Remember that effective acne treatment is a marathon, not a sprint. Some believe that quick fixes found in their medicine cabinet are viable options, wondering to themselves: Can hydrogen peroxide cure acne? or Does sulfur make acne better? In most cases like these, the answer is no. These solutions are short-lived, and can result in worsened breakouts.
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The first part of any treatment plan is diagnosis. Understanding how to treat acne truly starts with understanding acne itself. Self-diagnosing your acne can be a good start, but with severe cases, you’ll want to schedule an appointment with a licensed dermatologist.
FDA safety alert. Over-The-Counter Topical Acne Products: Drug Safety Communication – Rare But Serious Hypersensitivity Reactions. U.S. Food and Drug Administration. Available at http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm402722.htm. Accessed: June 30, 2014.
“Ice-cold temperatures help constrict blood vessels, so wrap an ice cube in a paper towel and hold it against the bump to reduce redness and bring down the swelling a bit,” says Zeichner, who recommends icing three times an hour in ten-minute intervals, i.e., ten minutes on, ten minutes off. (You want to do this after you wash your face since washing after icing would warm the skin right back up.)
Alternatively, mix the contents of 1 vitamin E capsule with 1 teaspoon of castor oil. Apply it on the affected skin before going to bed. Leave it on overnight and rinse it off the next morning using lukewarm water. Repeat daily until your scars fade.
A well-designed facial mask can help acne by removing the dirt and debris that can clog pores and block the flow of sebum which is ultimately broken down by P. acnes bacteria to create inflammatory mediators that provoke the formation of acne lesions. These products are typically either clay-based or solvent-based systems that are subsequently washed off the skin. The addition of benzoyl peroxide or colloidal sulfur can serve as a anti-bacterial agent, while salicylic acid is a keratolytic agent that removes skin cells uniformly so they cannot block pores.
Use oil-free makeup. If you wear makeup, you may be stuck in a vicious cycle of covering up acne while simultaneously causing it with your cover-up usage. Find acne-fighting oil-free mineral makeup to help prevent worsening your acne while simply trying to hide it. Power foundations are also recommended. When possible, avoid wearing make-up at all though as it clogs your pores over the course of the day.
Two factors are clear: a low-glycemic diet produces fewer pimples, the stricter the low-glycemic diet is applied, the more effective the treatment will be. Up to 50% reduction in acne lesions were observed among patients with acne who adhered to a strict low-glycemic index diet in just 12 weeks. There is alsoevidence that milk and other dairy products can contribute to acne, which works through the same mechanism of IGF-1 stimulation mentioned above.
The combination of progesterone and estrogen hormones can lower the amount of androgens in the body. Androgens are a group of hormones that contain high levels of testosterone, and are responsible for the production of sebum. As androgen levels decrease, the amount of sebum produced does as well. Decreased rates of sebum production can help keep pores unclogged and lessen the incidence of acne. For many women, contraceptive pills are taken in conjunction with topical acne solutions like BioClarity to provide the best form of treatment and clear up the skin.
“Treat painful undergrounders with this order of medications: a hydrocortisone cream to reduce inflammation, a 2 percent salicylic acid product to dry out excess oil, and then benzoyl peroxide to kill acne-causing bacteria.” — Joshua Zeichner, the director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City (We like Paula’s Choice Skin Perfecting 2 Percent BHA Gel Exfoliant to gently exfoliate and sop up oil.)
Antibiotics. Antibiotics may be used on top of the skin (topical) or taken orally (systemic). Antibiotics work by clearing the skin of acne-causing bacteria and reducing inflammation. There are several topical products available in creams, gels, solutions, pads, and lotions. Topical antibiotics are limited in their ability to penetrate the skin and clear more deep-seated acne, whereas systemic antibiotics circulate throughout the body and into sebaceous glands. However, systemic antibiotics often cause more side effects than topicals, but they can be used for more severe kinds of acne. Usually, topical antibiotics aren’t recommended alone as an acne treatment, as they can increase the risk for antibiotic resistance in skin bacteria. However, using benzoyl peroxide with a topical antibiotic may reduce the chances of developing antibiotic resistance.
Mild acne is predominately indicated by the presence of non-inflammatory lesions (i.e. comedones – see “The vocabulary of acne”, over page). Some inflammatory lesions (pustules or papules) may be present, but generally less than 10 – 15.
Topical antibiotics are mainly used for their role against C acnes (formerly P acnes). They may also have anti-inflammatory properties. Topical antibiotics are not comedolytic, and bacterial resistance may develop to any of these agents. Commonly prescribed topical antibiotics for acne vulgaris include clindamycin, erythromycin, or, more recently, dapsone. Topical dapsone is a new sulfone antibiotic with anti-inflammatory properties that has been shown to be effective for mild-to-moderate acne, and it has a convenient once-daily application schedule.  It is available as 5% twice-daily and 7.5% once-daily formulations.  The current American Academy of Dermatology guidelines preceded the FDA approval of the 7.5% formulation. Although no research has compared the efficacy of the 5% formulation with the 7.5% formulation, both have been separately shown to be efficacious and safe. The 7.5% formulation has the additional compliance factor of once-daily application. [29, 34]
Clogged pores, caused by things like excess oil production and dead skin cells. Sebum is the type of oil released into hair follicles that can become trapped beneath surface of the skin and clog pores.
3. Find an effective spot treatment. Once the pimples show up, you need an effective way to get rid of them. Spot treatments formulated with salicylic acid or benzoyl peroxide are typically the most effective at drying out pimples, but gentler, non-drying spot treatments with sulfur or tea tree oil can be effective too. Whichever you opt for, use it once or twice a day after you wash your face.
Blemish pads can be a really great option for getting rid of breakouts because they’re super easy to use. I have two favorites: Noxzema Ultimate Clear Anti-Blemish Pads and Image Clear Cell Clarifying Pads. Both pads are used the same way: make sure the infected area is clean, then gently rub with the pads once a day (twice if needed). The Noxzema pads are easy to find in drugstores (you can buy them at CVS), and they’re inexpensive. The Image Clear Cell Clarifying Pads, which are recommended by Esthetica M.D.’s lead doctor, Dr. Rabkin, are a little bit more difficult to find (you can purchase through Amazon), and are more expensive. There’s a reason for the price difference, though – the Image pads are stronger than the Noxzema pads. I tried them both, and they are both great! Just don’t overdo it – these will dry out your skin a little.
If you have large, deep, solid and painful lumps or cysts under your skin, you may have severe acne. The breakouts cover large areas of the face or body and last longer than in moderate acne, often not going away for months or years.