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]
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.
Considerations: THERE IS AN EXTREMELY HIGH RISK THAT A DEFORMED INFANT CAN RESULT IF PREGNANCY OCCURS WHILE TAKING ACCUTANE IN ANY AMOUNT AND EVEN FOR SHORT PERIODS OF TIME. FEMALES WHO ARE PREGNANT OR WHO MAY BECOME PREGNANT WHILE UNDERGOING TREATMENT SHOULD NOT TAKE ACCUTANE. There are many other warnings as well.1-3 Side effects of Accutane are many, some of which include dry and cracked lips, dry skin, dry nose and mouth, mild to moderate muscle or joint aches.1-2,4-7
Dr. Turner and her staff can offer many effective acne treatments. Before recommending a treatment plan, many factors are considered, including your gender, age and the severity of your condition. For women, other considerations are whether you are pregnant, nursing or trying to become pregnant. Before starting any treatment, be sure to tell Dr. Turner if any of these apply. This information will help her to create an appropriate treatment plan.
The good news: Topical spot treatments can quickly and effectively aid in the skin's healing process, shrinking existing pimples and preventing acne scars from forming. But with so many products on the market, it can be difficult to figure out which zit-zapping formulas are the most effective, so we turned to skincare professionals to get their expert opinions. Here, six powerful acne spot treatments that dermatologists swear by.
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.
While a few people suffer from acne that is so severe it requires a medical prescription from a doctor, most people with mild to medium acne problems can find decent over-the-counter treatments that really work. The first key to getting your acne cleanser right is to know what active ingredients combat your acne, and then finding an acne treatment that contains it. Here are a few of the ingredients you want to look for:
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A big acne myth is that you can wash it away. Although you should wash your face in the morning to rid it of any bacteria and saliva that might be lingering from your pillow, and you should wash it at night to clean away the sweat and grime that accumulated, twice a day is plenty. You also shouldn’t spend more than 30 seconds on this part of your skin care routine. Begin with warm water that is not too hot. When you are finished, you can splash your face with cold water to close the pores or use an astringent. Make sure you get a clean towel each time you wash so that you aren’t patting more bacteria onto your clean face. If you use a washcloth to clean your face, make sure you don’t reuse it.
The main hormonal driver of oily sebum production in the skin is dihydrotestosterone.[1] Another androgenic hormone responsible for increased sebaceous gland activity is DHEA-S. Higher amounts of DHEA-S are secreted during adrenarche (a stage of puberty), and this leads to an increase in sebum production. In a sebum-rich skin environment, the naturally occurring and largely commensal skin bacterium P. acnes readily grows and can cause inflammation within and around the follicle due to activation of the innate immune system.[10] P. acnes triggers skin inflammation in acne by increasing the production of several pro-inflammatory chemical signals (such as IL-1α, IL-8, TNF-α, and LTB4); IL-1α is known to be essential to comedo formation.[44]
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.

You’ve probably heard of the benefits of retinoid creams for anti-aging, but vitamin A is also efficient at clearing up acne. “[Retinoids] cause skin cells to turn over at a faster rate, decrease oil production, and help skin exfoliate,” board-certified dermatologist Rita Linkner, M.D., tells SELF. Another benefit: Acne is inflammation, and retinoids are anti-inflammatory.
For mild to moderate acne, dermatologists often suggest an acne face wash with bacteria-killing benzoyl peroxide (to minimize irritation, 3.5 percent strength should be your max if you have sensitive skin), along with a prescription topical antimicrobial such as clindamycin or erythromycin. If you rather go with a gentle face wash for sensitive skin, you can use that and apply a benzoyl peroxide acne spot treatment instead.
Considerations: Side effects are generally mild and short lived. Most common, in 1-5% of people are itching, burning, stinging, and tingling. Other side effects were reported in less than 1% of people. There have been a few reports from darker skinned people of lightening of the skin. Azelaic acid has not been well studied in people with dark complexions.1
The idea behind using antibiotics for acne is that they can help reduce the number of p. acnes on the skin and relieve an acute case of severe acne. After the person stops taking the antibiotics, the hope is that the reduced numbers of p. acnes will prevent the pimples or cysts from getting out of hand again. However, in reality, most people simply end up taking the antibiotics much longer than they should, and the acne almost always comes back. That’s because, according to The Lancet: Infectious Diseases, over 50 percent of p. acnes strains are resistant to antibiotics7. If your doctor tries to prescribe you antibiotics for your acne, we recommend asking about other courses of action.
It's a common misconception that those with oily skin shouldn't moisturize. Be sure you're treating your entire face to a full routine and not solely relying on spot treatments to battle your breakouts. If your acne comes with a side of oil, this is your best bet for a daily moisturizer. It contains panadoxine, a vitamin B6 derivative that improves skin’s overall healthy balance by visually minimizing pore size and shine.
The varying skin types can roughly be broken up into five different categories – normal, oily, combination, dry, and sensitive. These categories are quite broad with each having varying levels of intensity. For example, most people have an oily complexion somewhere on their faces, but some might have excessively oily skin that needs to be cleansed every second day.
Brand names:  Acne Treatment, BenzEFoam, PanOxyl, Acetoxyl, Acne-10, Acne-Clear, Acnomel BP 5, Alquam-X Acne Therapy Gel, Benprox, Benzac, Benzac AC, Benzac AC Wash, Benzac W, Benzagel, Benzagel Wash, Benzashave, BenzEFoam Ultra, BenzePro, Benziq, Benziq Wash, Binora, BP Foaming Wash, BPO-5 Wash, BPO-10 Wash, BPO 3 Foaming Cloths, BPO 6 Foaming Cloths, BPO 9 Foaming Cloths, BPO Gel, BP Wash, Brevoxyl, Brevoxyl Acne Wash Kit, Brevoxyl Creamy Wash, Clearskin, Clinac BPO, Delos, Desquam-X Wash, Fostex Wash 10%, Inova, NeoBenz Micro, NeoBenz Micro SD, NeoBenz Micro Wash Plus Pack, Neutrogena Clear Pore Cleanser / Mask, Neutrogena Rapid Clear Stubborn Acne, Oscion, Oxy-10, Oxy Daily Wash, Pacnex, PanOxyl 4% Acne Creamy Wash, PanOxyl 10% Acne Foaming Wash, Peroderm 7 Wash, Persa-Gel, PR Benzoyl Peroxide Wash, Riax, SE BPO, SoluCLENZ Rx, Triaz …show all

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]


Comedonal is the mildest type of acne and doesn’t cause painful swelling or inflammation in most cases. It usually manifests as blackheads or whiteheads on the skin. Blackheads occur when dirt and germs under the skin’s pores cause the skin to appear dark. Males going through puberty, as well as young adults, will experience some form of comedonal acne in their lives. It also may occur because of allergic reactions to skin or hair products, but most acne lesions, such as whiteheads and blackheads, occur because of a hard blockage of excess sebum in skin pores.

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.

Kiehl’s number one option for men’s acne treatment has men with oily skin in mind. When used daily, the Deep Cleansing Exfoliating Face Wash removes excess oil, sweat, and other grime to A) clean pores and B) reduce the shine that comes with oily skin. As its name suggests, the Deep Cleansing Face Wash also removes dead skin cells to leave your skin smooth and refreshed.
The main hormonal driver of oily sebum production in the skin is dihydrotestosterone.[1] Another androgenic hormone responsible for increased sebaceous gland activity is DHEA-S. Higher amounts of DHEA-S are secreted during adrenarche (a stage of puberty), and this leads to an increase in sebum production. In a sebum-rich skin environment, the naturally occurring and largely commensal skin bacterium P. acnes readily grows and can cause inflammation within and around the follicle due to activation of the innate immune system.[10] P. acnes triggers skin inflammation in acne by increasing the production of several pro-inflammatory chemical signals (such as IL-1α, IL-8, TNF-α, and LTB4); IL-1α is known to be essential to comedo formation.[44]
Considerations: Ask your doctor before using any other products on your skin while using erythromycin, as it may be too irritating. This includes other prescriptions, over-the-counter medicines (including those listed on this site), and harsh or abrasive cleansers, perfumes, or make-up.2 People report burning as the most frequent side effect, and also peeling, dryness, itching, redness, and oiliness, among others.2
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.
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