Combined oral contraceptives. Four combined oral contraceptives are approved by the FDA for acne therapy in women who also wish to use them for contraception. They are products that combine estrogen and progestin (Ortho Tri-Cyclen, Yaz, others). You may not see the benefit of this treatment for a few months, so using other acne medications with it the first few weeks may help.
Simple alcohols like 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. However, these ingredients destroy the skin’s barrier, called the acid mantle. When your acid mantle is damaged, you’re actually more susceptible to breakouts, enlarged pores, and inflammation. To make matters worse, evaporating all the oil on your face can actually set your sebaceous glands into overdrive, leaving your skin oilier than ever. If any product included a simple alcohol high up in its ingredients list, we nixed its whole kit.
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 (previously known as Accutane) is the most effective form of acne therapy and the only one that can actually result in a cure for your acne. After finishing a course 80 percent of people never see acne again. It works so well because it unclogs pores, kills bacteria, reduces oil production and reduces inflammation. It's taken as a daily pill. Isotretinoin has numerous rare and potential side effects that has made it a controversial choice, but for patients with severe acne there is often no other option. Patients taking isotretinoin must also be on highly effective birth control as the drug can cause birth defects. Isotretinoin can only be taken under close medical supervision.
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.
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.
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Inflammatory Acne: Inflammatory acne is red bumps and pustules, not whiteheads, blackheads and comedones. It doesn't necessarily start as them, either. It arises on its own. Whiteheads, blackheads or comedones that become inflamed can be painful and unsightly. Persistent inflammatory acne may require treatment by a physician or dermatologist, in addition to over-the-counter acne remedies.
Efforts to better understand the mechanisms of sebum production are underway. The aim of this research is to develop medications that target and interfere with the hormones that are known to increase sebum production (e.g., IGF-1 and alpha-melanocyte-stimulating hormone). Additional sebum-lowering medications being researched include topical antiandrogens and peroxisome proliferator-activated receptor modulators. Another avenue of early-stage research has focused on how to best use laser and light therapy to selectively destroy sebum-producing glands in the skin's hair follicles in order to reduce sebum production and improve acne appearance.
Acne, also known as acne vulgaris, is a long-term skin disease that occurs when hair follicles are clogged with dead skin cells and oil from the skin. It is characterized by blackheads or whiteheads, pimples, oily skin, and possible scarring. It primarily affects areas of the skin with a relatively high number of oil glands, including the face, upper part of the chest, and back. The resulting appearance can lead to anxiety, reduced self-esteem and, in extreme cases, depression or thoughts of suicide.
How to Handle It: Think of these as bigger, pissed-off whiteheads. Your best bet, says Zeichner, is to stock up on benzoyl peroxide, which kills the bacteria. A spot treatment like Murad Acne Spot Fast Fix ($22) should do the trick. Also, try not to pop them — as tempting as that may be. Since they're inflamed, they're more likely to scar if you go the DIY route.
Wear sunscreen everyday and do not tan. Ultraviolet Radiation is the number one cause of premature aging. It also leads to skin cancer in high enough doses. Treat the sun like the death ray that it is. Exposing your skin to harmful UVA and UVB rays damages skin and prolongs post inflammatory erythema(PIE)--red acne marks, as the sunlight stimulates pigment-producing cells.
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.
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.
Side effects include increased skin photosensitivity, dryness, redness and occasional peeling. Sunscreen use is often advised during treatment, to prevent sunburn. Lower concentrations of benzoyl peroxide are just as effective as higher concentrations in treating acne but are associated with fewer side effects. Unlike antibiotics, benzoyl peroxide does not appear to generate bacterial antibiotic resistance.
Acne vulgaris is a chronic skin disease of the pilosebaceous unit and develops due to blockages in the skin's hair follicles. These blockages are thought to occur as a result of the following four abnormal processes: a higher than normal amount of oily sebum production (influenced by androgens), excessive deposition of the protein keratin leading to comedo formation, colonization of the follicle by Cutibacterium acnes (C. acnes) bacteria, and the local release of pro-inflammatory chemicals in the skin.
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.
Shah often recommends over-the-counter retinols or prescription retinoids to her acne-prone patients. “I find that compared to other treatments they are beneficial for not just treating acne but also preventing new acne from forming as they help prevent that initial stage of the follicle getting clogged,” she says. “They can also help with some of the post acne [problems] such as hyperpigmentation.” But keep in mind if you have sensitive skin (or eczema or rosacea), a prescription retinoid might be too strong an option. However, your dermatologist can recommend an over-the-counter retinol with a low concentration (0.1 to 0.25 percent), which might be better tolerated. Retinol also isn’t a quick fix. It takes time to see results, and it’s something you’ll have to keep using to maintain its benefits. Shah also mentions that retinol plays well with other acne treatments on the list. "Retinol can be combined with other over-the-counter or prescription medications such as benzoyl peroxide, topical antibiotics, and oral medications. The right combination depends on the severity of the acne and your skin type."
“You unfortunately cannot determine the strength of a product strictly by the percentage of its active ingredients because how well a product works depends on how well its inactive ingredients help it penetrate the skin,” explains Dr. Green. “In other words, a 2 percent benzoyl peroxide may be more effective than another brand’s 5 percent benzoyl peroxide because there are other ingredients helping out.”
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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.
If your acne is severe, painful, or refusing to get lost, you may just be beyond what an over-the-counter treatment can do. Not only can a professional set you up with the really powerful stuff, but also Fitz Patrick explains that “working closely with an aesthetician or dermatologist means you can keep tweaking a routine to make it work best for you.”
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.
You've probably seen the Proactiv clear skin system advertised on television at some point over the last several years, but does it work? Proactiv is one of the better acne remedies out there for mild cases of inflammatory and noninflammatory acne, hormonal acne and adult acne. The starter kit comes with a gentle benzoyl peroxide exfoliating cleanser, a glycolic acid pore cleanser, and a benzoyl peroxide repairing treatment.
Believe it or not, as with adolescent acne, hormones are believed to be mainly to blame. In the case of newborns, however, it’s not their own hormones that are probably prompting the pimple problems, but Mom's — which are still circulating in baby's bloodstream as a holdover from pregnancy. These maternal hormones stimulate baby's sluggish oil-producing glands, causing pimples to pop up on the chin, forehead, eyelids and cheeks (and, sometimes, the head, neck, back and upper chest).
Minocycline is available in generic form or the branded formulation, Solodyn. The most-prescribed oral antibiotic acne medication for moderate to severe inflammatory acne like cystic acne, Solodyn is a minocycline like those mentioned above. However, it comes in an extended release formula that allows it to work to clear skin over the course of the day with just one daily dose.
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:
Cortisone is a quick fix for acne emergencies. We mean got a big board meeting tomorrow kind of quick. Go into the dermatologist’s office for a shot of this corticosteroid, and acne will disappear in 24 to 48 hours. The treatment works to curb inflammation, which makes it best for cystic breakouts and can be really good at combatting hormonal flare-ups. If done incorrectly, a cortisone shot can leave a small depression in the skin that lasts about eight weeks. “It’s a rare side effect that happens if dosage of cortisone is too high,” explains Linkner. “You want to go to someone who knows what they’re doing.”
Shower twice a day. Take a shower or bath in the morning and at night. Alternatively, take a shower in the morning and then again after physical activity, like exercise, or sweating. Wash your entire body with a mild cleanser and use shampoos that limit oil production in your hair. Be sure to always shower after exercising to remove the dead skin cells your body has sloughed off through sweating.
Acne appears when a pore in our skin clogs. This clog begins with dead skin cells. Normally, dead skin cells rise to surface of the pore, and the body sheds the cells. When the body starts to make lots of sebum (see-bum), oil that keeps our skin from drying out, the dead skin cells can stick together inside the pore. Instead of rising to the surface, the cells become trapped inside the pore.