If you’re used to seeing advertisements for acne treatments using five or six different products to clear up blemishes, you might be surprised that a simple three-step kit is our top pick. In fact, we favored Paula’s Choice for its simplicity. This twice-daily, three-step kit — which includes a cleanser, an anti-redness exfoliant, and a leave-on treatment — is concise without cutting corners.
The recognition and characterization of acne progressed in 1776 when Josef Plenck (an Austrian physician) published a book that proposed the novel concept of classifying skin diseases by their elementary (initial) lesions.[163] In 1808 the English dermatologist Robert Willan refined Plenck's work by providing the first detailed descriptions of several skin disorders using a morphologic terminology that remains in use today.[163] Thomas Bateman continued and expanded on Robert Willan's work as his student and provided the first descriptions and illustrations of acne accepted as accurate by modern dermatologists.[163] Erasmus Wilson, in 1842, was the first to make the distinction between acne vulgaris and rosacea.[164] The first professional medical monograph dedicated entirely to acne was written by Lucius Duncan Bulkley and published in New York in 1885.[165][166]
Topical treatments on their own may not be enough to give you clear skin, especially in those with complicated, inflammatory cystic acne. There are several acne medication options approved for use by the FDA, but which one is best for you is a question for your dermatologist and/or general practitioner. Baldwin says if you have insurance and you have acne, a prescription may be the best step because "it makes no sense to try to handle the condition yourself or to use over the counter products that are always less effective than prescriptions meds." Here are a few of the acne medications you'll want to ask about:

Alternative and integrative medicine approaches used in the treatment of acne include fish oil, brewer's yeast, probiotics, oral zinc and topical tea tree oil. More research is needed to establish the potential effectiveness and long-term safety of these and other integrative approaches, such as biofeedback and traditional Chinese medicine. Talk with your doctor about the pros and cons of specific treatments before you try them.
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Medical conditions that commonly cause a high-androgen state, such as polycystic ovary syndrome, congenital adrenal hyperplasia, and androgen-secreting tumors, can cause acne in affected individuals.[45][46] Conversely, people who lack androgenic hormones or are insensitive to the effects of androgens rarely have acne.[45] An increase in androgen and oily sebum synthesis may be seen during pregnancy.[46][47] Acne can be a side effect of testosterone replacement therapy or of anabolic steroid use.[1][48] Over-the-counter bodybuilding and dietary supplements are commonly found to contain illegally added anabolic steroids.[1][49]
The approach to acne treatment underwent significant changes during the twentieth century. Retinoids were introduced as a medical treatment for acne in 1943.[82] Benzoyl peroxide was first proposed as a treatment in 1958 and has been routinely used for this purpose since the 1960s.[167] Acne treatment was modified in the 1950s with the introduction of oral tetracycline antibiotics (such as minocycline). These reinforced the idea amongst dermatologists that bacterial growth on the skin plays an important role in causing acne.[163] Subsequently, in the 1970s tretinoin (original trade name Retin A) was found to be an effective treatment.[168] The development of oral isotretinoin (sold as Accutane and Roaccutane) followed in 1980.[169] After its introduction in the United States it was recognized as a medication highly likely to cause birth defects if taken during pregnancy. In the United States, more than 2,000 women became pregnant while taking isotretinoin between 1982 and 2003, with most pregnancies ending in abortion or miscarriage. About 160 babies were born with birth defects.[170][171]
The Anti-Redness Exfoliating Solution is mostly water, but its 2 percent salicylic acid is enough to eat through oil and remove the dead skin cells clogging your pores — and it boasts a higher concentration than nearly every other kit we looked at. Sodium hyaluronate, the super-moisturizing humectant we fell in love with in our review on the Best Face Moisturizer, also caught our eye sitting smack dab in the middle of the ingredients list.
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Risk factors for the development of acne, other than genetics, have not been conclusively identified. Possible secondary contributors include hormones, infections, diet and stress. Studies investigating the impact of smoking on the incidence and severity of acne have been inconclusive.[2][38][39] Sunlight and cleanliness are not associated with acne.[14]
Microneedling is a procedure in which an instrument with multiple rows of tiny needles is rolled over the skin to elicit a wound healing response and stimulate collagen production to reduce the appearance of atrophic acne scars in people with darker skin color.[142] Notable adverse effects of microneedling include postinflammatory hyperpigmentation and tram track scarring (described as discrete slightly raised scars in a linear distribution similar to a tram track). The latter is thought to be primarily attributable to improper technique by the practitioner, including the use of excessive pressure or inappropriately large needles.[142][146]
For an overnight solution or something that covers a larger surface area (rather than a smaller spot-treatment), Zeichner also recommends Neutrogena’s rapid-clear leave-on mask. The idea is that you spread benzoyl peroxide all over your face, but it’s not a wash-off mask, so you’re getting a prolonged exposure to the antibacterial peroxide. He says it’s helpful for treating the pimples you have and preventing new ones from popping up.
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Acne treatment that you apply to the skin: Most acne treatments are applied to the skin. Your dermatologist may call this topical treatment. There are many topical acne treatments. Some topicals help kill the bacteria. Others work on reducing the oil. The topical medicine may contain a retinoid, prescription-strength benzoyl peroxide, antibiotic, or even salicylic acid. Your dermatologist will determine what you need.
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.
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