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 earliest pathologic change is the formation of a plug (a microcomedone), which is driven primarily by excessive growth, reproduction, and accumulation of skin cells in the hair follicle.[1] In normal skin, the skin cells that have died come up to the surface and exit the pore of the hair follicle.[10] However, increased production of oily sebum in those with acne causes the dead skin cells to stick together.[10] The accumulation of dead skin cell debris and oily sebum blocks the pore of the hair follicle, thus forming the microcomedone.[10] This is further exacerbated by the biofilm created by P. acnes within the hair follicle.[44] If the microcomedone is superficial within the hair follicle, the skin pigment melanin is exposed to air, resulting in its oxidation and dark appearance (known as a blackhead or open comedo).[1][10][19] In contrast, if the microcomedone occurs deep within the hair follicle, this causes the formation of a whitehead (known as a closed comedo).[1][10]
Considerations: Despite the frequent referencing of an initial flare of acne when starting is tretinoin, there is no scientific evidence to back this up. You should not expect an initial worsening of acne.3-4 Exposure to sunlight should be minimized as you may be more sensitive to its rays. Ask your doctor before using other medication on the skin, especially anything containing sulfur, resorcinol, or salicylic acid, as the combination may be too irritating. Abrasive soaps and cleansers should be used with caution for the same reason. Side effects can include skin irritation, swelling, lightening or darkening of the skin, an increase in acne sores, excessive redness, and crusted or blistered skin.
The key is patience — don’t pick up a new cleanser and expect to see dramatic results right away. While you may be able to spot-treat a pimple or two overnight, it can take weeks before you really see a difference from switching cleansers. “It’s about trying different brands with different strengths and giving it sufficient time to work,” says Anna Avaliani, MD, a cosmetic and laser skin care specialist in NYC.
How to Handle It: Speaking of touching, don't! Picking it, squeezing it, or poking at it will only worsen the situation. These may disappear on their own after a few days. Otherwise, Zeichner suggests visiting your dermatologist for a shot of cortisone, which will reduce inflammation and shrink it in just 24 to 48 hours. But if a last-minute appointment isn't in the cards, play mad scientist. First, ice the area, and then apply salicylic acid gel, benzoyl peroxide gel, and 1 percent hydrocortisone cream. The combo will calm skin, kill bacteria, and draw out excess oil from the pimple — all things necessary to take this down, says Zeichner.
What it does: Benzoyl peroxide is the only known substance which can bring oxygen under the skin surface. Since bacteria cannot survive in the presence of oxygen, when used in an adequate dosage, benzoyl peroxide eradicates 99.9% of these bacteria almost immediately. It also exerts a mild drying and peeling effect, which is thought to help prevent breakouts.1-6 Benzoyl peroxide also helps lessen inflammation.7-9 2.5% benzoyl peroxide is just as effective as higher concentrations with less side effects.6,10

The Daily Skin Clearing Treatment is an all-over 2.5 percent benzoyl peroxide cream that also touts calming bisabolol and allantoin to alleviate the dryness and irritation that can crop up mid-treatment. Anyone frustrated with oil-slick skin will also love this part of the regimen — it creates a satin mattifying effect, instantly transforming shininess into a glow.
The 2-in-1 product is intended for simultaneous care of the skin of the face and the whole body. The regular applying has an effective influence on the skin in the fight against acne. The curative effect is achieved due to the presence of Benzoyl Peroxide. The active substance reduces sebum production, minimizes the number of pimples, controls water balance, and reduces the risk of acne in the future.
Low concentrations of salicylic acid, like 0.5 percent, are perfect for people who have both acne and sensitive skin. If you have sensitive skin, you know that most of the “best” acne medications just don’t work for you because they are too strong. Products that are too strong for you can cause increased inflammation, which can actually lead to more acne rather than less. Because of this, salicylic acid is our number one recommendation for sensitive skin.

Clean your face really well using a mild face cleanser and gently pat dry. Let your skin further air dry and don’t put anything else on it. Don’t put anything else on your face like moisturizer, serum, toner, etc. After a half hour, carefully check your cheeks, chin, forehead and nose, with a hand mirror, for any shine. Also, check if your skin feels tight when you smile or make exaggerated facial expressions.
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.

Properly selected face cleanser will help rid your skin of bacteria that clog pores and multiply in them. High-quality face cleaning also removes dead skin cells, making acne treatment more effective. It will take a strong but gentle remedy to remove dirt without new irritations. Therefore, you should avoid abrasive scrubs and soaps for the face, which can deprive the skin of its natural oils and may cause the painful irritation.

Acne vulgaris and its resultant scars have been associated with significant social and academic difficulties that can last into adulthood, including difficulties obtaining employment.[30][177] Until the 1930s, it was largely seen as a trivial problem among middle-class girls – a trivial problem, because, unlike smallpox and tuberculosis, no one died from it, and a feminine problem, because boys were much less likely to seek medical assistance for it.[165] During the Great Depression, dermatologists discovered that young men with acne had difficulty obtaining jobs, and during World War II, some soldiers in tropical climates developed such severe and widespread tropical acne on their bodies that they were declared medically unfit for duty.[165]


Considerations: Despite the frequent referencing of an initial flare of acne when starting is tretinoin, there is no scientific evidence to back this up. You should not expect an initial worsening of acne.3-4 Exposure to sunlight should be minimized as you may be more sensitive to its rays. Ask your doctor before using other medication on the skin, especially anything containing sulfur, resorcinol, or salicylic acid, as the combination may be too irritating. Abrasive soaps and cleansers should be used with caution for the same reason. Side effects can include skin irritation, swelling, lightening or darkening of the skin, an increase in acne sores, excessive redness, and crusted or blistered skin.
It is important to also note that thehealthbase.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for website owners to earn advertising fees by advertising and linking to amazon.com, endless.com, smallparts.com, myhabit.com, and any other website that may be affiliated with Amazon Service LLC Associates Program.
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).[31][32] They may be further classified as ice-pick scars, boxcar scars, and rolling scars.[30] Ice-pick scars are narrow (less than 2 mm across), deep scars that extend into the dermis.[31] Boxcar scars are round or ovoid indented scars with sharp borders and vary in size from 1.5–4 mm across.[31] Rolling scars are wider than icepick and boxcar scars (4–5 mm across) and have a wave-like pattern of depth in the skin.[31]

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.
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.
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.
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.
A major mechanism of acne-related skin inflammation is mediated by P. acnes's ability to bind and activate a class of immune system receptors known as toll-like receptors (TLRs), especially TLR2 and TLR4.[44][64][65] Activation of TLR2 and TLR4 by P. acnes leads to increased secretion of IL-1α, IL-8, and TNF-α.[44] Release of these inflammatory signals attracts various immune cells to the hair follicle including neutrophils, macrophages, and Th1 cells.[44] IL-1α stimulates increased skin cell activity and reproduction, which in turn fuels comedo development.[44] Furthermore, sebaceous gland cells produce more antimicrobial peptides, such as HBD1 and HBD2, in response to binding of TLR2 and TLR4.[44]

Azelaic acid has been shown to be effective for mild to moderate acne when applied topically at a 20% concentration.[66][129] Treatment twice daily for six months is necessary, and is as effective as topical benzoyl peroxide 5%, isotretinoin 0.05%, and erythromycin 2%.[130] 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.[66] 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.[1] Azelaic acid may cause skin irritation but is otherwise very safe.[131] It is less effective and more expensive than retinoids.[1]
For female adult patients, one medication that Dr. Turner often recommends is spironolactone. Many patients consider it the “miracle drug.” When used at low doses, such as 50 to 150mg per day, the androgen hormones are not cycling so rapidly, which in turn helps to relieve cystic acne, especially located on the lower cheeks, jawline and neck regions. Interestingly, spironolactone is an older drug that has been used since the ’50s, but at different doses, it acts by a completely different mechanism. Thus, it is as though it is two completely different drugs, depending on the dose, but it has the same name. The only negative aspect of spironolactone dosing at these levels is that a woman should never get pregnant while medicating with this due to ambiguity in the fetal genitalia.
Active Ingredients Check the product label for key active ingredients like salicylic acid or benzoyl peroxide, advises dermatologist Sandy Skotnicki, MD, founder of Toronto's Bay Dermatology Centre and author of the skincare book Beyond Soap. Other ingredients to look for include oils that can help to moisturize skin — just make sure the package says non-comedogenic, which means that it won’t clog pores.
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

Some acne cleansers and face soaps have added ingredients to fight acne and improve the skin's appearance. Medicated cleansers contain acne-fighting ingredients like salicylic acid, sodium sulfacetamide, or benzoyl peroxide, which can help clear up skin while cleaning it. Salicylic acid helps clear blocked pores and reduces swelling and redness. Benzoyl peroxide exfoliates the skin and kills bacteria. Sodium sulfacetamide interferes with the growth of bacteria.


Blue light rays penetrate follicles to kill off acne-causing bacteria. For severe cases, photodynamic therapy adds a topical solution called Levulan to blue light therapy. Note that these treatments can cause temporary redness and may not be covered by insurance. Prices vary greatly depending on the location and severity of acne, but can cost at least $50 for one blue light treatment and $100 or more per photodynamic therapy session. Most patients will need multiple treatments to see effective results, but many dermatologists offer package deals.

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 2-in-1 product is intended for simultaneous care of the skin of the face and the whole body. The regular applying has an effective influence on the skin in the fight against acne. The curative effect is achieved due to the presence of Benzoyl Peroxide. The active substance reduces sebum production, minimizes the number of pimples, controls water balance, and reduces the risk of acne in the future.
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.
The best acne treatment system will include a cleanser, exfoliant and a treatment product that can be used daily. The idea is to have a product that cleans and clears clogged pores, kills bacteria, exfoliates to remove dead cells and spot treats trouble spots to combat stubborn blemishes and reduces inflammation and redness. For those with oily skin, a toner may be useful. For those with black heads, deep cleansing pore strips will help. If you have dry skin, foaming face wash would be something you want to avoid. The point is, a carefully tailored system is the best approach to an effective acne treatment.
How to Handle It: Think of these as bigger, pissed-off whiteheads. Your best bet, says Zeichner, is to stock up on benzoyl peroxide, which kills the bacteria. A spot treatment like Murad Acne Spot Fast Fix ($22) should do the trick. Also, try not to pop them — as tempting as that may be. Since they're inflamed, they're more likely to scar if you go the DIY route.
Benzoyl peroxide is an antibacterial ingredient, and it’s very effective at killing the P. acnes bacteria that causes breakouts. But benzoyl isn’t without its downsides. The leave-on creams and cleansing treatments can dry out sensitive skin types and bleach clothing if you aren’t careful. Board-certified dermatologist Eric Meinhardt, M.D., previously told SELF that it's best to stick to formulations that have no more than 2 percent of benzoyl peroxide listed on the active ingredients chart; stronger concentrations are harder on your skin without being any tougher on bacteria.
For the purpose of sending out invitations to special events/promotions, personalized services in store and profiled marketing offers through email, SMS, letters, telephone, WeChat, Whatsapp and other social media. The legal basis is that the processing is necessary in order for us to be able to fulfill our contractual obligations to you under the Membership Policy.
×