Chemical peels can be used to reduce the appearance of acne scars. Mild peels include those using glycolic acid, lactic acid, salicylic acid, Jessner's solution, or a lower concentrations (20%) of trichloroacetic acid. These peels only affect the epidermal layer of the skin and can be useful in the treatment of superficial acne scars as well as skin pigmentation changes from inflammatory acne. Higher concentrations of trichloroacetic acid (30–40%) are considered to be medium-strength peels and affect skin as deep as the papillary dermis. Formulations of trichloroacetic acid concentrated to 50% or more are considered to be deep chemical peels. Medium-strength and deep-strength chemical peels are more effective for deeper atrophic scars, but are more likely to cause side effects such as skin pigmentation changes, infection, and small white superficial cysts known as milia.
Antibiotics are an acne treatment used to kill acne-causing bacteria. They may be applied directly on the skin (topical) or taken by mouth (oral). Topical antibiotics kill bacteria in the upper portion of your pores, while oral antibiotics can reach to the lower depths of the pores. Antibiotics used for acne treatment include clindamycin or tetracyclines like doxycycline or minocycline. These antibiotics are the most effective for treating acne because they both kill bacteria and act as anti-inflammatory agents to calm down the skin.
There are several low-level light devices designed as at-home acne remedies on the market—but do they really work? Some, like the Zeno electronic "zit-zapper" are FDA-approved as acne remedies, but reviews with these products are typically mixed. Even the best acne treatment won't work for everyone, as the severity of the acne, types of acne and quality of the device are all factors. Ask your dermatologist for a recommendation if you're considering purchasing an at-home light device to treat your acne.
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Many treatment options for acne are available, including lifestyle changes, medications, and medical procedures. Eating fewer simple carbohydrates such as sugar may help. Treatments applied directly to the affected skin, such as azelaic acid, benzoyl peroxide, and salicylic acid, are commonly used. Antibiotics and retinoids are available in formulations that are applied to the skin and taken by mouth for the treatment of acne. However, resistance to antibiotics may develop as a result of antibiotic therapy. Several types of birth control pills help against acne in women. Isotretinoin pills are usually reserved for severe acne due to greater potential side effects. Early and aggressive treatment of acne is advocated by some in the medical community to decrease the overall long-term impact to individuals.
How to Handle It: Consider salicylic acid your secret weapon. "This beta hydroxy acid helps remove excess oil and exfoliate dead cells from the skin's surface to keep pores clear," says Zeichner. Try Clinique's Acne Solution Clearing Gel, a two-time Best of Beauty winner that packs both salicylic acid and sea whip extract — an ingredient with skin-soothing properties — to help counteract the dryness sometimes caused by salicylic acid. The formula does double duty: It works as a spot treatment for mild to moderate acne and as a nightly allover treatment for pimple prevention. And since it dries clear, you can wear it to fight zits whenever, wherever.
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Salicylic acid and azelaic acid. Azelaic acid is a naturally occurring acid found in whole-grain cereals and animal products. It has antibacterial properties. A 20 percent azelaic acid cream seems to be as effective as many conventional acne treatments when used twice a day for at least four weeks. It's even more effective when used in combination with erythromycin. Prescription azelaic acid (Azelex, Finacea) is an option during pregnancy and while breast-feeding. Side effects include skin discoloration and minor skin irritation.
For UVA protection, a sunscreen with a high UVA protection of PA+++ or higher of PA++++ as recommended, especially to treat PIE. PPD is the UVA equivalent of SPF; use a sunscreen with a minimum of PPD20. The PA+ system has a + that corresponds to a tier of PPD protection. Of note, different countries use different PA systems. Japan and Taiwan changed their PA system to a 4+ tier system while Korea uses a 3+ tier system.
In 2015, acne was estimated to affect 633 million people globally, making it the 8th most common disease worldwide. Acne commonly occurs in adolescence and affects an estimated 80–90% of teenagers in the Western world. Lower rates are reported in some rural societies. Children and adults may also be affected before and after puberty. Although acne becomes less common in adulthood, it persists in nearly half of affected people into their twenties and thirties and a smaller group continue to have difficulties into their forties.
How to Handle It: Your best bet is benzoyl peroxide. "Benzoyl peroxide can kill acne-causing bacteria and reduce inflammation," says Zeichner. Try a cream like the La Roche-Posay Effaclar Duo Dual-Action Acne Treatment ($37), which also exfoliates with lipo-hydroxy acid. Be aware that it can seriously dry out skin so moisturize well after you use it.
Acne removal: Your dermatologist may perform a procedure called “drainage and extraction” to remove a large acne cyst. This procedure helps when the cyst does not respond to medicine. It also helps ease the pain and the chance that the cyst will leave a scar. If you absolutely have to get rid of a cyst quickly, your dermatologist may inject the cyst with medicine.