From the What to Expect editorial team and Heidi Murkoff, author of What to Expect the First Year. Health information on this site is based on peer-reviewed medical journals and highly respected health organizations and institutions including ACOG (American College of Obstetricians and Gynecologists), CDC (Centers for Disease Control and Prevention) and AAP (American Academy of Pediatrics), as well as the What to Expect books by Heidi Murkoff.
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.
Topical and oral preparations of nicotinamide (the amide form of vitamin B3) have been suggested as alternative medical treatments. It is thought to improve acne due to its anti-inflammatory properties, its ability to suppress sebum production, and by promoting wound healing. 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. The purported efficacy of zinc is attributed to its capacity to reduce inflammation and sebum production, and inhibit C. acnes. Antihistamines may improve symptoms among those already taking isotretinoin due to their anti-inflammatory properties and their ability to suppress sebum production.
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.
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.
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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. In normal skin, the skin cells that have died come up to the surface and exit the pore of the hair follicle. However, increased production of oily sebum in those with acne causes the dead skin cells to stick together. The accumulation of dead skin cell debris and oily sebum blocks the pore of the hair follicle, thus forming the microcomedone. This is further exacerbated by the biofilm created by C. acnes within the hair follicle. 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). In contrast, if the microcomedone occurs deep within the hair follicle, this causes the formation of a whitehead (known as a closed comedo).
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The other downside to Proactiv+ is that the bottles are small — like, half the size of Paula’s Choice small. Combine that with its recommended two or three-times daily application, and you’re going to be going through a lot of kits, which ultimately means spending more money on your treatment. If Proactiv is the only thing that works for you, it may very well be worth the investment, but we recommend starting with Paula’s Choice to see if you can get the same results at a cheaper price.
Acne, also known as acne vulgaris, is a long-term skin disease that occurs when hair follicles are clogged with dead skin cells and oil from the skin. It is characterized by blackheads or whiteheads, pimples, oily skin, and possible scarring. It primarily affects areas of the skin with a relatively high number of oil glands, including the face, upper part of the chest, and back. The resulting appearance can lead to anxiety, reduced self-esteem and, in extreme cases, depression or thoughts of suicide.
What is a pimple in the first place? A pimple is a small comedone, pustule or papule that forms a skin lesion; the more technical term is acne vulgaris. There are numerous causes, but regardless of the cause, pimples develop when the sebaceous glands (oil glands) get clogged and infected from bacteria. This is why pimples swell up and become red, pus-filled lesions on the surface, and just under the surface, of the skin. (2)
Baby acne is usually mild, and it’s limited to the face 99 percent of the time, says Teri Kahn, MD, clinical associate professor of dermatology and pediatrics at University of Maryland School of Medicine and Mt. Washington Pediatric Hospital in Baltimore. “Typically, baby acne appears in the form of little whiteheads and blackheads on the forehead, cheeks, and chin,” she says. Other skin conditions, like eczema, show up on other parts of the body.
It is widely suspected that the anaerobic bacterial species Cutibacterium acnes (formerly Propionibacterium. acnes) contributes to the development of acne, but its exact role is not well understood. There are specific sub-strains of C. acnes associated with normal skin, and moderate or severe inflammatory acne. 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. It is unclear whether eradication of the mite improves acne.
Hormonal treatments for acne such as combined birth control pills and antiandrogens may be considered a first-line therapy for acne under a number of circumstances, including when contraception is desired, when known or suspected hyperandrogenism is present, when acne occurs in adulthood, when acne flares premenstrually, and when symptoms of significant sebum production (seborrhea) are co-present. Hormone therapy is effective for acne even in women with normal androgen levels.
Side effects include increased skin photosensitivity, dryness, redness and occasional peeling. Sunscreen use is often advised during treatment, to prevent sunburn. Lower concentrations of benzoyl peroxide are just as effective as higher concentrations in treating acne but are associated with fewer side effects. Unlike antibiotics, benzoyl peroxide does not appear to generate bacterial antibiotic resistance.
Get at least eight hours of sleep. Sleeping kills two birds with one stone, as it helps to relax your body as well as detoxify it. If you aren’t getting enough sleep, chances are your skin hasn’t had the time or ability to renew its skin cells. Regulate your sleep cycle by going to bed at a consistent time every night and sleeping for a minimum of eight hours at least.
The path to clear skin is often one of trial and error; you might need to try several acne remedies before you find the right treatment for the types of acne affecting your skin. Before trying acne medication, you may prefer to give different natural acne treatment options a chance. While there's no research supporting the effective use of natural acne treatments, here are two popular options that you may want to try.
^ White, Stephen D.; Bordeau, Patrick B.; Blumstein, Philippe; Ibisch, Catherine; GuaguÈre, Eric; Denerolle, Philippe; Carlotti, Didier N.; Scott, Katherine V. (1 September 1997). "Feline acne and results of treatment with mupirocin in an open clinical trial: 25 cases (1994–96)". Veterinary Dermatology. 8 (3): 157–164. doi:10.1046/j.1365-3164.1997.d01-16.x. ISSN 1365-3164.
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.
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The relationship between diet and acne is unclear, as there is no high-quality evidence that establishes any definitive link between them. High-glycemic-load diets have been found to have different degrees of effect on acne severity. Multiple randomized controlled trials and nonrandomized studies have found a lower-glycemic-load diet to be effective in reducing acne. There is weak observational evidence suggesting that dairy milk consumption is positively associated with a higher frequency and severity of acne. Milk contains whey protein and hormones such as bovine IGF-1 and precursors of dihydrotestosterone. These components are hypothesized to promote the effects of insulin and IGF-1 and thereby increase the production of androgen hormones, sebum, and promote the formation of comedones. Available evidence does not support a link between eating chocolate or salt and acne severity. Chocolate does contain varying amounts of sugar, which can lead to a high glycemic load, and it can be made with or without milk. Few studies have examined the relationship between obesity and acne. Vitamin B12 may trigger skin outbreaks similar to acne (acneiform eruptions), or worsen existing acne, when taken in doses exceeding the recommended daily intake. Eating greasy foods does not increase acne nor make it worse.
Lavender oil is another favorite of mine, not only because it can help prevent and keeps acne at bay, but it smells amazing, and provides relaxation qualities — something much needed in today’s world. Lavender helps regenerate skin cells, minimize sun spots and even reduce scarring caused by acne. Additionally, it can help reduce swelling and inflammation that may be caused by acne due to the polysaccharides it contains. (20)
It’s no surprise that coconut oil may help since it’s so useful in just about anything. But there is a reason for this. Coconut oil contains properties that encourage the elimination of bacteria, which is why there are so many uses of coconut oil for skin. Lauric acid is the main ingredient in coconut oil, and this acid that makes it an effective treatment against acne because it provides antibacterial results. (17)
The birth control pill is another option for women suffering hormonal acne. Four types of birth control pills have been approved by the FDA for use as acne treatment, and all four are combination pills that contain both estrogen and progesterone. Talk to your doctor about how to get rid of acne using birth control and keep in mind that Ortho Tri-cyclen, Estrostep YAZ and Beyaz are the only four brands specifically FDA approved as acne remedies.
3. Self-Care: Self-care practices and lifestyle choices can also help clear complexions. Nutrition, stress management, ample sleep, and good hygiene can help treat existing acne and might be able to prevent it from forming in the first place. Self-care practices can – and should! – be used in conjunction with all skincare treatments; they even deliver health benefits for those without acne problems.
You’ve probably heard of the benefits of retinoid creams for anti-aging, but vitamin A is also efficient at clearing up acne. “[Retinoids] cause skin cells to turn over at a faster rate, decrease oil production, and help skin exfoliate,” board-certified dermatologist Rita Linkner, M.D., tells SELF. Another benefit: Acne is inflammation, and retinoids are anti-inflammatory.
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.