 25 years of experience. Her area of expertise and interest are acne, rosacea and keloid scars. Baldwin received her BA and MA in biology from Boston University. She became a research assistant at Harvard University before attending Boston University School of Medicine. She then completed a medical internship at Yale New Haven Hospital before becoming a resident and chief resident in dermatology at New York University Medical Center.
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.
Our skin contains millions of small sebaceous glands underneath the surface. These glands excrete an oil, called sebum, that helps to keep our skin smooth and supple. This oil is released via pores, which are small holes on the surface of the skin, which is also where hairs grow out of. When the body produces a lot of sebum, the skin can feel oily and these pores can become clog. It is when these pores become clogged that germs and bacteria can thrive and grow. The result – pimples.
Steroid injections: If you feel a stress pimple rearing its ugly head, a steroid shot can be administered the same day you call your derm because the process is very fast. Not only does it immediately reduce the inflammation of an existing zit, but cortisone can also help thick scars (keloids) appear softer and flatter. "These are specifically for raised scars, however," says Dr. Shah. "It'll help flatten out the scar, but it won't do anything to any discrepancies in the texture."
There are simple things you can do on your own to help prevent adult acne and keep it from getting worse. First, wash your skin once or twice a day with a non-drying, non-comedogenic cleanser that won't clog your pores. Look for cosmetic products labeled oil-free, non-comedogenic and non-acnegenic (unlikely to cause acne breakouts). In addition, avoid heavy skin creams or hair products which may aggravate your skin condition.
Drugs: Some medications may cause or worsen acne, such as those containing iodides, bromides, or oral or injected steroids (either the medically prescribed prednisone [Deltasone, Orasone, Prednicen-M, Liquid Pred] or the steroids that bodybuilders or athletes sometimes take). Other drugs that can cause or aggravate acne are anticonvulsant medications and lithium (Eskalith, Lithobid). Most cases of acne, however, are not drug related.