Post-inflammatory hyperpigmentation is not an acne scar, but a red, pink, brown or tan skin discoloration where acne has previously flared up. It'll usually disappear on its own in a year or so. Many skin lightening products claim to help reduce the visibility of these acne "scars." Their active ingredient, hydroquinone, works to slow melanin production and can reduce dark brown marks, but melanin isn't the cause of red and pink acne discolorations. A better option is to use the best foundation for acne prone skin you can find to hide the marks until they naturally fade away.
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Benzoyl peroxide attacks the P. acnes bacteria. However, one of its main side effects is dryness: If you’re going to use anything with benzoyl peroxide, make sure to moisturize afterwards. Sulfur and azelaic acid are less common and less severe alternatives to benzoyl peroxide. Dr. Peter Lio, assistant professor of clinical dermatology at Northwestern University, says sulfur-based treatments are “a good fit for patients who can’t tolerate the side effects of benzoyl peroxide.”
How to Handle It: Consider salicylic acid your secret weapon. "This beta hydroxy acid helps remove excess oil and exfoliate dead cells from the skin's surface to keep pores clear," says Zeichner. Try Clinique's Acne Solution Clearing Gel, a two-time Best of Beauty winner that packs both salicylic acid and sea whip extract — an ingredient with skin-soothing properties — to help counteract the dryness sometimes caused by salicylic acid. The formula does double duty: It works as a spot treatment for mild to moderate acne and as a nightly allover treatment for pimple prevention. And since it dries clear, you can wear it to fight zits whenever, wherever.
Oh, hello old friend. Salicylic acid is the go-to fix for pimply preteens. And cruising through the aisles at the drugstore, you’ll find it as the active ingredient on the majority of products labeled “acne wash” or “spot treatment.” Salicylic acid is a beta-hydroxy acid that works by dissolving excess oil and gently exfoliating away dead skin cells. Salicylic also has anti-inflammatory properties to help with inflamed cystic breakouts that can occur when blockages deep in the hair follicles rupture beneath the skin. It’s best to apply this ingredient as a toner, moisturizer, or leave-on spot treatment instead of a face wash to give it time to do its work. And keep in mind, salicylic acid can dry out the skin if over-applied, so maybe choose only one product with the ingredient to use every day.

Some people swear by the disinfecting power of tea tree oil for acne treatment. It can be applied either full strength or slightly diluted with water directly onto pimples. Use a small amount on a clean cotton swab or cotton pad and dab on the affected areas immediately after cleansing. Because tea tree oil can be drying, you might choose to use both tea tree oil and coconut oil for acne as part of your clear skin regimen.
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All acne is not, actually, created equal. This makes perfect sense, seeing as there are so many factors — i.e. hygiene, hormones, and genetics — that can both lead to and exacerbate your breakouts. But knowledge is power, and just knowing that there are different types, and that each kind requires its own plan of attack, puts you ahead of the clear-skin curve. Once you figure out what you're working with, it gets far easier to treat. Here, your ultimate guide to identifying, and then taking down, every type of acne out there, according to dermatologists. Find out how to identify and deal with the different kinds of acne, including blackheads, whiteheads, blind pimples, and cystic zits.
How to Handle It: Your best bet is benzoyl peroxide. "Benzoyl peroxide can kill acne-causing bacteria and reduce inflammation," says Zeichner. Try a cream like the La Roche-Posay Effaclar Duo Dual-Action Acne Treatment ($37), which also exfoliates with lipo-hydroxy acid. Be aware that it can seriously dry out skin so moisturize well after you use it.
Hydroquinone lightens the skin when applied topically by inhibiting tyrosinase, the enzyme responsible for converting the amino acid tyrosine to the skin pigment melanin, and is used to treat acne-associated postinflammatory hyperpigmentation.[35] By interfering with new production of melanin in the epidermis, hydroquinone leads to less hyperpigmentation as darkened skin cells are naturally shed over time.[35] Improvement in skin hyperpigmentation is typically seen within six months when used twice daily. Hydroquinone is ineffective for hyperpigmentation affecting deeper layers of skin such as the dermis.[35] The use of a sunscreen with SPF 15 or higher in the morning with reapplication every two hours is recommended when using hydroquinone.[35] Its application only to affected areas lowers the risk of lightening the color of normal skin but can lead to a temporary ring of lightened skin around the hyperpigmented area.[35] Hydroquinone is generally well-tolerated; side effects are typically mild (e.g., skin irritation) and occur with use of a higher than the recommended 4% concentration.[35] Most preparations contain the preservative sodium metabisulfite, which has been linked to rare cases of allergic reactions including anaphylaxis and severe asthma exacerbations in susceptible people.[35] In extremely rare cases, repeated improper topical application of high-dose hydroquinone has been associated with an accumulation of homogentisic acid in connective tissues, a condition known as exogenous ochronosis.[35]
^ Jump up to: a b c Zaenglein, AL; Graber, EM; Thiboutot, DM (2012). "Chapter 80 Acne Vulgaris and Acneiform Eruptions". In Goldsmith, Lowell A.; Katz, Stephen I.; Gilchrest, Barbara A.; Paller, Amy S.; Lefell, David J.; Wolff, Klaus (eds.). Fitzpatrick's Dermatology in General Medicine (8th ed.). New York: McGraw-Hill. pp. 897–917. ISBN 978-0-07-171755-7.
Since benzoyl peroxide is often prescribed in office for handling cystic acne (it kills acne-causing bacteria within the hair follicle), it was the first choice among dermatologists I spoke to as an over-the-counter treatment. There are a couple of different options out there from face washes to topical creams to bodywashes, but dermatologist Ross S. Levy, of CareMount Medical — the director of dermatologic surgery at the Albert Einstein College of Medicine — says that typically “the benzoyl peroxide (5 to 10 percent) topical creams or gels are more effective than the cleansers or washes.” The only danger with benzoyl peroxide to be mindful of is that it will stain clothing and pillowcases. Clean & Clear’s Persa-Gel, which contains 10 percent benzoyl peroxide, is one of Gonzalez’s go-to recommendations for treating cystic acne at home.
Purchase overview:You will be able to log into your account and review your previous purchases with us. When shopping in our physical stores or online, the purchases will be registered in your name. Please note that you may be required to show your ID in order to register a purchase in one of our physical stores. When you shop online, the purchase will be registered if you have made the purchase through your account. 

Dermabrasion is an effective therapeutic procedure for reducing the appearance of superficial atrophic scars of the boxcar and rolling varieties.[32] Ice-pick scars do not respond well to treatment with dermabrasion due to their depth.[32] The procedure is painful and has many potential side effects such as skin sensitivity to sunlight, redness, and decreased pigmentation of the skin.[32] Dermabrasion has fallen out of favor with the introduction of laser resurfacing.[32] Unlike dermabrasion, there is no evidence that microdermabrasion is an effective treatment for acne.[8]

Accutane is especially good for cystic acne in women and body acne in men. “Oral vitamin A basically shuts down your sebaceous glands. If you suppress [them] for a long enough period, you can cure someone of their acne, and about 50 percent do hit that cure rate,” says Linkner. A course of Accutane can take about six to nine months. Sometimes patients need to repeat the course at a higher dosage in order to truly eliminate acne.


Isotretinoin is an oral retinoid that is very effective for severe nodular acne, and moderate acne that is stubborn to other treatments.[1][20] One to two months use is typically adequate to see improvement. Acne often resolves completely or is much milder after a 4–6 month course of oral isotretinoin.[1] After a single course, about 80% of people report an improvement, with more than 50% reporting complete remission.[20] About 20% of patients require a second course.[20] Concerns have emerged that isotretinoin use is linked with an increased risk of adverse effects, like depression, suicidality, anemia, although there is no clear evidence to support some of these claims.[1][20] Isotretinoin is superior to antibiotics or placebo in reducing acne lesions.[17] The frequency of adverse events was about twice as high with isotretinoin, although these were mostly dryness-related events.[17] No increased risk of suicide or depression was conclusively found.[17] Isotretinoin use in women of childbearing age is regulated due to its known harmful effects in pregnancy.[20] For such a woman to be considered a candidate for isotretinoin, she must have a confirmed negative pregnancy test and use an effective form of birth control.[20] In 2008, the United States started the iPLEDGE program to prevent isotretinoin use during pregnancy.[84] iPledge requires the woman under consideration for isotretinoin therapy to have two negative pregnancy tests and mandates the use of two types of birth control for at least one month before therapy begins and one month after therapy is complete.[84] The effectiveness of the iPledge program has been questioned due to continued instances of contraception nonadherence.[84][85]
Antibiotics are frequently applied to the skin or taken orally to treat acne and are thought to work due to their antimicrobial activity against C. acnes and their ability to reduce inflammation.[20][80][86] With the widespread use of antibiotics for acne and an increased frequency of antibiotic-resistant C. acnes worldwide, antibiotics are becoming less effective,[80] especially macrolide antibiotics such as topical erythromycin.[16][86] Therefore, they are not recommended for use alone but are preferred as part of combination therapy.[15] Commonly used antibiotics, either applied to the skin or taken orally, include clindamycin, erythromycin, metronidazole, sulfacetamide, and tetracyclines such as doxycycline and minocycline.[47] Doxycycline 40 milligrams daily (low-dose) appears to have similar efficacy to doxycycline 100 milligrams daily and has fewer gastrointestinal side effects.[15] When antibiotics are applied to the skin, they are typically used for mild to moderately severe acne.[20] Antibiotics taken orally are generally considered to be more effective than topical antibiotics, and produce faster resolution of inflammatory acne lesions than topical applications.[1] Topical and oral antibiotics are not recommended for use together.[86]
Purchase overview:You will be able to log into your account and review your previous purchases with us. When shopping in our physical stores or online, the purchases will be registered in your name. Please note that you may be required to show your ID in order to register a purchase in one of our physical stores. When you shop online, the purchase will be registered if you have made the purchase through your account.

Acne removal: Your dermatologist may perform a procedure called “drainage and extraction” to remove a large acne cyst. This procedure helps when the cyst does not respond to medicine. It also helps ease the pain and the chance that the cyst will leave a scar. If you absolutely have to get rid of a cyst quickly, your dermatologist may inject the cyst with medicine.
Ablative lasers deliver an intense wavelength of light to the skin, removing thin outer layers of the skin (epidermis). In addition, collagen production is stimulated in the underlying layer (the dermis). Patients are typically numbed with local anesthetic and the ablation is done as an outpatient procedure. CO2 and erbium are the ablative lasers most often used for acne scar treatment.
This article was medically reviewed by Hilary Baldwin, MD. Baldwin, medical director of the Acne Treatment Research Center, is a board-certified dermatologist with nearly 25 years of experience. Her area of expertise and interest are acne, rosacea and keloid scars. Baldwin received her BA and MA in biology from Boston University. She became a research assistant at Harvard University before attending Boston University School of Medicine. She then completed a medical internship at Yale New Haven Hospital before becoming a resident and chief resident in dermatology at New York University Medical Center.
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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.
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.[75] They are believed to work in at least four different ways, including the following: reducing inflammation, hormonal manipulation, killing C. acnes, and normalizing skin cell shedding and sebum production in the pore to prevent blockage.[15] Common treatments include topical therapies such as antibiotics, benzoyl peroxide, and retinoids, and systemic therapies including antibiotics, hormonal agents, and oral retinoids.[20][76]
Dear acne, you suck. Seriously, we thought the breakouts would be over soon after AP Calculus. But it’s actually something that affects women and men in their 20s and 30s, and even well past their 50s. It’s just not fair (throws childlike temper tantrum). And if you thought blackheads and whiteheads were annoying, the deep painful pimples that often pop up in adult acne are much more aggravating—and harder to get rid of. So, we talked to dermatologists to find out which acne treatments are the most effective on all types of pimples.
Recommended therapies for first-line use in acne vulgaris treatment include topical retinoids, benzoyl peroxide, and topical or oral antibiotics.[77] Procedures such as light therapy and laser therapy are not considered to be first-line treatments and typically have an adjunctive role due to their high cost and limited evidence of efficacy.[76] Medications for acne work by targeting the early stages of comedo formation and are generally ineffective for visible skin lesions; improvement in the appearance of acne is typically expected between eight and twelve weeks after starting therapy.[15]
When regular light is used immediately following the application of a sensitizing substance to the skin such as aminolevulinic acid or methyl aminolevulinate, the treatment is referred to as photodynamic therapy (PDT).[10][128] Many different types of nonablative lasers (i.e., lasers that do not vaporize the top layer of the skin but rather induce a physiologic response in the skin from the light) have been used to treat acne, including those that use infrared wavelengths of light. Ablative lasers (such as CO2 and fractional types) have also been used to treat active acne and its scars. When ablative lasers are used, the treatment is often referred to as laser resurfacing because, as mentioned previously, the entire upper layers of the skin are vaporized.[142] Ablative lasers are associated with higher rates of adverse effects compared with nonablative lasers, with examples being postinflammatory hyperpigmentation, persistent facial redness, and persistent pain.[8][143][144] Physiologically, certain wavelengths of light, used with or without accompanying topical chemicals, are thought to kill bacteria and decrease the size and activity of the glands that produce sebum.[128] Disadvantages of light therapy can include its cost, the need for multiple visits, time required to complete the procedure(s), and pain associated with some of the treatment modalities.[10] Typical side effects include skin peeling, temporary reddening of the skin, swelling, and postinflammatory hyperpigmentation.[10]
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^ Jump up to: a b c Zaenglein, AL; Graber, EM; Thiboutot, DM (2012). "Chapter 80 Acne Vulgaris and Acneiform Eruptions". In Goldsmith, Lowell A.; Katz, Stephen I.; Gilchrest, Barbara A.; Paller, Amy S.; Lefell, David J.; Wolff, Klaus (eds.). Fitzpatrick's Dermatology in General Medicine (8th ed.). New York: McGraw-Hill. pp. 897–917. ISBN 978-0-07-171755-7.
Benzoyl peroxide is an antibacterial ingredient, and it’s very effective at killing the P. acnes bacteria that causes breakouts. But benzoyl isn’t without its downsides. The leave-on creams and cleansing treatments can dry out sensitive skin types and bleach clothing if you aren’t careful. Board-certified dermatologist Eric Meinhardt, M.D., previously told SELF that it's best to stick to formulations that have no more than 2 percent of benzoyl peroxide listed on the active ingredients chart; stronger concentrations are harder on your skin without being any tougher on bacteria.
Blackheads are a mild form of acne that appear as unsightly, open pores that look darker than the skin surrounding them. They get their dark appearance from a skin pigment called melanin, which oxidizes and turns black when it's exposed to the air. Blackheads aren't caused by dirt, but by sebum (oil) and dead skin cells blocking the pore. If the pore remains open, it becomes a blackhead; if it's completely blocked and closed, it turns into a whitehead.
Bacteria. Excess sebum clogs the openings to hair follicles -- especially those on the face, neck, chest, and back. Bacteria grow in these clogged follicles. This makes blackheads or whiteheads, also known as ''comedones,'' form on the skin's surface. Sometimes, this clogging causes the follicle wall to break under the pressure of this buildup. When this happens, sebum leaks into nearby tissues and forms a pustule or a papule -- this is called inflammatory acne. Larger, tender pustules are called nodules.
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