The problem with the old rub-and-scrub approach to acne is that it only takes care of one part of the problem. Vigorous detergent treatment of the skin only gets rid of excess oil on the skin. Sometimes that makes a difference, but if the problem is that the oil is trapped under tiny flakes of dead skin stuck together with a kind of biological glue at the top of a pore, all that washing your skin will do is to irritate the healthy skin surrounding blemishes.
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.
Salicylic acid is the gold standard of acne treatment. It’s also called a beta-hydroxy acid. Salicylic works by exfoliating gently to unclog pores. It’s in a ton of OTC cleansers and spot treatments, and it’s gentle enough to use on your whole face.
Considerations: Because tazarotene is a retinoid (vitamin A derivative), like Accutane, it should not be used by women who are pregnant because of potential harm to the fetus. Exposure to sunlight should be avoided. Wind or cold may be more irritating when taking tazarotene. Side effects occured in 10-30% of patients and included dry peeling skin, burning, stinging, dry skin, redness, and itchiness.
If you’ve got acne scars, there’s reason to be optimistic, though: Not all scarring is truly permanent. With the right products and doctor-endorsed prescriptions, you can lessen the discoloration and appearance of these scars on your face. We asked dermatologist David Lortscher, CEO and founder of Curology skincare, to break it all down for us.
There’s always a time and place for everything, including this. When you finally spot that whitehead, “you can gently squeeze it out as long as it comes out in one or two tries,” Renée specifies. “Anything more than that means it wasn’t ready to come out and you will injure the skin resulting in a red or dark scar.” If you choose this path, make sure you wrap your fingers in tissues and prep the blemish with a warm, damp washcloth for two minutes can soften up the skin to make for an easier extraction. Once the whitehead is removed, NOW you can dab on a zit-killing lotion (Renée makes a Night Time Spot Lotion for this sort of thing) to dry out any remaining bacteria to help close up the skin.
Retinoids’ adverse effects (AE) include dryness, peeling, erythema, and irritation. If patients have any of these symptoms, they should be advised to decrease the frequency of use. Tretinoin isn’t photo-stable; it must be applied at bedtime and shouldn’t be used with benzoyl peroxide because it can become inactivated. Tazarotene is category X, so all women of childbearing age should be counseled carefully when receiving the prescription. Adapalene 1% gel is approved for patients as young as 9 years, and tretinoin 0.05% micronized is approved for patients 10 years and older. All other retinoid products are approved for patients 12 years or older, limiting their use in early-onset acne.
Inside your hair follicles, there are small glands producing oil called sebum. This oil mixes with skin cells in the follicle and joins them on the journey outward. But when there’s too much sebum, too many dead skin cells or something on the surface that blocks their exit from the follicle, a blockage can occur. Bacteria joins the party, and the result is acne vulgaris, the most common form of acne.
Keep in mind with microdermabrasion, you won’ be able to treat very deep acne scars. If you suffer from severe acne scarring, lasers or deep chemical peeling would be more suited to get a more drastic resurfacing treatment (with longer downtime and higher risks though).
If you have acne, chances are pretty good that you also tend to get blackheads — they’re caused by oil and debris that has darkened within clogged pores. To battle them without causing irritation, start by degunking with an exfoliator with 2 percent or less salicylic acid or glycolic and lactic Acids every morning. Let it sit for about a minute on damp skin in order to give the acid time to do its thing, then rinse. We like Ole Henriksen’s Pore-Balance Facial Sauna Scrub. Then extract them. Yes, you can go the DIY route, but only if you follow these instructions. Don’t even think about using your fingers to do it. After you shower, hold a cotton swab on either side of the blackhead, then gently press down. Don’t force anything — if it doesn’t budge, abort mission and apply a benzoyl peroxide spot treatment.
No one factor causes acne. Acne occurs when sebaceous (oil) glands attached to the hair follicles are stimulated at the time of puberty or due to other hormonal changes. Sebum (oil) is a natural substance that lubricates and protects the skin. Associated with increased oil production is a change in the manner in which the skin cells mature, predisposing them to plug the follicular pore. The plug can appear as a whitehead if it is covered by a thin layer of skin, or if exposed to the air, the darker exposed portion of the plug is called a “blackhead.” The plugged hair follicle gradually enlarges, producing a bump. As the follicle enlarges, the wall may rupture, allowing irritating substances and normal skin bacteria access into the deeper layers of the skin, ultimately producing inflammation. Inflammation near the skin’s surface produces a pustule; deeper inflammation results in a papule (pimple); if the inflammation is deeper still, it forms a cyst.
Because acne is a chronic condition, adhering to your treatment regimen is important even after you see an improvement in your acne.2,11 Talk to your dermatologist about ongoing treatment options that may be right for you.13
If you notice that you’re breaking out right around your period every month, your acne might be linked to hormones. “A sensitivity to the hormones called androgens manifests in the form of cystic acne,” says Linkner. Androgens, namely testosterone, cause the skin to produce more sebum. More sebum equals more acne. Birth control, which has estrogen and progestin, helps keep hormones balanced and skin clear. Ortho Tri-Cyclen, Estrostep, and YAZ are all FDA-approved as acne treatments.
Both doctors recommend the use of retinoid skin products for both kinds of acne marks. These creams brighten and heal the skin. For an over-the-counter solution, Dr. Bowe suggests RoC Retinol Correxion Instant Facial Smoother, and for prescription remedies she usually puts her patients on Differin, Tazorac or Retin-A Micro. Dr. MacGregor advises patients to use Elure products, which utilize an enzyme called melanonzyme to even out your skin tone.
Isopropyl alcohol, SD alcohol, and denatured alcohol are everywhere in acne treatment because they trick you into thinking they’re working: Splash some on and any oil on your face instantly vaporizes. Granted, there are other less nefarious reasons for alcohol too, such as helping vitamin C penetrate the skin. But ultimately, we weren’t fans of their inclusion in acne treatment ingredient lists.
There are a number of mild chemical peels available over the counter, but acne scar removal requires a stronger peel typically administered by a doctor or dermatologist. Trichloroacetic acid (TCA) peels are slightly stronger than alpha hydroxy acid (AHA) peels and may be used for acne scar treatment. The strongest type, phenol peels, may cause significant swelling and require up to two weeks of recovery time at home. Neither are recommended for people with active severe acne.
One word of caution, though: Dr. Lawrence Green, board-certified dermatologist and assistant clinical professor of dermatology at George Washington University, warns that even moderate acne can be beyond what an over-the-counter treatment can handle, and recommends seeing a specialist. Our advice: Track your progress while using any over-the-counter treatments, and consider consulting a doctor if your skin continues to worsen or not improve after one month.
If you have been taking topical retinoids while you were pregnant do not immediately assume the worst. Findings from a study of a large number of pregnancies where the mother was exposed to topical retinoids, along with data from studies looking into the absorption of retinoids after use of topical cream on the face, suggests that you have not exposed your child to any extra risks. However, as retinoids are known to cause birth defects, it is important that you discuss issue with your doctor.
Combined oral contraception is an effective treatment for mild to moderate acne in females.10 In general, oral contraception has fewer adverse effects than long-term antibiotics, and should be considered first for females.
What’s more, Zeichner brings up the fact that now more than ever women are starting birth control pills at a young age, with many staying on the drug for decades. This might be fine while it lasts, as the hormones in the pill help to regulate oil production and keep acne under control, but Zeichner explains that it can turn into an issue after discontinuation, because the body is then forced to go through an “adjustment period” to the normal hormonal environment that the oil glands haven’t experienced in years. Needless to say, it could be worth taking into consideration next time you’re due to discuss birth control options with your OBGYN.
Oral antibiotics are designed to kill the acne-causing bacteria found within your skin pores. The most common oral antibiotics prescribed for acne treatment are Tetracyclines, which include Minocycline and Doxycycline, and Erthromycin. Like their topical antibiotics counterparts, bacterial resistance may result in ineffectiveness of this treatment regimen so overuse is to be avoided.
Aloe vera gel has a pleasant soothing effect on the skin. In addition to its antibacterial properties, it also reduces redness and swelling. You can use aloe vera alone or with several other substances like garlic or tea tree oil. Aloe vera is a nice indoor plant, so you should consider growing it at home. But you can also buy the extracted gel and use to spot treat the pimples on your face.