Hair follicles are the tiny structures that grow hair in the scalp. Sebaceous glands produce sebum. On areas where acne develops, sebaceous glands surround the hair follicles. The combination of the sebaceous glands and the hair follicles is the "pilosebaceous unit," where acne pimples and cysts develop. Sebum moisturizes hair and skin. Each hair pushes up through the skin surface along with sebum.
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]
Even though scientists know how pimples and blackheads are formed, they are still not sure what causes you to have a body full of blemishes and the guy sitting next to you not to have a single spot on his face? It’s probably related to hereditary factors. If your parents dealt with acne when they were younger, you’re more likely to struggle with acne, too.

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.


Although some people think they can get the best acne treatment by mixing and matching products, this is not the recommended method of treating blemishes. Aside from doctors, few people understand how different products can react with each other. In some cases, combining two products increases how well both work. For example, green tea extract and salicylic acid complement each other. Skin care system makers usually hire doctors to help improve the effectiveness of their systems.
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.

The treatment regimen your doctor recommends depends on your age, the type and severity of your acne, and what you are willing to commit to. For example, you may need to wash and apply medications to the affected skin twice a day for several weeks. Often topical medications and drugs you take by mouth (oral medication) are used in combination. Pregnant women will not be able to use oral prescription medications for acne.


Topical and oral preparations of nicotinamide (the amide form of vitamin B3) have been suggested as alternative medical treatments.[134] It is thought to improve acne due to its anti-inflammatory properties, its ability to suppress sebum production, and by promoting wound healing.[134] Topical and oral preparations of zinc have similarly been proposed as effective treatments for acne; evidence to support their use for this purpose is limited.[135] The purported efficacy of zinc is attributed to its capacity to reduce inflammation and sebum production, and inhibit P. acnes.[135] Antihistamines may improve symptoms among those already taking isotretinoin due to their anti-inflammatory properties and their ability to suppress sebum production.[136]
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.
Cortisone is a quick fix for acne emergencies. We mean got a big board meeting tomorrow kind of quick. Go into the dermatologist’s office for a shot of this corticosteroid, and acne will disappear in 24 to 48 hours. The treatment works to curb inflammation, which makes it best for cystic breakouts and can be really good at combatting hormonal flare-ups. If done incorrectly, a cortisone shot can leave a small depression in the skin that lasts about eight weeks. “It’s a rare side effect that happens if dosage of cortisone is too high,” explains Linkner. “You want to go to someone who knows what they’re doing.”
Microneedling is a procedure in which an instrument with multiple rows of tiny needles is rolled over the skin to elicit a wound healing response and stimulate collagen production to reduce the appearance of atrophic acne scars in people with darker skin color.[140] Notable adverse effects of microneedling include postinflammatory hyperpigmentation and tram track scarring (described as discrete slightly raised scars in a linear distribution similar to a tram track). The latter is thought to be primarily attributable to improper technique by the practitioner, including the use of excessive pressure or inappropriately large needles.[140][146]
Oral antibiotics are recommended for no longer than three months as antibiotic courses exceeding this duration are associated with the development of antibiotic resistance and show no clear benefit over shorter courses.[87] Furthermore, if long-term oral antibiotics beyond three months are thought to be necessary, it is recommended that benzoyl peroxide and/or a retinoid be used at the same time to limit the risk of P. acnes developing antibiotic resistance.[87]
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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.
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.
If you take a close look at the acne-fighting ingredients, you will find that no single ingredient does all the work to get rid of acne. Each one has a unique effect that plays a role in the elimination of acne, but only when they are used combined or in sequence in a system do they have ability to get rid of acne altogether. This is why it is so important to use an effective system for fight acne, not just a single product.
In terms of their effectiveness, both these ingredients are beneficial. Any related product worth its salt will have either one of these in their formula. In fact, some products incorporate both. However, in saying this, our research has provided conclusive proof that salicylic acid is the one to choose. Below are the main points as to why we think this is the case:
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]

How to Handle It: Pair two of the best-known acne-fighting ingredients, salicylic acid and benzoyl peroxide, in the week leading up to your period. (If you're feeling bloated, now's the time to do it.) The combo can help prevent hormonal acne from happening in the first place. Zeichner suggests following a salicylic acid wash, like fan-favorite Neutrogena Oil-Free Acne Wash Pink Grapefruit Facial Cleanser ($7), with a benzoyl peroxide spot treatment, such as Murad Acne Spot Fast Fix ($22). If you're still seeing zits, "visit your dermatologist to discuss prescription options, like birth control pills, oral spironolactone — which blocks oil — or topical Aczone 7.5 percent gel," says Zeichner. "It's shown to be particularly effective in adult women without causing irritation." Oral contraceptives level out those hormone fluctuations, keeping your oil production normal and your skin clear.
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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.

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
Considerations: Cigarette smoking with oral contraceptive use increases the risk of serious heart disease.2 There are many negative side effects and positive side effects to taking birth control pills for acne. Talk to your doctor to decide if it is right for you.1-3 While it is a widely held belief, evidence does not show a correlation between pregnancy rates and concurrent administration of birth control pills and oral antibiotics. [With the exception of anti-tuberculosis drugs like rifampin.]
Benzoyl Peroxide – A strong compound that kills the bacteria that causes acne1. It also gets rid of excess oil and the build-up of dead skin cells which clog your pores. This ingredient is exceptionally strong, and it can cause some side effects like redness, dry skin, burning or stinging and scaling. You’ll only find it in products at 2.5% to 10% strength. However, dermatologists recommend that adults stick to a low-dose of benzoyl peroxide, at around 3% for minimal irritation and to avoid bleaching your skin, hair or clothing.
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.
If you take a close look at the acne-fighting ingredients, you will find that no single ingredient does all the work to get rid of acne. Each one has a unique effect that plays a role in the elimination of acne, but only when they are used combined or in sequence in a system do they have ability to get rid of acne altogether. This is why it is so important to use an effective system for fight acne, not just a single product.
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).
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.
Misperceptions about acne's causative and aggravating factors are common, and those affected by it are often blamed for their condition.[176] Such blame can worsen the affected person's sense of self-esteem.[176] Until the 20th century, even among dermatologists, the list of causes was believed to include excessive sexual thoughts and masturbation.[165] Dermatology's association with sexually transmitted infections, especially syphilis, contributed to the stigma.[165]
This AHA 10% Skin Perfecting Cleanser is an incredible combination of Glycolic Acid and natural ingredients like rosehip oil, chamomile, seaweed extract, grapefruit seed oil and more. It doesn’t just tackle blackheads, whiteheads, and blemishes, but also smoothes out fine lines and wrinkles. If you want a high-quality product, with real and lasting results, Misumi has got you covered.
This dermatologist-tested formula is a foaming face wash that works incredibly fast. It can make skin visibly clearer in as little as 12 hours. It’s made with 2% salicylic acid, Acceladerm Technology™, and PHAs, polyhydroxy acids that open pores, improve skin moisturization and calms the skin. It unblocks pores, kills bacteria and calms and soothes the skin. This Clearasil product is guaranteed to be so good that if it doesn’t work for you, they have a 30-day money-back guarantee that you can take them up on.
Globally, acne affects approximately 650 million people, or about 9.4% of the population, as of 2010.[157] It affects nearly 90% of people in Western societies during their teenage years, but can occur before adolescence and may persist into adulthood.[18][19][22] While acne that first develops between the ages of 21 and 25 is uncommon, it affects 54% of women and 40% of men older than 25 years of age,[46][158] and has a lifetime prevalence of 85%.[46] About 20% of those affected have moderate or severe cases.[2] It is slightly more common in females than males (9.8% versus 9.0%).[157] In those over 40 years old, 1% of males and 5% of females still have problems.[19]
Microneedling is a procedure in which an instrument with multiple rows of tiny needles is rolled over the skin to elicit a wound healing response and stimulate collagen production to reduce the appearance of atrophic acne scars in people with darker skin color.[140] Notable adverse effects of microneedling include postinflammatory hyperpigmentation and tram track scarring (described as discrete slightly raised scars in a linear distribution similar to a tram track). The latter is thought to be primarily attributable to improper technique by the practitioner, including the use of excessive pressure or inappropriately large needles.[140][146]
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.
Combined oral contraceptives. Four combined oral contraceptives are approved by the FDA for acne therapy in women who also wish to use them for contraception. They are products that combine estrogen and progestin (Ortho Tri-Cyclen, Yaz, others). You may not see the benefit of this treatment for a few months, so using other acne medications with it the first few weeks may help.

Sometimes birth control alone isn’t enough to really make a difference in hormonal acne. That’s when your doctor might recommend adding in an androgen blocker such as Spironalactone. Spiro (as it’s called) minimizes the amount of androgen hormones in circulation by blocking the receptors that bind with testosterone. When these pills are taken at the same time as an oral contraceptive, 90 percent of women see an improvement in breakouts, according to Linkner. The drug is sometimes prescribed to women with PCOS (polycystic ovarian syndrome) to relieve androgen-related symptoms like excessive hair growth, hypertension, oily skin, and acne.
Acne vulgaris is a chronic skin disease of the pilosebaceous unit and develops due to blockages in the skin's hair follicles. These blockages are thought to occur as a result of the following four abnormal processes: a higher than normal amount of oily sebum production (influenced by androgens), excessive deposition of the protein keratin leading to comedo formation, colonization of the follicle by Propionibacterium acnes (P. acnes) bacteria, and the local release of pro-inflammatory chemicals in the skin.[49]
Clascoterone is a topical antiandrogen which has demonstrated effectiveness in the treatment of acne in both males and females and is currently in the late stages of clinical development.[120][121][122][123] It has shown no systemic absorption or associated antiandrogenic side effects.[122][123][124] In a direct head-to-head comparison, clascoterone showed greater effectiveness than topical isotretinoin.[122][123][124] 5α-Reductase inhibitors such as finasteride and dutasteride may be useful for the treatment of acne in both males and females, but have not been thoroughly evaluated for this purpose.[1][125][126][127] In addition, the high risk of birth defects with 5α-reductase inhibitors limits their use in women.[1][126] However, 5α-reductase inhibitors can be combined with birth control pills to prevent pregnancy, and are frequently used to treat excessive hair in women.[125] There is no evidence as of 2010 to support the use of cimetidine or ketoconazole in the treatment of acne.[128]
No one knows exactly what causes acne. Hormone changes, such as those during the teenage years and pregnancy, probably play a role. There are many myths about what causes acne. Chocolate and greasy foods are often blamed, but there is little evidence that foods have much effect on acne in most people. Another common myth is that dirty skin causes acne; however, blackheads and pimples are not caused by dirt. Stress doesn't cause acne, but stress can make it worse.

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.
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.
Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Data sources include IBM Watson Micromedex (updated 1 May 2019), Cerner Multum™ (updated 2 May 2019), Wolters Kluwer™ (updated 1 May 2019) and others.
Acne is not curable, but it is controllable. Proper acne treatment can prevent and/or improve acne scars and help you to feel and look your best. Seeing a dermatologist like Dr. Turner helps ensure that you are getting the best acne treatment available, since she makes outstanding patient care a priority. This means she listens to patients’ concerns and chooses appropriate therapies for each individual. A consultation with Dr. Turner will be comfortable, informative and respectful. To schedule a visit to discuss therapeutic options, you can book an appointment online or call the office to make an appointment at (214) 373-7546.
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
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.

We suggest avoiding spot treatments. “Benzoyl peroxide, when placed on red spots, can actually cause more irritation and inflammation to the area. It’s best used to prevent red bumps and pustules, and applied all over the area you want to treat,” said Townsend, who was also quick to naysay a spot-treat-only approach: “Acne affects all of the pores. If someone is going to spot treat against my advice, I still suggest they spot treat one day and treat the whole face the next.”
Tea Tree Oil – Another anti-bacterial ingredient that is common in over-the-counter treatments, tea tree oil combats acne-causing bacteria. While the FDA hasn’t officially approved it for acne treatment, some dermatologists say it’s almost as effective as benzoyl peroxide for clearing skin, although it doesn’t work quite as fast. It can be used for spot treatment as well.
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