Jump up ^ Melnik, BC (2011). “Evidence for Acne-Promoting Effects of Milk and Other Insulinotropic Dairy Products”. Milk and Milk Products in Human Nutrition. Nestlé Nutrition Institute Workshop Series: Pediatric Program. 67. p. 131. doi:10.1159/000325580. ISBN 978-3-8055-9587-2.
The earliest pathologic change is the formation of a plug (a microcomedone), which is driven primarily by excessive growth, reproduction, and accumulation of skin cells in the hair follicle. In normal skin, the skin cells that have died come up to the surface and exit the pore of the hair follicle. However, increased production of oily sebum in those with acne causes the dead skin cells to stick together. The accumulation of dead skin cell debris and oily sebum blocks the pore of the hair follicle, thus forming the microcomedone. This is further exacerbated by the biofilm created by P. acnes within the hair follicle. If the microcomedone is superficial within the hair follicle, the skin pigment melanin is exposed to air, resulting in its oxidation and dark appearance (known as a blackhead or open comedo). In contrast, if the microcomedone occurs deep within the hair follicle, this causes the formation of a whitehead (known as a closed comedo).
Salicylic acid 0.1 – 2% cream is an alternative to benzoyl peroxide, but is generally less effective and may also cause skin dryness.6 It works by softening and descaling the skin, thereby reducing comedones.
Acne is a skin condition that shows up as different types of bumps. They include whiteheads, blackheads, red bumps (pimples), and bumps that are filled with pus (called pustules). What causes these annoying bumps? Well, your skin is covered with tiny holes called hair follicles, or pores. Pores contain sebaceous (say: suh-BAY-shus) glands (also called oil glands) that make sebum (say: SEE-bum), an oil that moistens your hair and skin.
Salicylic acid and azelaic acid. Azelaic acid is a naturally occurring acid found in whole-grain cereals and animal products. It has antibacterial properties. A 20 percent azelaic acid cream seems to be as effective as many conventional acne treatments when used twice a day for at least four weeks. It’s even more effective when used in combination with erythromycin. Prescription azelaic acid (Azelex, Finacea) is an option during pregnancy and while breast-feeding. Side effects include skin discoloration and minor skin irritation.
Oral antibiotics have been used to treat acne for many years. Like topical antibiotics, oral antibiotics work by reducing Propionibacteria acnes (the bacteria responsible for acne breakouts). They also help decrease inflammation of the skin.
Prescribed Medications: Your healthcare professional may deem it necessary to prescribe oral antibiotics to help fight bacteria in the skin or a prescription only topical cream. In some cases a combination of both may be the solution.
^ Jump up to: a b c Barnes, LE; Levender, MM; Fleischer, AB, Jr.; Feldman, SR (April 2012). “Quality of life measures for acne patients”. Dermatologic Clinics (Review). 30 (2): 293–300. doi:10.1016/j.det.2011.11.001. PMID 22284143.
Isotretinoin is a systemic retinoid that is highly effective in the treatment of severe, recalcitrant acne vulgaris.  Isotretinoin causes normalization of epidermal differentiation, depresses sebum excretion by 70%, is anti-inflammatory, and even reduces the presence of C acnes (formerly P acnes). 
Recent studies conducted by dermatologists in 2012 show that green tea has a positive impact on acne, when applied externally. Green tea has an antioxidant known as epigallocatechin-3-gallate (EGCG). It was observed that EGCG reduced inflammation, sebum production and bacterial growth on pimple-prone skin. Place 2 teaspoons of organic tea leaves in 1/2 cup of fresh boiling water. Steep for 5 minutes; strain the leaves and let the mixture cool. Then use a cotton pad to apply it on your face. You may also put it inside a spray bottle and spray it on. Leave it on overnight.
Comedo extraction is supported by limited evidence but is recommended for comedones that do not improve with standard treatment. Another procedure for immediate relief is injection of a corticosteroid into an inflamed acne comedo. Electrocautery and electrofulguration have also been reported as effective treatments for comedones.
Many different treatments exist for acne. These include alpha hydroxy acid, anti-androgen medications, antibiotics, antiseborrheic medications, azelaic acid, benzoyl peroxide, hormonal treatments, keratolytic soaps, nicotinamide, retinoids, and salicylic acid. They are believed to work in at least four different ways, including the following: reducing inflammation, hormonal manipulation, killing P. acnes, and normalizing skin cell shedding and sebum production in the pore to prevent blockage. Common treatments include topical therapies such as antibiotics, benzoyl peroxide, and retinoids, and systemic therapies including antibiotics, hormonal agents, and oral retinoids.
Subantimicrobial therapy or concurrent treatment with topical benzoyl peroxide may reduce the emergence of resistant strains.  Comparing subantimicrobial 40-mg doxycycline, 100-mg doxycycline, and placebo, Moore et al found a comparable percentage of patients clear of acne between at the 40-mg and 100-mg doses, both significantly higher than placebo.  Additionally, less drug-related adverse events were found with the 40-mg subantimicrobial dosing. Enteric-coated, delayed-release formulations of doxycycline can further reduce gastrointestinal adverse effects. 
Pustules are inflamed pores filled with the P. acnes bacteria. These lesions are what people typically think of when they think of pimples. The bacteria attracts the body’s natural infection-fighting cells, which cause the irritation and redness associated with pimples.
Wash your face twice daily with a pH balanced cleanser.  The first step to getting clear skin is to set up a regimented cleansing routine to restore the skin’s acid mantle and thus discourage acne vulgaris growth. Buckle down and force yourself to wash your face with a pH balanced cleanser of 5.5  when you wake up in the morning and before going to bed at night. As tired or busy as you may be, taking the extra few minutes to cleanse your skin will reduce your acne significantly.
If you are prescribed antibiotics for acne, discuss these concerns with your doctor. Make sure your acne treatment is reviewed regularly. It’s best to limit a course of antibiotics to 3 months, if possible. Apply topical benzoyl peroxide and/or a topical retinoid to areas affected by acne while on antibiotics and after they have been stopped. Find out if other, non-antibiotic treatment might be suitable for you.
2. Use an exfoliating acid to de-gunk your pores. When you think about an exfoliant, you probably think of a cleanser with beads or granules. These are called physical exfoliants, and while they’re great for sloughing away dead skin, they can be irritating to acne that’s already present on the skin. And, even worse, they inadvertently spread bacteria across your face, causing more breakouts. Acid exfoliators (also referred to as chemical exfoliants) sound strong and scary, but in reality, they’re phenomenal for your complexion. They work like little Pac-Man on your skin, helping to devour dirt, debris, and dead skin cells that clog your pores. The all-star chemical exfoliators for acne are glycolic acid and fruit-based enzymes, such as papaya and pumpkin. Just be careful not to over-exfoliate, which can dry out the skin and lead to the overproduction of oil and, therefore, more acne; two or three times a week should suffice.
Anyone who has severe acne knows how stubborn it can be. You cannot clear it with acne treatment that you buy at the store. To see clearing, you either have to wait it out or see a dermatologist. Waiting out severe acne can take years.
Deep peel: phenol. Phenolic peels are the strongest of the peels. It be a bit toxic to the kidneys, and can bleach skin, which is why it is less and less recommended for the treatment of acne scars. Usually TCA is used instead.
Don’t be surprised if the skin sloughing off is not flaky. It will be thicker than flakes, almost like the skin’s outer layer is being peeled off. This is what it means to have a deep peel. Your recovering time will be around 2 weeks.
The Journal of Clinical and Aesthetic Dermatology states that salicylic acid and benzoyl peroxide are by far the most common acne ingredients and they’re effective in double-blind studies of patients with mild-to-moderately severe acne. We looked for kits that included at least one ingredient targeting each camp: the comedones and the pimples.
Silicone gel sheets work well with hypertrophic scars. They have been known to soften, flatten and improve the appearance of scars, but they won’t disappear totally. The most famous brand is this one.