Aside from adding bacteria to your skin, these forms of contact can irritate the skin, adding to the appearance of redness and causing increased inflammation. In the event that your pimples get ruptured during this process, the oil and bacteria that was trapped inside could spread to the surrounding skin on your face, which causes acne to spread. So, not only will rubbing, squeezing and scratching leave your acne-ridden skin further irritated, it will increase the amount of acne you will have to deal with.

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.
The Exposed Facial Cleanser is our top pick. This cleanser is one of the very best on the market and it works for all skin types. The gentle yet rich formula is ideal for anyone, and it’s especially good for those with sensitive skin. It’s non-comedogenic, hypoallergenic, and soap free, with just 0.5% salicylic acid. Plus, it’s made with a combination of natural ingredients, including sage leaf extract, and vitamins like pro b5.
Retinoids are medications which reduce inflammation, normalize the follicle cell life cycle, and reduce sebum production.[44][83] They are structurally related to vitamin A.[83] The retinoids appear to influence the cell life cycle in the follicle lining. This helps prevent the accumulation of skin cells within the hair follicle that can create a blockage. They are a first-line acne treatment,[1] especially for people with dark-colored skin, and are known to lead to faster improvement of postinflammatory hyperpigmentation.[35]

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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.
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.

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.
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.
Chemical peels – Professionally-administered (don’t try it at home) chemical peels involve the use of acids to remove superficial areas of the skin. The strength of chemical peels varies from treatment to treatment but work best on people with lighter skin, because the acids used in the peel may cause darkening of the skin. It’s imperative that you talk with a dermatologist before using chemical peels for acne treatment if you have darker skin. The good news, however, is that people with darker skin can use OTC products that contain the same chemicals used in chemical peels (but at a lower percentage).
Sodium sulfacetamide-sulfur is another acne medications often found in over-the-counter treatments, and it works especially well for those with mild-moderate acne that is largely made up of pimples. This is because it effectively dries out excess sebum without drying out the skin, and some studies suggest that this combination of sodium sulfacetamide and sulfur has antibacterial properties. According to one study published in The Journal of Clinical and Aesthetic Dermatology, sodium sulfacetamide 10 percent-sulfur 5 percent can significantly reduce the size of p. acnes colonies when used as an emollient foam6. This treatment option is also available as a facewash, topical gel, and topical cream, and can be found at most drugstores.
Acne isn’t just a problem for teens. According to studies, those pesky zits and pimples can pop up at any age. Whether it’s your diet, environment or stress that’s to blame, you don’t have to suffer helplessly. To get the skinny on acne, we talked to board-certified dermatologist Cynthia Bailey, M.D., president and CEO of Advanced Skin Care and Dermatology Physicians, Inc. and founder of DrBaileySkinCare.com. Here, she shares her best tips on how to choose the right acne cleanser for you, as well as how to use it to get the best results.
This top-of-line cleanser is one that really works amazingly for normal, combination and oily skin types. It’s a foaming face wash with 3% sulfur that makes your skin visibly clearer without drying it out. It removes blemishes, unclogs pores, draws out impurities all while calming redness and reducing excess sebum production. The sulfur in it helps to prevent future breakouts and tames even the worst acne breakouts.
San Francisco-based dermatologist William Kwan, MD, swears by this treatment—and its powerful ingredients. "It has a combination of glycolic acid (AHA) and salicylic acid (BHA)," he explains. "These are helpful to exfoliate the comedone and heal the acne." Dr. Kwan also likes that this gel contains licorice extract, which helps lighten dark spots left behind by past blemishes.
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.

The side effects depend on the type of treatment you use. Generally, for topical, over-the-counter creams, you can watch out for stinging, redness, irritation and peeling — these side effects usually don’t go any deeper than the skin. Others, like oral antibiotics or hormonal medications, could come with new sets of complications, so we suggest talking to your doctor before pursuing the treatment.


The Body Shop Tea Tree Oil Products: Even though it’s not made in a lab, tea tree oil has been studied and proven to be a powerful anti-acne agent. The Body Shop takes advantage of this ingredient with their full line of tea tree oil products, from pure oil to face wipes to a clay mask, all containing tea tree oil. These products are best for oily skin, pimples, and cystic acne.
Retinoids: Retinoids are substances that are derived from vitamin A, which includes retinol, but also includes synthetic versions of retinol with activated retinoic acid which tends to be more effective in treating acne. Retinoic acid has been shown to reduce sebum production8 and regulate skin cell production9, which together can greatly reduce acne. These synthetic retinoids include adapalene, tretinoin, isotretinoin, and others. Although these synthetic options are more reliably effective, they also tend to have more side effects, like burning, itching, and dryness. Unlike retinol, which is available over-the-counter, nearly all synthetic retinoids are prescription-only. One of the main exceptions is Differin, which is a brand that sells a topical gel containing adapalene, a mild synthetic retinoid, over-the-counter.
For adult women, spironolactone is preferred over oral antibiotics since women with adult acne will likely have this condition at least until menopause, and starting and stopping an oral antibiotic over many years could potentially contribute to drug resistance and decreased microbial response. Spironolactone is completely safe to use on an ongoing basis once the correct dose is determined by the treating physician. It is advisable to check a potassium level at the 150mg dosing.

Exposed Skin Care: Exposed Skin Care products include benzoyl peroxide, salicylic acid, and azelaic acid (see below for more details), all at low concentrations that are safe for all skin types. Plus they also incorporate powerful natural ingredients, like tea tree oil, vitamin E, and green tea extract. Before jumping straight to the strongest (and harshest) prescription treatment available, we highly recommend giving this gentle but effective brand a try for a few weeks. If it doesn’t work, you can always send your empty product bottles back to the company and they will reimburse you in full.
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.
For adult women, spironolactone is preferred over oral antibiotics since women with adult acne will likely have this condition at least until menopause, and starting and stopping an oral antibiotic over many years could potentially contribute to drug resistance and decreased microbial response. Spironolactone is completely safe to use on an ongoing basis once the correct dose is determined by the treating physician. It is advisable to check a potassium level at the 150mg dosing.
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
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.
The gel also contains benzoyl peroxide, which is essential for eliminating bacteria that provoke inflammation and redness of the skin. Apply a small amount of gel to cleansed skin and leave it on for a few minutes. After that, rinse with water. The number of applications should be from 1 to 3 times per day. The gel is well tolerated and can be used on all skin types, including sensitive.

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.
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.
For adult women, spironolactone is preferred over oral antibiotics since women with adult acne will likely have this condition at least until menopause, and starting and stopping an oral antibiotic over many years could potentially contribute to drug resistance and decreased microbial response. Spironolactone is completely safe to use on an ongoing basis once the correct dose is determined by the treating physician. It is advisable to check a potassium level at the 150mg dosing.

Tretinoin: As we said above, tretinoin (common brand name: Retin-A) is a synthetic retinoid, but it is stronger than some of the other options, and its cousin, isotretinoin, is even stronger. Isotretinoin, better known as Accutane, is an oral synthetic retinoid typically only prescribed for very severe cases of cystic acne because it can cause intense side effects and is a powerful teratogen, meaning it causes birth defects. However, after taking isotretinoin for several months, many people never need to do any serious acne treatment again, so for some, it is well worth the side effects.
All the dermatologists we talked to agreed that there is no one-size-fits-all solution to acne. Every patient responds to treatments differently, and sometimes it can get worse before it gets better. But with the help of your dermatologist, you can find an acne treatment regimen that works for you. And, yes, we do stress how helpful it is to work with a derm to get it right.
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]

Hydroquinone lightens the skin when applied topically by inhibiting tyrosinase, the enzyme responsible for converting the amino acid tyrosine to the skin pigment melanin, and is used to treat acne-associated postinflammatory hyperpigmentation.[34] By interfering with new production of melanin in the epidermis, hydroquinone leads to less hyperpigmentation as darkened skin cells are naturally shed over time.[34] Improvement in skin hyperpigmentation is typically seen within six months when used twice daily. Hydroquinone is ineffective for hyperpigmentation affecting deeper layers of skin such as the dermis.[34] The use of a sunscreen with SPF 15 or higher in the morning with reapplication every two hours is recommended when using hydroquinone.[34] Its application only to affected areas lowers the risk of lightening the color of normal skin but can lead to a temporary ring of lightened skin around the hyperpigmented area.[34] Hydroquinone is generally well-tolerated; side effects are typically mild (e.g., skin irritation) and occur with use of a higher than the recommended 4% concentration.[34] Most preparations contain the preservative sodium metabisulfite, which has been linked to rare cases of allergic reactions including anaphylaxis and severe asthma exacerbations in susceptible people.[34] In extremely rare cases, repeated improper topical application of high-dose hydroquinone has been associated with an accumulation of homogentisic acid in connective tissues, a condition known as exogenous ochronosis.[34]


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.
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.
Infused with salicylic acid from white willow bark and antioxidant-rich chamomile and gotu kola, this clarifying face wash is formulated for men and women of all skin types. It exfoliates and unclogs pores to boost cell turnover, soothes inflamed skin and counters free radical damage. Also works as a makeup remover and a deep-cleansing shaving cream!
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.
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.
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.
Acne vulgaris is the catch-all term for everything from angry red lesions to tiny white bumps, which are the results of hair follicles and their sebaceous glands becoming blocked and inflamed So our first plan was to look at it all — spot treatments, washes, scrubs and creams — until we learned that when it comes to over-the-counter treatments, there is no single cure.
Although immediate results would be great, acne treatment does not occur overnight. It is a process that requires follow-up appointments to determine and adjust your treatments to your particular skin type. Expect six to 12 weeks for results. While waiting for an acne treatment to work, it can be tempting to squeeze lesions to get rid of them. Dermatologists do not recommend this. Picking, scratching, popping and squeezing tend to make the lesions worse and can cause acne scars.
Dapsone is not a first-line topical antibiotic due to higher cost and lack of clear superiority over other antibiotics.[1] Topical dapsone is not recommended for use with benzoyl peroxide due to yellow-orange skin discoloration with this combination.[10] While minocycline is shown to be an effective acne treatment, it is no longer recommended as a first-line antibiotic due to a lack of evidence that it is better than other treatments, and concerns of safety compared to other tetracyclines.[88]
Comedones (blackheads and whiteheads) must be present to diagnose acne. In their absence, an appearance similar to that of acne would suggest a different skin disorder.[27] Microcomedones (the precursor to blackheads and whiteheads) are not visible to the naked eye when inspecting the skin and can only be seen with a microscope.[27] There are many features that may indicate a person's acne vulgaris is sensitive to hormonal influences. Historical and physical clues that may suggest hormone-sensitive acne include onset between ages 20 and 30; worsening the week before a woman's period; acne lesions predominantly over the jawline and chin; and inflammatory/nodular acne lesions.[1]
A complete skin care regimen to control acne usually starts with washing. The ideal face wash creates a soft creamy lather in warm water. It rinses off dirt, excess oil, and makeup, leaving the face ready for the next step in daily skin care, whether that is toner, moisturizer, exfoliant, sunblock, or more makeup. It is fragrance-free, and it does not create a foam, film, or tingly sensation on the face. Any product that foams and suds vigorously, like a detergent, is a strict no-no for acne treatment, especially on dry skin.
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.

Chemical peels – Professionally-administered (don’t try it at home) chemical peels involve the use of acids to remove superficial areas of the skin. The strength of chemical peels varies from treatment to treatment but work best on people with lighter skin, because the acids used in the peel may cause darkening of the skin. It’s imperative that you talk with a dermatologist before using chemical peels for acne treatment if you have darker skin. The good news, however, is that people with darker skin can use OTC products that contain the same chemicals used in chemical peels (but at a lower percentage).

Even though it may be convenient to wash your face with whatever you have in your bathroom, there are a lot of reasons why you want to avoid that like the plague. Summed up in one word, those reasons are; ingredients. Because different people have different skin types, not all ingredients will work the same for everybody, but the general principle remains the same.
It’s safe to say there are more types of treatment for acne than there are types of acne. From OTC medicines to home remedies to dermatologist-prescribed products, there are many ways to combat acne breakouts. We’ve talked primarily about over-the-counter products, but here are just a few other treatment options (as well as a look at acne’s causes – and myths).

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.

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