When whiteheads and blackheads become infected with bacteria, called Propionibacterium acnes, it leads to inflammatory acne. Regular bacteria is found in most whiteheads and blackheads, but P. acnes is attracted to the closed, oily environment. This bacteria makes acne more difficult to treat. The four different pimple types that characterize inflammatory acne are papules, pustules, nodules and cysts.

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.[44][45] Conversely, people who lack androgenic hormones or are insensitive to the effects of androgens rarely have acne.[44] An increase in androgen and oily sebum synthesis may be seen during pregnancy.[45][46] Acne can be a side effect of testosterone replacement therapy or of anabolic steroid use.[1][47] Over-the-counter bodybuilding and dietary supplements are commonly found to contain illegally added anabolic steroids.[1][48]
Azelaic acid is a natural acid that is derived from various grains like wheat and barley. It helps reduce acne by preventing skin cell buildup, killing p. acnes bacteria, and reducing inflammation4. This means it can help reduce all kinds of acne, from blackheads to pimples. Blackheads and whiteheads form when dead skin cells combine with sebum, the oil our skin naturally produces and get clogged in a pore. To get rid of this kind of acne, it helps to regulate your skin cell production and exfoliate your skin to remove excess dead skin cells. Azelaic acid is a great way to do both of these things, while also decreasing inflammation and killing bacteria. When the skin is inflamed, it swells slightly, causing the pores to constrict. This traps dead skin cells and sebum inside, leading to blackheads and whiteheads, and if bacteria get trapped as well, then pimples can also form.

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.


Oftentimes, our first instinct when we encounter bumps, pimples and other blemishes on our skin is to touch it. But if you’ve been dealing with acne for a while, you’ve probably learned by now that these practices only make acne and skin problems worse. For starters, our hands come into contact with more bacteria, pathogens and contaminants than any other part of our bodies. Even when we try to wash our hands often, there is only so much of that we can avoid putting on our faces every time we reach out to touch it. So, there’s the fact that we could be adding harmful bacteria our facial skin to begin with. But it doesn’t end there.

This type of skin can be oily and dry or oily and normal. Different places on your face will have different symptoms. The good news is that you probably won’t have acne on your cheeks since the skin there is usually less oily. You may have to use different treatments on different areas of your face, though. The T-Zone area of the forehead, nose and chin may be oilier, so exfoliating with a gentle cleanser each day should keep your facial skin balanced. You should look for a moisturizer that isn’t too heavy but that will hold in your skin’s moisture. Gel-like moisturizers are absorbed into combination skin quickly, but don’t over moisturize or your pores may become clogged. You may need to try several brands before finding one that works for you.
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.
Benzoyl Peroxide penetrates deep into the upper layers of the skin and destroys the bacteria that cause acne. The product is recommended for use twice a day: in the morning before applying conventional cosmetic care products and in the evening. The skin is gradually smoothed and becomes soft and delicate, pores are narrowed, and you are guaranteed a young and fresh look!

Any acne treatment is a weeks-long experiment that you’re conducting with your skin. Acne is slow to heal, and in some cases, it can get worse before it gets better (nearly every benzoyl peroxide product we looked at emphasized the likeliness of irritating acne further, and starting off with a lighter application). April W. Armstrong, a doctor at the University of California Davis Health System, recommends waiting at least one month before you deem a product ineffective.

If you notice that you’re breaking out right around your period every month, your acne might be linked to hormones. “A sensitivity to the hormones called androgens manifests in the form of cystic acne,” says Linkner. Androgens, namely testosterone, cause the skin to produce more sebum. More sebum equals more acne. Birth control, which has estrogen and progestin, helps keep hormones balanced and skin clear. Ortho Tri-Cyclen, Estrostep, and YAZ are all FDA-approved as acne treatments.
The alkaline ingredients in Ivory Soap reach into the skin and dissolve the fats and ceramides that lock moisture in and keep the skin soft and flexible. Tight skin constricts pores, locking oil and acne bacteria inside. If you wash your face with Ivory Soap once or twice a day, you almost certainly will have no big pieces of dirt or grime lurking in enlarged pores, but you are likely to have an ongoing problem with whiteheads and blackheads, and the constant irritation will also make pimples redder and more inflamed.
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.

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Spot treatments are designed to give problem pimples a mega-dose of concentrated benzoyl peroxide — in a couple of regimens, like the Proactiv Teen Kit, the spot treatment had nearly three times the benzoyl peroxide as its all-over treatment. The logic: If benzoyl peroxide can be irritating to the skin in high concentrations, limiting its intensity to just the pimple itself could save the rest of your healthy skin.
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.

Blue light rays penetrate follicles to kill off acne-causing bacteria. For severe cases, photodynamic therapy adds a topical solution called Levulan to blue light therapy. Note that these treatments can cause temporary redness and may not be covered by insurance. Prices vary greatly depending on the location and severity of acne, but can cost at least $50 for one blue light treatment and $100 or more per photodynamic therapy session. Most patients will need multiple treatments to see effective results, but many dermatologists offer package deals.
Although home remedies are generally convenient and popular, some have significant counterproductive effects on the skin. The famous Procter & Gamble product Ivory Soap is probably the world’s most frequently used acne face wash ingredient. It is also probably the world’s worst acne face wash ingredient. Often advertised as “so pure that it floats,” Ivory Soap is depicted with pictures of babies and fair-skinned blondes to imply that it is a good and inexpensive face wash for acne-affected skin. Nothing could be farther from the truth.

If you have oily, tight skin and tend to get age spots or sun spots, try an exfoliant made with glycolic acid right after you cleanse your skin, no more than 4 or 5 times a week. Aveeno Positively Radiant Cleansing Pads provides just a “dab” of exfoliant that will help lighten the spots without irritating your skin (which over the long run would create new brown spots).

The best acne medication differs from person to person based on their skin care needs. For some, a gentle over-the-counter option is the best way to reduce acne, while for others, stronger prescription medication is necessary. Regardless of your acne needs, there is an acne medication available for you. The best way to find the right acne treatment is with patience, and sometimes with the assistance of a dermatologist. This guide will cover the basics of acne medication, from benzoyl peroxide to Accutane.
The skin care products you apply to your face regularly can have a big impact on your complexion. You shouldn’t skip moisturizing if you have acne, especially if you’re using drying treatments—but the type of moisturizer you use can make a difference. “Even acne-prone teenagers need to moisturize to keep their skin barrier healthy. The skin barrier can become damaged from drying acne products and medications,” Arielle Kauvar, MD, director of New York Laser & Skin Care and clinical professor of dermatology at New York University School of Medicine, recently told Prevention.
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]
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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.

Cons: This is not actually a con, but their face wash is part of a comprehensive acne treatment system that effectively treats your skin while helping you save a bundle on the products that should be part of your skincare routine for best results. They have the best guarantee we have seen so far anywhere and you can read our review of the complete Exposed Skin Care kit here.
When whiteheads and blackheads become infected with bacteria, called Propionibacterium acnes, it leads to inflammatory acne. Regular bacteria is found in most whiteheads and blackheads, but P. acnes is attracted to the closed, oily environment. This bacteria makes acne more difficult to treat. The four different pimple types that characterize inflammatory acne are papules, pustules, nodules and cysts.
Many different treatments exist for acne. These include alpha hydroxy acid, anti-androgen medications, antibiotics, antiseborrheic medications, azelaic acid, benzoyl peroxide, hormonal treatments, keratolytic soaps, nicotinamide, retinoids, and salicylic acid.[75] They are believed to work in at least four different ways, including the following: reducing inflammation, hormonal manipulation, killing P. acnes, and normalizing skin cell shedding and sebum production in the pore to prevent blockage.[76] Common treatments include topical therapies such as antibiotics, benzoyl peroxide, and retinoids, and systemic therapies including antibiotics, hormonal agents, and oral retinoids.[19][77]
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]
Retinol: Retinol is simply another word for vitamin A, sort of like how we call vitamin B7 “biotin.” It’s important that our bodies get systemic vitamin A through our diet for good vision, a strong immune system, and general organ function, but some research suggests that vitamin A could have a positive impact on the skin when applied to it directly. The problem is, regular retinol doesn’t actually do much for acne. That’s because the retinoic acid found in retinol isn’t always activated when left to its own devices. We typically have to activate the retinoic acid synthetically through the creation of various medications.
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]

Keep in mind that even if some products market themselves toward severe acne breakouts, all the kits we looked at are definitely designed for mild to moderate acne. Not sure if you fit on that scale? You’re not alone! When you’re in the middle of a breakout, all acne seems severe, so it can be difficult to self-diagnose your symptoms. We talked to dermatologists and cosmetic chemists to better understand the differences between the various types of acne (see below).
Acne inversa (L. invertō, "upside down") and acne rosacea (rosa, "rose-colored" + -āceus, "forming") are not true forms of acne and respectively refer to the skin conditions hidradenitis suppurativa (HS) and rosacea.[25][26][27] Although HS shares certain common features with acne vulgaris, such as a tendency to clog skin follicles with skin cell debris, the condition otherwise lacks the defining features of acne and is therefore considered a distinct skin disorder.[25]

If you notice that you’re breaking out right around your period every month, your acne might be linked to hormones. “A sensitivity to the hormones called androgens manifests in the form of cystic acne,” says Linkner. Androgens, namely testosterone, cause the skin to produce more sebum. More sebum equals more acne. Birth control, which has estrogen and progestin, helps keep hormones balanced and skin clear. Ortho Tri-Cyclen, Estrostep, and YAZ are all FDA-approved as acne treatments.


Dry Skin – Skin that doesn’t produce enough sebum, so it doesn’t retain moisture well and dries out. Dry skin tends to crack, peel, and become itchy, flaky, irritated or inflamed easily. Acne is caused by dead skin cells and bacteria clogging pores, while dryness tightens the pores to clog them further. The best acne face washes should exfoliate your skin, but shouldn’t dry it out further.

In one 2018 meta-analysis published in the Journal of the European Academy of Dermatology and Venereolog, researchers found that milk consumption—particularly skim milk, which is higher in sugar than whole milk—was associated with a greater risk of acne. Beyond the higher sugar content, scientists believe that proteins and hormones found in milk products, including IGF-1, may play a role in acne flare-ups by increasing oil production and inflammation.

Perhaps one of the most popular cleansers for combination skin care on the market today, Boscia's purifying cleansing gel works best for oily to normal skin types. It works by gently cleansing skin without stripping it and adding harsh elements to the skin. It can be a tad drying, so it works best on women with more oily spots than dry spots. You can also use it to cleanse your oily T-zone, but keep it away from your dry spots, where you may want to moisturize more.

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.
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