Acne scars are caused by inflammation within the dermal layer of skin and are estimated to affect 95% of people with acne vulgaris.[30] The scar is created by abnormal healing following this dermal inflammation.[31] Scarring is most likely to take place with severe acne, but may occur with any form of acne vulgaris.[30] Acne scars are classified based on whether the abnormal healing response following dermal inflammation leads to excess collagen deposition or loss at the site of the acne lesion.[32]
Antibiotics for acne, both topical and oral, used to be the top prescriptions for getting clear skin, but research has revealed that they aren’t the best option for most people today due to something called antibacterial resistance. This is where bacteria mutate, become immune to certain antibiotics, then reproduce offspring that are also immune, creating entire colonies of bacteria that can’t be killed by certain antibiotics.
What's Going On: If it's big, red, and painful, you're probably experiencing cystic acne, one of the more severe types. "Cystic pimples are caused by genetics and hormonal stimulation of oil glands," says Zeichner. Not only are they large, but they're also notoriously tough to treat. They often recur in the same place, because even if you manage to get rid of one, it can keep filling up with oil again and again, like an immortal pimple.

Considerations: Despite the frequent referencing of an initial flare of acne when starting is tretinoin, there is no scientific evidence to back this up. You should not expect an initial worsening of acne.3-4 Exposure to sunlight should be minimized as you may be more sensitive to its rays. Ask your doctor before using other medication on the skin, especially anything containing sulfur, resorcinol, or salicylic acid, as the combination may be too irritating. Abrasive soaps and cleansers should be used with caution for the same reason. Side effects can include skin irritation, swelling, lightening or darkening of the skin, an increase in acne sores, excessive redness, and crusted or blistered skin.
Glycolic acid is another chemical exfoliant that dissolves the structural lipids that hold dead skin cells and bind them to the surface. But aside from this, studies have also shown that glycolic acid effectively encourages and stimulates the production of collagen and elastin, restoring damaged skin faster and reducing signs of environmental damage with continuous use.
Hormonal treatments for acne such as combined birth control pills and antiandrogens may be considered a first-line therapy for acne under a number of circumstances, including when contraception is desired, when known or suspected hyperandrogenism is present, when acne occurs in adulthood, when acne flares premenstrually, and when symptoms of significant sebum production (seborrhea) are co-present.[128] Hormone therapy is effective for acne even in women with normal androgen levels.[128]
Another once-daily gel your dermatologist might prescribe for acne is Aczone 7.5 percent. The active ingredient, dapsone, is both antimicrobial and anti-inflammatory, and it’s proven to help with blackheads, whiteheads, and deeper painful pimples. Oftentimes, Aczone is used alongside other acne treatments. And like many of those other remedies, Aczone can cause skin to dry out.
Considerations: Regardless of the type of antibiotic prescribed, only about one half of patients respond. When antibiotics do produce results, these results are moderate at best.5-8 Oral antibiotics should be used for only a short period of time, up to 6 months. However, even within this short time frame, antibiotics have been implicated in the proliferation of resistant colonies of bacteria. Some antibiotics cause increased sensitivity to sunlight. Exposure to the sun could cause a rash, itchiness, or redness, and you may be burnt more easily, so you'll want to wear protective clothing and sunscreen.2 Side effects may include upset stomach, diarrhea, nausea, headache, vomiting, dizziness, or light-headedness as your body becomes accustomed to it.2 Minocycline is less prescribed because it works no better than any other antibiotic and comes with safety concerns, including the possibility of irreversible skin pigmentation.8-11

In most cases, acne products need to be used for at least 30 days before you can begin to ascertain its efficacy. Some skin and acne types may see noticeable results in a few days and end up totally clear in just a few weeks. Others may take several weeks to see the slightest change, or need to have their regimen adjusted as their skin adapts. Treating acne can often be a months-long process.
Hormonal treatments for acne such as combined birth control pills and antiandrogens may be considered a first-line therapy for acne under a number of circumstances, including when contraception is desired, when known or suspected hyperandrogenism is present, when acne occurs in adulthood, when acne flares premenstrually, and when symptoms of significant sebum production (seborrhea) are co-present.[128] Hormone therapy is effective for acne even in women with normal androgen levels.[128]

Acne treatments come with different ingredients and formulas, but our method for choosing the best acne products is hardly top-secret. As with all of our “best of” reviews, we looked for products that have plenty of positive reviews and a strong track record of delivering proven results over time. We ignore products that promise a quick-fix or aren’t backed by sound science. We like products with natural ingredients, but that didn’t determine our final choices. We think you’ll be well-served by the products listed here.
If even a trace of sodium lauryl sulfate is left on the skin for more than an hour, however, the upper layer of living skin cells is irritated and dies. Tiny flakes of skin make the texture of the skin look uneven, and they can clog pores. The scent of sodium lauryl sulfate also causes your nose and tongue to be less sensitive to sweet tastes and their associated odors, so you will crave sugar.
Recommended therapies for first-line use in acne vulgaris treatment include topical retinoids, benzoyl peroxide, and topical or oral antibiotics.[78] 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.[77] 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 six and eight weeks after starting therapy.[1]
The best acne-fighting ingredients will offer several benefits, including reducing or eliminating excess oil and removing the dead skin that builds up and clogs your pores. There are two main chemical ingredients that are FDA approved for fighting acne and you can find them in a range of acne-fighting products, including the ones in the chart above. The natural ingredients, on the other hand, have been proven to work by scientific studies but not all have been approved by the FDA as a guaranteed acne-fighting ingredient, like tea tree oil for example. Nonetheless, you will still find a combination of these chemical and natural ingredients in many skin care products on the market, and many of them work amazingly on the right skin type.

Acne usually improves around the age of 20, but may persist into adulthood.[75] Permanent physical scarring may occur.[19] There is good evidence to support the idea that acne and associated scarring negatively affect a person's psychological state, worsen mood, lower self-esteem, and are associated with a higher risk of anxiety disorders, depression, and suicidal thoughts.[3][30][50] Another psychological complication of acne vulgaris is acne excoriée, which occurs when a person persistently picks and scratches pimples, irrespective of the severity of their acne.[61][155] This can lead to significant scarring, changes in the affected person's skin pigmentation, and a cyclic worsening of the affected person's anxiety about their appearance.[61] Rare complications from acne or its treatment include the formation of pyogenic granulomas, osteoma cutis, and solid facial edema.[156] Early and aggressive treatment of acne is advocated by some in the medical community to reduce the chances of these poor outcomes.[4]
^ White, Stephen D.; Bordeau, Patrick B.; Blumstein, Philippe; Ibisch, Catherine; GuaguÈre, Eric; Denerolle, Philippe; Carlotti, Didier N.; Scott, Katherine V. (1 September 1997). "Feline acne and results of treatment with mupirocin in an open clinical trial: 25 cases (1994–96)". Veterinary Dermatology. 8 (3): 157–164. doi:10.1046/j.1365-3164.1997.d01-16.x. ISSN 1365-3164.

Protect your skin. Skin care doesn't end when you leave your bathroom. Wear a noncomedogenic (non-pore clogging) sunscreen with an SPF of 30 or more that offers both UVA and UVB protection to shield your sensitive skin against the sun's harsh rays. A water- or light liquid-based sunscreen is best for acne-prone skin. Limit your time in the sun, especially between the hours of 10 a.m. and 2 p.m. While outside, wear a hat with at least a 2-inch brim and clothing to cover exposed skin.

Antibiotics. These work by killing excess skin bacteria and reducing redness. For the first few months of treatment, you may use both a retinoid and an antibiotic, with the antibiotic applied in the morning and the retinoid in the evening. The antibiotics are often combined with benzoyl peroxide to reduce the likelihood of developing antibiotic resistance. Examples include clindamycin with benzoyl peroxide (Benzaclin, Duac, Acanya) and erythromycin with benzoyl peroxide (Benzamycin). Topical antibiotics alone aren't recommended.

But the side effects of targeted breakout cream treatments aren’t always worth it. “So many products instruct consumers to use benzoyl peroxide spot treat red bumps and pustules. I don’t recommend it,” says Dr. Lawrence Green, board-certified dermatologist and assistant clinical professor of dermatology at George Washington University. Such high concentrations of benzoyl peroxide cause added irritation and inflammation to already sensitive skin, so with this in mind, we cut kits that included spot treatments.


A major mechanism of acne-related skin inflammation is mediated by P. acnes's ability to bind and activate a class of immune system receptors known as toll-like receptors (TLRs), especially TLR2 and TLR4.[44][64][65] Activation of TLR2 and TLR4 by P. acnes leads to increased secretion of IL-1α, IL-8, and TNF-α.[44] Release of these inflammatory signals attracts various immune cells to the hair follicle including neutrophils, macrophages, and Th1 cells.[44] IL-1α stimulates increased skin cell activity and reproduction, which in turn fuels comedo development.[44] Furthermore, sebaceous gland cells produce more antimicrobial peptides, such as HBD1 and HBD2, in response to binding of TLR2 and TLR4.[44]

Considerations: Because tazarotene is a retinoid (vitamin A derivative), like Accutane, it should not be used by women who are pregnant because of potential harm to the fetus. Exposure to sunlight should be avoided. Wind or cold may be more irritating when taking tazarotene. Side effects occured in 10-30% of patients and included dry peeling skin, burning, stinging, dry skin, redness, and itchiness.
Properly selected face cleanser will help rid your skin of bacteria that clog pores and multiply in them. High-quality face cleaning also removes dead skin cells, making acne treatment more effective. It will take a strong but gentle remedy to remove dirt without new irritations. Therefore, you should avoid abrasive scrubs and soaps for the face, which can deprive the skin of its natural oils and may cause the painful irritation.
According to Dr. Bailey, the best facial cleansers for acne should have at least one of these key ingredients: salicylic acid, glycolic acid or benzoyl peroxide. Cleansers with these ingredients can penetrate your pores and eliminate pore-clogging impurities—like dead skin cells, makeup, excess oil and bacteria—that irritate skin and make acne worse.

Our favorite for banishing blemishes on the fly, Glossier's zit stick is not only effective, but it's portable. Just stash it in your purse for any unexpected breakouts! Packed with acne-fighting benzoyl peroxide, this convenient roll-on works extremely quickly. In a clinical trial, 83% of test subjects said that it lessened the appearance of pimples in just 3 hours. We've tried it ourselves and can confirm the 3-hour claim is true.
Skincare is an extra challenge for those with sensitive skin because certain ingredients might cause irritation or inflammation. Spending too much time out in the wind and sun can also increase reactions. You can have oily, dry or combination skin and still have sensitive skin, too. For both skincare products and cosmetics, try out only one product at a time to see what effects it will have on your skin. The best way to start out is by patch-testing the product on your inner forearm. If you see no negative impact, you can apply it to the area behind your ear before trying it on your face. There are many products on the market now that advertise as effective for sensitive skin, but testing them is the only way to determine which is best for your skin.
The Swedish company Acne Studios AB, reg. No. 556504-7726 (“Acne Studios”), is the controller of your personal data. Acne Studios’ affiliated companies (including other companies within the Acne Studios group, joint ventures, franchisees and licensees) and selected suppliers may process your personal data on Acne Studios’ behalf and in accordance with Acne Studios’ instructions as stated below and are thereby processors of your personal data. You may contact Acne Studios at any time, please find our contact details below.
×