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.
The treatment regimen your doctor recommends depends on your age, the type and severity of your acne, and what you are willing to commit to. For example, you may need to wash and apply medications to the affected skin twice a day for several weeks. Often topical medications and drugs you take by mouth (oral medication) are used in combination. Pregnant women will not be able to use oral prescription medications for acne.
Topical antibiotics available in combination with benzoyl peroxide include clindamycin (preferred) and erythromycin. Azelaic acid and salicylic acid are sometimes used for their comedolytic effects, but azelaic acid can cause lightening of the skin and should be used cautiously with darker skin tones.
Certain hormones called androgens are an additional factor in causing acne. Androgens are male hormones that are present in both men and women but are present at higher levels in men. Androgens do two things: First, they enlarge the sebaceous glands in the skin. Second, they cause these glands to increase sebum (oil) production. The increased sebum production exacerbates plug formation and serves as more “food” for the bacteria. Androgens surge at puberty, which is why teens develop armpit and pubic hair and why boys develop facial hair and deeper voices. This hormonal surge also contributes to the development of acne in teens.
Because the cost of a deep peel for full face can be pretty high ($2000-$5000), many affordable home kits are now available. There are even professional peel kits with high concentration of TCA that are available.
Not all birth control pills have the same effect, though. Androgenic pills, those containing androgen-based progestin (rather than an anti-androgenic progestin), can actually promote acne. The progestins to look out for in these pills include: norgestrel, norethindrone acetate and levonorgestrel.
Tell your doctor about all of your medical conditions, including if you have glucose-6-phosphate dehydrogenase deficiency (G6PD) or higher than normal levels of methemoglobin in your blood (methemoglobinemia).
Selecting appropriate treatment in pregnant women can be challenging because many acne therapies are teratogenic; all topical and especially oral retinoids should be avoided.38 Oral therapies such as tetracyclines and antiandrogens are also contraindicated in pregnancy. Topical and oral treatment with erythromycin may be considered.
Isotretinoin (eye-soh-tret-in-OH-in) is a prescription medicine for severe acne. This type of acne causes deep, painful cysts and nodules. These can be the size of a pencil eraser — or larger. As this acne clears, scars often appear.
A 2011 clinical study examining photos of women from age 10-70 for visible signs of acne found that 45 percent of women aged 21-30 had clinical acne, 26 percent of women aged 31-40 had clinical acne, and 12 percent of women aged 41-50 had clinical acne.
Aloe vera gel can be used for acne vulgaris treatment and also on larger areas like the entire face or the back. It has antibacterial and anti-inflammatory properties and helps to reduce redness and skin irritation (33).
Over the years I struggled with acne, I had begun to think of it as a personal failure. Something was wrong with my skin, but I also felt like something was wrong with me because I couldn’t fix it. Worst of all, there was no hiding this failure. I was convinced it was the first thing people saw when they looked at me because I knew it was the first thing I saw when I looked at myself.
For 6 –12 months after an acne breakout, stay out of the sun as much as possible to avoid making dark spots and scars worse. When you are in the sun, use an all-natural sunscreen to protect skin. If scars do develop, dot a drop of rosehip seed oil or carrot seed oil on the scars twice per day until you notice a difference in the scar.
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Ideally, do this in the shower where warm water will naturally help open pores. Popping pimples in the shower also ensures you’re in a clean environment. Otherwise, use clean hands and put a warm compress on the pimple to help draw it out. After you squeeze all the contents out, wash your hands again to avoid spreading the bacteria to another site on your skin—or even someone else. (Yikes!)
Ortho-Cyclen contains ethinyl estradiol and norgestimate. Doctors prescribe these hormones to treat severe acne. You should not use this drug if you have abnormal vaginal bleeding, breast or uterine cancer, history of circulation problems, liver disease, severe migraines, liver cancer or a history of blood clots.
Even though you may be antsy to know if your skin care routine is working, it’s important to give a new regimen two or three months before expecting results. (As long as your skin isn’t irritated by a new product, of course–if it is, stop using it.) “Your acne didn’t start overnight, so it won’t disappear overnight either,” cautions Dr. Lee.
Oatmeal is much more gentle. Yet, don’t underestimate its properties. It contains saponins which is a a naural plant based cleanser that will help remove dirt and oil. It has also anti inflammatory and antioxydant properties that will help with red patches.
The most common bacteria that causes acne is Propionibacterium acnes, a gram-positive anaerobic rod. Most acne isn’t tested for microbes unless conventional treatments are resistant. Androgen levels can also play a role in acne pathogenesis, but most patients have normal hormone levels, so androgen levels play more of a role in treatment rather than diagnosis.
^ Jump up to: a b Sánchez Viera, M (July 2015). “Management of acne scars: fulfilling our duty of care for patients”. British Journal of Dermatology (Review). 172 (Supplement 1): 47–51. doi:10.1111/bjd.13650. PMID 25597636.
Lemongrass oil, like the other oils mentioned above, possesses antimicrobial properties and can eliminate the bacteria that is aggravating the acne (17). It also acts a skin toner and astringent and balances the sebum production.
Use of medicines that may cause acne, e.g. antipsychotics or lithium. Anabolic steroids are associated with acne (particularly on the trunk), and should be enquired about if there is other evidence for this suspicion.