The best way to fix them: You have a few options with these. The first would be to visit an aesthetician or a dermatologist for a deep-cleaning in a sterile environment. The second? Use an exfoliator. That could be a face scrub, retinol—which boosts skin cell turnover—or even facial cleansing brushes. If you go this route, just pick one. "You just don’t want to combine all them, since that’ll make skin sensitive," adds Dr. Hale.
It is a myth that women get acne because they don't wash enough. Too much washing or scrubbing the skin harshly can make acne worse. And washing away surface oils doesn't do much to prevent or cure acne, because it forms under the skin. The best way to clean the face is to gently wash it twice a day with a mild soap or cleanser. Be careful to remove make-up without harsh scrubbing.
A recent study has found a difference between strains of acne bacteria, which could have a significant impact on acne treatment down the road. This study, published in the Journal of Investigative Dermatology, found that these strains play a role in the severity and frequency of developing pimples. One particular strain of P. acnes was found among study participants that exhibited few symptoms of acne. Researchers came to the conclusion that this “good” strain of bacteria features a natural defense mechanism that fights back bacteria which might infect the cell. Researchers are hopeful that this discovery will help dermatologists better and more accurately prescribe effective acne treatment in the future, and reduce the severity of acne by ridding the skin of bad acne bacteria while preserving the good. 
Laser treatment may cause some discomfort. While most patients are able to endure the procedure, ice packs and topical anesthetic cream can help alleviate the discomfort. Multiple treatments are typically necessary, and most insurances do not cover the procedure. Doctors recommend treatments in three- to six-week intervals; during this time, sun avoidance is necessary. Review risk, benefits, and alternatives with a physician prior to treatment. Combine laser treatments with photodynamic therapy (light-activated chemical using Levulan) for more noticeable results.
Since there is some overlap between acne and rosacea, some of the medications may be similar. Acne and rosacea have in common several possible treatments, including (but not limited to) oral antibiotics, topical antibiotics, sulfa-based face washes, isotretinoin, and many others. It is important to seek a physician's advice before using random over-the-counter acne medications since they can actually irritate skin that is prone to rosacea. Overall, rosacea skin tends to be more sensitive and easily irritated than that of common acne.
Some skin advocates suggest foregoing this method. The pH of baking soda is 7.0, which is far too basic for skin's pH. Optimal skin pH occurs between 4.7 and 5.5, which is an inhospitable environment for p. acne (the bacteria responsible for causing most acne). By raising the pH to a more basic level, p. acne is able to survive longer and cause more infection and inflammation. So try this method with care, and stop using it if it's not effective for you.
"I often recommend PCA Skin Pigment Gel to patients looking to treat scars left behind from acne," explains Rebecca Kazin, a dermatologist at Washington Institute of Dermatologic Laser Surgery and Johns Hopkins department of dermatology. "This gel contains 2 percent hydroquinone blended with other skin brighteners, like kojic acid, resorcinol, and azeleic acid, which work to lighten the pigmentation without irritating the skin," she says. The addition of lactic acid helps maintain moisture to prevent overdrying, which can worsen pigmentation.
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. 
Can’t use the good stuff: The best medications for clearing acne include topical retinoids like Differin and Retin-A. The strong chemicals that are used in exfoliants can cause severe inflammation and sun irritation when combined with these medications. This means that you will have to choose between facials or proper medications. The choice is yours.
Retinoids: Retin-A (tretinoin) has been in use for years, and preparations have become milder and gentler while still maintaining its effectiveness. Newer retinoids include adapalene (Differin) and tazarotene (Tazorac). These medications are especially helpful for unclogging pores. Side effects may include irritation and a mild increase in sensitivity to the sun. Adapalene 0.1% is now available without a prescription. With proper sun protection, however, they can be used even during sunny periods. The combination medication known as Epiduo gel -- which contains the retinoid, adapalene, along with the antibacterial, benzoyl peroxide -- is applied once a day.
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