Several scales exist to grade the severity of acne vulgaris, but no single technique has been universally accepted as the diagnostic standard.[68][69] Cook's acne grading scale uses photographs to grade severity from 0 to 8 (0 being the least severe and 8 being the most severe). This scale was the first to use a standardized photographic protocol to assess acne severity; since its creation in 1979, the scale has undergone several revisions.[69] The Leeds acne grading technique counts acne lesions on the face, back, and chest and categorizes them as inflammatory or non-inflammatory. Leeds scores range from 0 (least severe) to 10 (most severe) though modified scales have a maximum score of 12.[69][70] The Pillsbury acne grading scale simply classifies the severity of the acne from grade 1 (least severe) to grade 4 (most severe).[68][71]
Spironolactone has relatively minor side effects, like low appetite, weakness, or cramping, but there’s one major exception: spironolactone comes with a black box warning about its cancer-causing effects. The FDA is required to include this label based on a study conducted in the 1950s that found carcinogenic properties in the spironolactone given to rats in an experiment. However, the dose of spironolactone used in this study was nearly 500 times higher than the dose currently prescribed, and no studies since have found anything carcinogenic about spironolactone. Because of this, most dermatologists feel comfortable prescribing spironolactone for acne. Still, it’s something to be aware of before you take it. Additionally, those with low blood pressure or kidney conditions are likely not good candidates for spironolactone and may want to explore other acne treatment options.

Feverfew – Commonly known as wild chamomile, feverfew is a plant that has been used for generations. It was once called “parthenium” by the ancient Greeks and is used to treat various ailments and disease. When it comes to your skin, feverfew is anti-inflammatory7, reducing and preventing redness and swelling. It’s also high in anti-oxidants and can be consumed orally in the form of tea for added benefits, like healing your skin from the inside out.


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Sudden breakouts are incredibly frustrating. And even if you eat a healthy diet, wear makeup that won't clog your pores, change your pillowcase regularly, and use acne-fighting skincare products (such as cleansers that contain ingredients like salicylic acid), you can still wake up to the unpleasant discovery that a pimple has pushed its way to the surface of your skin.
Pustules, as their name suggests, are filled with pus. They usually have a white or yellow center surrounded by extremely inflamed skin that is pink or red. The pus isn’t just bacteria and skin cells—it contains some dead white blood cells that were trying to fight the bacteria, too. Squeezing these can cause the skin around them to darken and scar.

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Dr. Turner recommends that acne be properly treated. Treatment should continue as long as needed to prevent it from recurring. Excessive washing and scrubbing can irritate the skin and make the problem worse. Therefore, Dr. Turner recommends gentle cleansing twice a day with a mild cleanser and lukewarm water. This helps remove excess sebum, which is crucial for control.

Also, refrain from moisturizing as you’ll want your face clear of even beneficial elements. Then, in the morning, gently press the blotting paper to the different areas of the face that you want to check. Don’t rub your skin with the paper as this will cause irritation, so instead just blot. The result will be that you’ll be able to see the amount of oil that is present in the different areas of your skin.
Photodynamic therapy – Photodynamic therapy is a relative newcomer to the world of acne treatment. Often reserved for moderate to severe acne because of the seriousness of the procedure and the downtime required following each treatment, photodynamic therapy reduces the size of sebaceous glands that produce oil. However, permanently reducing your skin’s sebum output may have long-term consequences because of sebum’s positive qualities, such as helping the skin to retain moisture and fighting bacteria.
Diet. Studies indicate that certain dietary factors, including skim milk and carbohydrate-rich foods — such as bread, bagels and chips — may worsen acne. Chocolate has long been suspected of making acne worse. A small study of 14 men with acne showed that eating chocolate was related to a worsening of symptoms. Further study is needed to examine why this happens and whether people with acne would benefit from following specific dietary restrictions.
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Retinoids and retinoid-like drugs. These come as creams, gels and lotions. Retinoid drugs are derived from vitamin A and include tretinoin (Avita, Retin-A, others), adapalene (Differin) and tazarotene (Tazorac, Avage). You apply this medication in the evening, beginning with three times a week, then daily as your skin becomes used to it. It works by preventing plugging of the hair follicles.
Dr. Ellen Turner and her team provide treatment for skin conditions, including eczema, psoriasis, rosacea, acne, moles, and more in Dallas, Irving, and Cleburne; as well as Plano, Arlington, and beyond. Cosmetic options include Botox®, Juvéderm®, Restylane®, Perlane®, Ultherapy®, Fraxel®, IPL, laser hair removal, laser resurfacing, and CoolSculpting®.
What it is: Spironolactone is a prescription medication in tablet form used to treat certain patients with hyperaldosteronism (the body produces too much aldosterone, a naturally occurring hormone), low potassium levels, and in patients with edema (fluid retention) caused by various conditions.1 Learn more from the U.S. National Library of Medicine.
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.
Although combined oral contraceptives are a more popular treatment with women, men can use them as well, as they may also experience hormonal fluctuations. The only downside is that birth control pills tend to produce feminizing features in the person taking them, such as reduced hair growth or enlarged breast tissue. To get a prescription for a combined oral contraceptive, you can talk to your family doctor, a dermatologist, or an OB/GYN, or visit your local Planned Parenthood.
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.
Decreased levels of retinoic acid in the skin may contribute to comedo formation. To address this deficiency, methods to increase the skin's production of retinoid acid are being explored.[10] A vaccine against inflammatory acne has shown promising results in mice and humans.[49][180] Some have voiced concerns about creating a vaccine designed to neutralize a stable community of normal skin bacteria that is known to protect the skin from colonization by more harmful microorganisms.[181]
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.

I've been using it now for quite some time (along with a few other Tracie Martyn products and the hyaluronic acid product my dermatologist recommended) and it's my new obsession. My drying, aging skin problems have cleared up. No more flaky skin. No more grease face from Pond's (my long-time love), no more tight skin feeling from the other cleansers I've tried that are really not for dry skin.


What it is: You may have heard of tretinoin in reference to "Retin-A" wrinkle treatments. Tretinoin is retinoic acid and vitamin A acid combined, and comes in various strengths in creams, gels, and liquids for topical use on the skin. It is used to treat acne and also to treat sun damaged skin or wrinkles and is usually applied once per day.1Learn more from the U.S. National Library of Medicine.

The foaming gel is made as a facial cleanser for oily, porous skin prone to irritation, inflammation and acne. The washing gel gently and thoroughly cleanses the skin from particles of dirt and oil, normalizes water balance, eliminates acne and facial spots, gives the skin freshness and elasticity. The gel does not contain parabens, alcohol and artificial fragrances.


The good news about oily skin is that it is less likely to wrinkle, is more supple and doesn’t show its age as soon as other skin types. The bad news is that pores get clogged with oil more frequently. Using a daily gentle exfoliator can balance your skin’s tone and texture and keep pores unplugged. There are also anti-bacterial exfoliators that can speed up healing for breakouts.

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.
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