Frequently used topical retinoids include adapalene, isotretinoin, retinol, tazarotene, and tretinoin.[47] They often cause an initial flare-up of acne and facial flushing, and can cause significant skin irritation. Generally speaking, retinoids increase the skin's sensitivity to sunlight and are therefore recommended for use at night.[1] Tretinoin is the least expensive of the topical retinoids and is the most irritating to the skin, whereas adapalene is the least irritating to the skin but costs significantly more.[1][83] Most formulations of tretinoin cannot be applied at the same time as benzoyl peroxide.[15] Tazarotene is the most effective and expensive topical retinoid, but is not as well-tolerated.[1][83] Retinol is a form of vitamin A that has similar but milder effects, and is used in many over-the-counter moisturizers and other topical products.
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.

Blemishes on your new baby's face aren't necessarily acne, however. Tiny white bumps that are there at birth and disappear within a few weeks are called milia, and they're not related to acne. If the irritation looks more rashy or scaly than pimply, or it appears elsewhere on your baby's body, he may have another condition, such as cradle cap or eczema.


The Pore Normalizing Cleanser is designed just to cleanse, not treat, which is a good thing: The Nurse Practitioner study emphasizes the importance of washing with mild cleansers in conjunction with topical acne medications to combat or avoid excessive skin irritation. This one is water-based and fragrance-free, and uses sodium laureth sulfate (as opposed to its harsh cousin sodium lauryl sulfate) to eliminate any chance for irritation.
Dermal or subcutaneous fillers are substances injected into the skin to improve the appearance of acne scars. Fillers are used to increase natural collagen production in the skin and to increase skin volume and decrease the depth of acne scars.[145] Examples of fillers used for this purpose include hyaluronic acid; poly(methyl methacrylate) microspheres with collagen; human and bovine collagen derivatives, and fat harvested from the person's own body (autologous fat transfer).[145]
How to Handle It: If you've tried the usual anti-acne ingredients, like salicylic acid and benzoyl peroxide (which, we should warn you, rarely work for this), you should consider paying your dermatologist a visit. "You may need a cortisone injection or an oral medication, like an antibiotic, in addition to topical formulas," says Zeichner. He's also a fan of a prescription topical medication called Epiduo Forte Gel, since, he says, it's been shown to be effective at controlling severe acne without the help of oral treatments.
Retinoids are medications which reduce inflammation, normalize the follicle cell life cycle, and reduce sebum production.[45][82] They are structurally related to vitamin A.[82] Studies show they are underprescribed by primary care doctors and dermatologists.[15] The retinoids appear to influence the cell life cycle in the follicle lining. This helps prevent the accumulation of skin cells within the hair follicle that can create a blockage. They are a first-line acne treatment,[1] especially for people with dark-colored skin, and are known to lead to faster improvement of postinflammatory hyperpigmentation.[36]

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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.

Your pimples need TLC, too. The study on acne vulgaris found that, in an attempt to dry out acne lesions, patients often use too many products or apply excessive amounts to problem areas, resulting in further irritation and over drying of the skin. Vigorous scrubbing and using harsh exfoliants can make acne worse by rupturing whiteheads and blackheads, turning them into painful red ones. And remember: no matter how satisfying it is, picking and popping your zits will also increase inflammation and opportunity for infection.

The costs and social impact of acne are substantial. In the United States, acne vulgaris is responsible for more than 5 million doctor visits and costs over US$2.5 billion each year in direct costs.[13] Similarly, acne vulgaris is responsible for 3.5 million doctor visits each year in the United Kingdom.[20] Sales for the top ten leading acne treatment brands in the US in 2015, have been reported as amounting to $352 million.[175]
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For those with acne-prone skin, it can be tough finding a sunscreen that doesn’t clog pores and meshes well with your skincare regimen. Oily sunscreens often lead to breakouts. In addition to the wash, toner, moisturizer and treatments, the Clear Start kit includes an acne-safe (read: oil-free) sunscreen in its lineup — perfect for those wanting the best of both worlds in avoiding all types of red faces.
Warning: Sulfur smells like rotten eggs. But it is an effective ingredient at drying up pus-filled pimples and whiteheads (you’ve gotta take the good with the bad). It works by sucking up the oil. Sulfur is typically mixed with other active ingredients to get the most efficacy and fragrances to mask the strong scent. You can often find it in masks and spot treatments.
The three-piece set doesn’t come with a sun protection treatment, but Paula’s Choice has one in the line, the Clear Ultra-Light Daily Fluid SPF 30+. “Sun protection is really important, especially with acneic skin,” says Townsend. “In many cases, stronger acne products can make the skin photosensitive to the sun.” This isn’t your normal gloppy white sunscreen. Its fluid formula slips over tender skin, doesn’t need a ton of rubbing in, and also leaves a mattifying finish.
“Sometimes I see people try over-the-counter products just for a couple of weeks, they get frustrated, they say it’s not working, and they discontinue them,” Arthur says. “But it really does take a while to see the effectiveness. So unless you’re having a problem with the medication, like it’s causing severe irritation or dryness, it’s recommended to give it at least 2-3 months before switching to something else.”
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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]
Everything you need to know about cystic acne Cystic acne is an uncommon and severe form of acne. The skin condition results from blocked pores in the skin that cause infection and inflammation. Treatment often requires the help of a specialist doctor who can prescribe potent drugs. Read on to learn about symptoms, causes, diagnosis, and prevention. Read now
The path to clear skin is often one of trial and error; you might need to try several acne remedies before you find the right treatment for the types of acne affecting your skin. Before trying acne medication, you may prefer to give different natural acne treatment options a chance. While there's no research supporting the effective use of natural acne treatments, here are two popular options that you may want to try.

This at-home skin peel available at Sephora tightens pores, reduces oil, helps retexturize skin and diminishes dark spots. It's paraben and sulfate free, non-comedogenic and isn't tested on animals. Use this peel each week as part of your clear skin regimen to help even out skin tone and gently remove unhealthy top skin layers, revealing new, healthier skin underneath. 
Acne medications work by reducing oil production, speeding up skin cell turnover, fighting bacterial infection or reducing inflammation — which helps prevent scarring. With most prescription acne drugs, you may not see results for four to eight weeks, and your skin may get worse before it gets better. It can take many months or years for your acne to clear up completely.
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