How to Handle It: Consider salicylic acid your secret weapon. "This beta hydroxy acid helps remove excess oil and exfoliate dead cells from the skin's surface to keep pores clear," says Zeichner. Try Clinique's Acne Solution Clearing Gel, a two-time Best of Beauty winner that packs both salicylic acid and sea whip extract — an ingredient with skin-soothing properties — to help counteract the dryness sometimes caused by salicylic acid. The formula does double duty: It works as a spot treatment for mild to moderate acne and as a nightly allover treatment for pimple prevention. And since it dries clear, you can wear it to fight zits whenever, wherever.

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.
Pharaohs are recorded as having had acne, which may be the earliest known reference to the disease. Since at least the reign of Cleopatra (69–30 BC), the application of sulfur to the skin has been recognized as a useful treatment for acne.[162] The sixth-century Greek physician Aëtius of Amida is credited with coining the term "ionthos" (ίονθωξ,) or "acnae", which is believed to have been a reference to facial skin lesions that occur during "the 'acme' of life" (puberty).[163]
Oral antibiotics are the standard of care in managing acne that is moderate to severe, resistant to topical therapy and covers large body surface areas. Oral antibiotics that may be prescribed to treat acne include tetracycline, doxycycline, minocycline, erythromycin, trimethoprim-sulfamethoxazole, trimethoprim and azithromycin. Combination therapy (the use of two or more therapies) including oral antibiotics and topical medication (often retinoids) may help treat acne.

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®.


Just as there are no bells and whistles with Purpose above, there are none with this baby-mild product that renowned dermatologists swear by. So why is this $10 cleanser such a must-have? It's creamy, simple and isn't loaded with chemicals or perfumes that can irritate the skin. Cetaphil products are revered in the industry and their cleanser is one of the best drugstore buys out there. Period.
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®.

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 dermatologist Dr. Dennis Gross did a major study on water and its effect on skin and he found that the heavy metals in tap water can actually ruin the benefits expensive lotions and serums do for skin. Some cities (New York and L.A., for example) have worse water than others (Seattle, for example). While some dermatologists aren't buying his claims, (Patricia Wexler for one), you can fight the drying effects of water on skin by cleansing with cold cream, a practice common with European women.
Stronger cases may call for prescription retinoids (such as Retin-A or Tazorac), which “are really the standard of care for most acne therapy,” says Joshua Zeichner, MD, director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City. Certain drugs, such as Epiduo and Ziana, combine retinoids with antibacterials and may be more effective than separate products. Because retinoids also have anti-wrinkle properties (they help stimulate collagen production), they are especially beneficial for adult acne sufferers.

Those with dry skin can experience flaking and skin that feels tight. Dehydration is one cause of dry skin, so be sure to drink plenty of fluids. Also stay away from alcohol and caffeine, which can draw fluid from your body. Exfoliating daily with a product that is non-abrasive will help with skin cell turnover without erasing your skin’s natural oils. Look for moisturizers that contain hyaluronic acid (also listed as sodium hyaluronate in the ingredients list), glycerin, and algae, which is a marine component that can attract water and send it to your skin cells. Emollients like camellia oil and squalene are great to smooth and hydrate your skin.


Combination therapy—using medications of different classes together, each with a different mechanism of action—has been demonstrated to be a more efficacious approach to acne treatment than monotherapy.[10][46] The use of topical benzoyl peroxide and antibiotics together has been shown to be more effective than antibiotics alone.[10] Similarly, using a topical retinoid with an antibiotic clears acne lesions faster than the use of antibiotics alone.[10] Frequently used combinations include the following: antibiotic and benzoyl peroxide, antibiotic and topical retinoid, or topical retinoid and benzoyl peroxide.[46] The pairing of benzoyl peroxide with a retinoid is preferred over the combination of a topical antibiotic with a retinoid since both regimens are effective but benzoyl peroxide does not lead to antibiotic resistance.[10]

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Isotretinoin is an oral retinoid that is very effective for severe nodular acne, and moderate acne that is stubborn to other treatments.[1][19] One to two months use is typically adequate to see improvement. Acne often resolves completely or is much milder after a 4–6 month course of oral isotretinoin.[1] After a single course, about 80% of people report an improvement, with more than 50% reporting complete remission.[19] About 20% of patients require a second course.[19] Concerns have emerged that isotretinoin use is linked with an increased risk of adverse effects, like depression, suicidality, anemia, although there is no clear evidence to support some of these claims.[1][19] Isotretinoin is superior to antibiotics or placebo in reducing acne lesions.[16] The frequency of adverse events was about twice as high with isotretinoin, although these were mostly dryness-related events.[16] No increased risk of suicide or depression was conclusively found.[16] Isotretinoin use in women of childbearing age is regulated due to its known harmful effects in pregnancy.[19] For such a woman to be considered a candidate for isotretinoin, she must have a confirmed negative pregnancy test and use an effective form of birth control.[19] In 2008, the United States started the iPLEDGE program to prevent isotretinoin use during pregnancy.[85] iPledge requires the woman under consideration for isotretinoin therapy to have two negative pregnancy tests and mandates the use of two types of birth control for at least one month before therapy begins and one month after therapy is complete.[85] The effectiveness of the iPledge program has been questioned due to continued instances of contraception nonadherence.[85][86]
Skin type, tone, and condition vary from person to person. That explains why what worked for your best friend hasn’t helped you at all. If you are at the end of your rope with your acne and find that it is affecting your life, you really should see a dermatologist before struggling to find a new treatment. A dermatologist might still have to try a few different approaches, but they are trained to get through the process quicker. However, if your acne hasn’t caused you serious problems yet, visiting a dermatologist can be a time-consuming and expensive option. This is why many doctors say mild- to moderate- acne can be treated with over-the-counter products.

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.
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.

Scientists initially hypothesized that acne represented a disease of the skin's hair follicle, and occurred due to blockage of the pore by sebum. During the 1880s, bacteria were observed by microscopy in skin samples affected by acne and were regarded as the causal agents of comedones, sebum production, and ultimately acne.[163] During the mid-twentieth century, dermatologists realized that no single hypothesized factor (sebum, bacteria, or excess keratin) could completely explain the disease.[163] This led to the current understanding that acne could be explained by a sequence of related events, beginning with blockage of the skin follicle by excessive dead skin cells, followed by bacterial invasion of the hair follicle pore, changes in sebum production, and inflammation.[163]
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.
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.
Although there is no one single cure for acne, we based our reviews first on what doctors are saying about these products and their ingredients. Then we did some digging into all the reviews. We ruled out those products that had primarily negative responses. After all that, we consulted natural product experts to see which system they felt were the best acne treatment.
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.
Although there is no one single cure for acne, we based our reviews first on what doctors are saying about these products and their ingredients. Then we did some digging into all the reviews. We ruled out those products that had primarily negative responses. After all that, we consulted natural product experts to see which system they felt were the best acne treatment.
For some, the right dosage can be found over-the-counter in concentrations as low as 2.5 percent or up to 10 percent, but for others, a prescription dosage is needed to see the best results. Prescription doses rarely go over 10 percent, as benzoyl peroxide is known to cause stinging, burning, itching, flaking, peeling, and redness2 when used in concentrations over 5 percent, but they may combine the benzoyl peroxide with other acne medications.
Stronger cases may call for prescription retinoids (such as Retin-A or Tazorac), which “are really the standard of care for most acne therapy,” says Joshua Zeichner, MD, director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City. Certain drugs, such as Epiduo and Ziana, combine retinoids with antibacterials and may be more effective than separate products. Because retinoids also have anti-wrinkle properties (they help stimulate collagen production), they are especially beneficial for adult acne sufferers.
Pharaohs are recorded as having had acne, which may be the earliest known reference to the disease. Since at least the reign of Cleopatra (69–30 BC), the application of sulfur to the skin has been recognized as a useful treatment for acne.[162] The sixth-century Greek physician Aëtius of Amida is credited with coining the term "ionthos" (ίονθωξ,) or "acnae", which is believed to have been a reference to facial skin lesions that occur during "the 'acme' of life" (puberty).[163]
What's Going On: Do you tend to get these at the same time every month — say, just before you get your period? Because these are the work of fluctuating hormones, says Joshua Zeichner, a dermatologist and the director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City. Hormones can put oil production into overdrive, and having an excess of it means that it’s more likely to settle in your pores and cause zits.
“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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It is widely suspected that the anaerobic bacterial species Propionibacterium acnes (P. acnes) contributes to the development of acne, but its exact role is not well understood.[2] There are specific sub-strains of P. acnes associated with normal skin, and moderate or severe inflammatory acne.[49] It is unclear whether these undesirable strains evolve on-site or are acquired, or possibly both depending on the person. These strains have the capability of changing, perpetuating, or adapting to the abnormal cycle of inflammation, oil production, and inadequate sloughing of dead skin cells from acne pores. Infection with the parasitic mite Demodex is associated with the development of acne.[29][50] It is unclear whether eradication of the mite improves acne.[50]
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]
The other downside to Proactiv+ is that the bottles are small — like, half the size of Paula’s Choice small. Combine that with its recommended two or three-times daily application, and you’re going to be going through a lot of kits, which ultimately means spending more money on your treatment. If Proactiv is the only thing that works for you, it may very well be worth the investment, but we recommend starting with Paula’s Choice to see if you can get the same results at a cheaper price.

That’s why, no matter how uncomfortable your skin may feel while plagued with acne, you must resist the urge to touch your skin. If the irritating sensations become unbearable, there are other methods of treating your skin, such as cooling it with ice packs or aloe vera gel. You can even use medicated creams designed to soothe irritated skin – given that your dermatologist says it’s okay.

Salicylic acid and azelaic acid. Azelaic acid is a naturally occurring acid found in whole-grain cereals and animal products. It has antibacterial properties. A 20 percent azelaic acid cream seems to be as effective as many conventional acne treatments when used twice a day for at least four weeks. It's even more effective when used in combination with erythromycin. Prescription azelaic acid (Azelex, Finacea) is an option during pregnancy and while breast-feeding. Side effects include skin discoloration and minor skin irritation.
Scientists initially hypothesized that acne represented a disease of the skin's hair follicle, and occurred due to blockage of the pore by sebum. During the 1880s, bacteria were observed by microscopy in skin samples affected by acne and were regarded as the causal agents of comedones, sebum production, and ultimately acne.[163] During the mid-twentieth century, dermatologists realized that no single hypothesized factor (sebum, bacteria, or excess keratin) could completely explain the disease.[163] This led to the current understanding that acne could be explained by a sequence of related events, beginning with blockage of the skin follicle by excessive dead skin cells, followed by bacterial invasion of the hair follicle pore, changes in sebum production, and inflammation.[163]

But Accutane has mixed reviews for a reason. It makes the skin super dry and sensitive, which means it’s important to keep moisturizers and lip balm nearby while you’re on the treatment. Oh, and don’t even think about waxing your eyebrows (just imagine your skin ripping off). There’s another downside to Accutane: It requires a lot of paperwork and office visits. Since isotretinoin can cause birth defects, you have to come into the dermatologist once a month to get a pregnancy test and take a lengthy survey with embarrassing questions about your sex life to prove that you are using sufficient birth control. These precautions are intense, but dermatologists agree that the final results for Accutane are like no other. “This is one of the few medicines that I can look [patients] in the eye and guarantee them it will work,” says Friedman.
The second reason is that alcohol is super at removing oil from the skin. The problem lies in the fact that alcohol removes too much of this oil. This can cause your complexion to become raw and irritated. Also, your glands will react to the sudden lack of oil/sebum by trying to generate more and more. As noted before, this will result in a viscious cycle that will be disastrous for the well-being of your skin.
Alpha-Hydroxy Acids – These are synthetic acids derived from sugary fruits that remove dead skin cells3 while reducing inflammation. The two common types that can be found in over-the-counter acne treatments are glycolic acid and lactic acid. Another benefit of these acids is that they improve the appearance of your acne scars and make your pores look smaller by stimulating the growth of new, healthy skin.
One of the best face washes for sensitive skin, this soap-free, fragrance-free, non-comedogenic cleanser works to remove excess oil from your skin without irritation. It’s great for oily and combination skin types, as it cleans and purifies without making the skin taut and dry. Its formula is glycerin-based for a gentle cleanser that won’t provoke even the most sensitive of skin types.

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.

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