All the dermatologists we talked to agreed that there is no one-size-fits-all solution to acne. Every patient responds to treatments differently, and sometimes it can get worse before it gets better. But with the help of your dermatologist, you can find an acne treatment regimen that works for you. And, yes, we do stress how helpful it is to work with a derm to get it right.
A nodule is an abnormal tissue growth which can either develop just below the skin or anywhere within the skin’s three layers (the epidermis, dermis, and subcutaneous tissue). Nodules commonly form in regions such as the face, neck, armpits, and groin, although they can also develop on internal organs such as the lungs, thyroid, and lymph nodes. They create solid, raised lumps that are more than 1 to 2 centimeters in diameter, with the potential to reach up to the size of a hazelnut. Nodules are hard and firm to the touch, unlike cysts whose pus makes them softer to the touch. This type of severe acne should be consulted by a doctor, as it might be indicative of a more serious condition.
Back acne (sometimes called "bacne") is a potentially embarrassing and sometimes painful condition where clogged hair follicles on the back cause pimples and blackheads. Back acne can be caused by the same factors as other types of acne: diet, hormones, certain medications, genetics or any combination thereof. But when you're considering how to get rid of back acne, also remember that most people have their back covered the majority of the day. The clothing we wear matters, and the way in which we wash the skin on our back is key for clear skin, the whole body over. Learn more about common back acne causes, the best acne products for your body, and how to prevent acne on the back from returning in this section.
Sugar: For starters, sugar can use up your valuable acne-fighting minerals, particularly zinc because it’s used to process the sugar you consume. Sugar also causes a spike in blood sugar level, leading to high insulin levels, which creates increased sebum production and blocked pores. Additionally, studies show that sugar also has an inflammatory effect which can worsen existing acne. Steer clear of sweets like cookies and cakes, but don’t worry – chocolate is considered safe for skin.
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. There is no universally accepted scale for grading acne severity. 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.
You've probably seen the Proactiv clear skin system advertised on television at some point over the last several years, but does it work? Proactiv is one of the better acne remedies out there for mild cases of inflammatory and noninflammatory acne, hormonal acne and adult acne. The starter kit comes with a gentle benzoyl peroxide exfoliating cleanser, a glycolic acid pore cleanser, and a benzoyl peroxide repairing 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.
Scientists initially hypothesized that acne represented a disease of the skin's hair follicle, and occurred due to blockage of the pore by sebum. During the 1880s, bacteria were observed by microscopy in skin samples affected by acne and were regarded as the causal agents of comedones, sebum production, and ultimately acne. During the mid-twentieth century, dermatologists realized that no single hypothesized factor (sebum, bacteria, or excess keratin) could completely explain the disease. This led to the current understanding that acne could be explained by a sequence of related events, beginning with blockage of the skin follicle by excessive dead skin cells, followed by bacterial invasion of the hair follicle pore, changes in sebum production, and inflammation.
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).
Apricot seeds may be a great option for how to get rid of pimples. A recent study published in Phytotherapy Research notes that the phytonutrients and antimicrobial qualities of apricot essential oil obtained from apricot seeds may help provide glowing skin. Apricot essential oil showed antimicrobial activity against a range of bacteria and yeasts that were tested, indicating its possible benefits to prevent and minimize acne. (18)
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.