The severity of acne vulgaris (Gr. ἀκµή, "point" + L. vulgaris, "common") can be classified as mild, moderate, or severe as this helps to determine an appropriate treatment regimen. Mild acne is classically defined by the presence of clogged skin follicles (known as comedones) limited to the face with occasional inflammatory lesions. Moderate severity acne is said to occur when a higher number of inflammatory papules and pustules occur on the face compared to mild cases of acne and are found on the trunk of the body. Severe acne is said to occur when nodules (the painful 'bumps' lying under the skin) are the characteristic facial lesions and involvement of the trunk is extensive.
Genetics is thought to be the primary cause of acne in 80% of cases. The role of diet and cigarette smoking is unclear, and neither cleanliness nor exposure to sunlight appear to play a part. In both sexes, hormones called androgens appear to be part of the underlying mechanism, by causing increased production of sebum. Another frequent factor is excessive growth of the bacterium Propionibacterium acnes, which is normally present on the skin.
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.
Although the late stages of pregnancy are associated with an increase in sebaceous gland activity in the skin, pregnancy has not been reliably associated with worsened acne severity. In general, topically applied medications are considered the first-line approach to acne treatment during pregnancy, as they have little systemic absorption and are therefore unlikely to harm a developing fetus. Highly recommended therapies include topically applied benzoyl peroxide (category C) and azelaic acid (category B). Salicylic acid carries a category C safety rating due to higher systemic absorption (9–25%), and an association between the use of anti-inflammatory medications in the third trimester and adverse effects to the developing fetus including too little amniotic fluid in the uterus and early closure of the babies' ductus arteriosus blood vessel. Prolonged use of salicylic acid over significant areas of the skin or under occlusive dressings is not recommended as these methods increase systemic absorption and the potential for fetal harm. Tretinoin (category C) and adapalene (category C) are very poorly absorbed, but certain studies have suggested teratogenic effects in the first trimester. Due to persistent safety concerns, topical retinoids are not recommended for use during pregnancy. In studies examining the effects of topical retinoids during pregnancy, fetal harm has not been seen in the second and third trimesters. Retinoids contraindicated for use during pregnancy include the topical retinoid tazarotene, and oral retinoids isotretinoin and acitretin (all category X). Spironolactone is relatively contraindicated for use during pregnancy due to its antiandrogen effects. Finasteride is not recommended as it is highly teratogenic.
If you're willing to invest in some serious skincare to soothe your acne-prone skin woes, Lancer's blemish-control polish is a great addition to your skincare routine. This treatment can be used as an exfoliant in conjunction with the best spot treatment for your acne type to further treat severe acne and improve the overall appearance of blemishes.
Remember, when making the choice to buy a certain face wash, always consider your unique skin type. A face wash tailored to your skin type will give you the best results, and help you clear up your acne. Also, keep in mind that a good face wash is only one important step in a system of skin care for clear and healthy skin. With the right adjustments, you can achieve that glowing, beautiful skin you know you deserve.
A purifying gel cleanser made with 99.4% natural ingredients, this face wash is clinically proven to wash away excess oil, impurities and the bacteria that causes acne. It’s made with salicylic acid naturally derived from willow bark extract, evening primrose and beet root extracts that reduce acne, prevent future breakouts and calms acne prone skin. Best for oily skin types, this face wash helps to keep you oil-free without making your dry or irritated.
Considerations: Regardless of the type of antibiotic prescribed, only about one half of patients respond. When antibiotics do produce results, these results are moderate at best.5-8 Oral antibiotics should be used for only a short period of time, up to 6 months. However, even within this short time frame, antibiotics have been implicated in the proliferation of resistant colonies of bacteria. Some antibiotics cause increased sensitivity to sunlight. Exposure to the sun could cause a rash, itchiness, or redness, and you may be burnt more easily, so you'll want to wear protective clothing and sunscreen.2 Side effects may include upset stomach, diarrhea, nausea, headache, vomiting, dizziness, or light-headedness as your body becomes accustomed to it.2 Minocycline is less prescribed because it works no better than any other antibiotic and comes with safety concerns, including the possibility of irreversible skin pigmentation.8-11
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.
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.
Azelaic acid has been shown to be effective for mild to moderate acne when applied topically at a 20% concentration. Treatment twice daily for six months is necessary, and is as effective as topical benzoyl peroxide 5%, isotretinoin 0.05%, and erythromycin 2%. Azelaic acid is thought to be an effective acne treatment due to its ability to reduce skin cell accumulation in the follicle, and its antibacterial and anti-inflammatory properties. It has a slight skin-lightening effect due to its ability to inhibit melanin synthesis, and is therefore useful in treating of individuals with acne who are also affected by postinflammatory hyperpigmentation. Azelaic acid may cause skin irritation but is otherwise very safe. It is less effective and more expensive than retinoids.
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.
Corticosteroid injections may be used to treat large, painful lesions. These injections can ease the pain and help clear a large lesion more quickly. A systemic acne treatment that you may have heard about is isotretinoin (aka Accutane). This is the only medication approved by the U.S. Food and Drug Administration (FDA) to treat severe resistant nodular cystic acne, the most severe form. Dr. Turner does use Accutane in appropriate patients, however it is typically a five- to six-month course of therapy, which requires monthly office visits.
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:
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.
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.
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).
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. By interfering with new production of melanin in the epidermis, hydroquinone leads to less hyperpigmentation as darkened skin cells are naturally shed over time. 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. The use of a sunscreen with SPF 15 or higher in the morning with reapplication every two hours is recommended when using hydroquinone. 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. 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. 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. 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.
Atrophic acne scars have lost collagen from the healing response and are the most common type of acne scar (account for approximately 75% of all acne scars). They may be further classified as ice-pick scars, boxcar scars, and rolling scars. Ice-pick scars are narrow (less than 2 mm across), deep scars that extend into the dermis. Boxcar scars are round or ovoid indented scars with sharp borders and vary in size from 1.5–4 mm across. Rolling scars are wider than icepick and boxcar scars (4–5 mm across) and have a wave-like pattern of depth in the skin.
I've been using it now for quite some time (along with a few other Tracie Martyn products and the hyaluronic acid product my dermatologist recommended) and it's my new obsession. My drying, aging skin problems have cleared up. No more flaky skin. No more grease face from Pond's (my long-time love), no more tight skin feeling from the other cleansers I've tried that are really not for dry skin.
Benzoyl peroxide (BPO) is a first-line treatment for mild and moderate acne due to its effectiveness and mild side-effects (mainly skin irritation). In the skin follicle, benzoyl peroxide kills P. acnes by oxidizing its proteins through the formation of oxygen free radicals and benzoic acid. These free radicals are thought to interfere with the bacterium's metabolism and ability to make proteins. Additionally, benzoyl peroxide is mildly effective at breaking down comedones and inhibiting inflammation. Benzoyl peroxide may be paired with a topical antibiotic or retinoid such as benzoyl peroxide/clindamycin and benzoyl peroxide/adapalene, respectively.