A study conducted by the Department of Dermatology at the University of Freiburg in Germany reports that using frankincense and five other plant extracts for antimicrobial effects on bacteria and yeast relating to the skin proved effective. The study concluded that their antimicrobial effects were powerful enough to be used as a topical treatment of some skin disorders, including acne and eczema. (19) 
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Simple alcohols like isopropyl alcohol, SD alcohol, and denatured alcohol are everywhere in acne treatment because they trick you into thinking they’re working: Splash some on and any oil on your face instantly vaporizes. However, these ingredients destroy the skin’s barrier, called the acid mantle. When your acid mantle is damaged, you’re actually more susceptible to breakouts, enlarged pores, and inflammation. To make matters worse, evaporating all the oil on your face can actually set your sebaceous glands into overdrive, leaving your skin oilier than ever. If any product included a simple alcohol high up in its ingredients list, we nixed its whole kit.
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Pustules are another form of moderate acne very similar to papules. The difference is that pustules are filled with liquid pus, giving them a white or yellowish appearance akin to blisters. They’re accompanied by surrounding inflammation and are usually tender and hard (but not as hard as papules). Pustules appear when white blood cells attempt to fight off infection within a given area.
Acne vulgaris and its resultant scars have been associated with significant social and academic difficulties that can last into adulthood, including difficulties obtaining employment.[31][178] 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.[166] 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.[166]
Everything you need to know about blackheads Blackheads are small lesions that often appear on the face or neck. They are a feature of mild acne, and handling blackheads in the right way can help to prevent the acne from becoming more severe. We look at ways to reduce and treat breakouts. Learn more about what causes blackheads and how to get rid of them here. Read now
The relationship between diet and acne is unclear, as there is no high-quality evidence that establishes any definitive link between them.[52] High-glycemic-load diets have been found to have different degrees of effect on acne severity.[7][53][54] Multiple randomized controlled trials and nonrandomized studies have found a lower-glycemic-load diet to be effective in reducing acne.[53] There is weak observational evidence suggesting that dairy milk consumption is positively associated with a higher frequency and severity of acne.[51][52][53][55][56] Milk contains whey protein and hormones such as bovine IGF-1 and precursors of dihydrotestosterone.[53] 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.[53] Available evidence does not support a link between eating chocolate or salt and acne severity.[52][55] 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.[2] Vitamin B12 may trigger skin outbreaks similar to acne (acneiform eruptions), or worsen existing acne, when taken in doses exceeding the recommended daily intake.[57] Eating greasy foods does not increase acne nor make it worse.[58][59]
Believe it or not, as with adolescent acne, hormones are believed to be mainly to blame. In the case of newborns, however, it’s not their own hormones that are probably prompting the pimple problems, but Mom's — which are still circulating in baby's bloodstream as a holdover from pregnancy. These maternal hormones stimulate baby's sluggish oil-producing glands, causing pimples to pop up on the chin, forehead, eyelids and cheeks (and, sometimes, the head, neck, back and upper chest).

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.
Medical conditions that commonly cause a high-androgen state, such as polycystic ovary syndrome, congenital adrenal hyperplasia, and androgen-secreting tumors, can cause acne in affected individuals.[45][46] Conversely, people who lack androgenic hormones or are insensitive to the effects of androgens rarely have acne.[45] An increase in androgen and oily sebum synthesis may be seen during pregnancy.[46][47] Acne can be a side effect of testosterone replacement therapy or of anabolic steroid use.[1][48] Over-the-counter bodybuilding and dietary supplements are commonly found to contain illegally added anabolic steroids.[1][49]
Blackheads appear as small black dots on the skin. They usually occur on the face – especially the nose and T-Zone – but can also be seen on the back, neck, chest, shoulders and arms. Blackheads are one of two types of comedones, or acne lesions caused by clogged pores. Blackhead comedones are open versus closed, leaving the plug at the top of the clogged pore exposed to air on the skin’s surface. It’s this exposure to oxygen that accounts for their color, which can not only be black but also gray, yellow or brown. When melanin – a pigment produced by oil glands and found within sebum – makes contact with air, it oxidizes and turns dark. Blackheads are a mild, usually painless form of acne, as there’s less inflammation associated with this type of lesion.

Oral antibiotics are recommended for no longer than three months as antibiotic courses exceeding this duration are associated with the development of antibiotic resistance and show no clear benefit over shorter courses.[87] Furthermore, if long-term oral antibiotics beyond three months are thought to be necessary, it is recommended that benzoyl peroxide and/or a retinoid be used at the same time to limit the risk of C. acnes developing antibiotic resistance.[87]
Isotretinoin is an oral retinoid that is very effective for severe nodular acne, and moderate acne that is stubborn to other treatments.[1][20] One to two months use is typically adequate to see improvement. Acne often resolves completely or is much milder after a 4–6 month course of oral isotretinoin.[1] After a single course, about 80% of people report an improvement, with more than 50% reporting complete remission.[20] About 20% of patients require a second course.[20] Concerns have emerged that isotretinoin use is linked with an increased risk of adverse effects, like depression, suicidality, anemia, although there is no clear evidence to support some of these claims.[1][20] Isotretinoin is superior to antibiotics or placebo in reducing acne lesions.[17] The frequency of adverse events was about twice as high with isotretinoin, although these were mostly dryness-related events.[17] No increased risk of suicide or depression was conclusively found.[17] Isotretinoin use in women of childbearing age is regulated due to its known harmful effects in pregnancy.[20] For such a woman to be considered a candidate for isotretinoin, she must have a confirmed negative pregnancy test and use an effective form of birth control.[20] In 2008, the United States started the iPLEDGE program to prevent isotretinoin use during pregnancy.[85] iPledge requires the woman under consideration for isotretinoin therapy to have two negative pregnancy tests and mandates the use of two types of birth control for at least one month before therapy begins and one month after therapy is complete.[85] The effectiveness of the iPledge program has been questioned due to continued instances of contraception nonadherence.[85][86]
1. Topical Treatment: This refers to acne medications which are applied directly onto the skin, such as creams, gels, serums and ointments. Topical treatments can be found over-the-counter (OTC) or at a pharmacy when prescribed by a doctor. If you’re shopping for topical treatment solutions, look for products that contain acne-fighting ingredients such as salicylic acid, benzoyl peroxide, and glycolic acid that can penetrate pores to loosen and dissolve debris. Topical solutions are generally best suited to treat mild to moderate acne. 2. Systematic Treatment: Systemic acne medications are consumed orally, such as antibiotics or hormone pills, and work from the inside out to help clear your complexion. Antibiotics can help kill the bacteria lodged within infected pores to reduce inflammation, redness and swelling. Hormones pills such as birth control are frequently used to regulate androgen levels and treat hormonal acne. You won’t be able to purchase systemic treatments OTC and will need a doctor’s recommendation for these medications. 
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Finally, we included light therapy devices that treat acne. These are not the laser devices that the dermatologist uses. Instead, these are tools you can use at home to clear up your skin. They usually work best on your face where there is less tissue for the light to penetrate. Plus, you can treat yourself with light therapy at the same time you use salicylic acid or benzoyl peroxide, too.
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Some people swear by the disinfecting power of tea tree oil for acne treatment. It can be applied either full strength or slightly diluted with water directly onto pimples. Use a small amount on a clean cotton swab or cotton pad and dab on the affected areas immediately after cleansing. Because tea tree oil can be drying, you might choose to use both tea tree oil and coconut oil for acne as part of your clear skin regimen.
Toothpaste is a good option if you have a mammoth pimple that you want to take care of quickly. It is effective because it contains silica, which is the same substance that can be found in bags of beef jerky to keep moisture out. As such, toothpaste has been know to dry out and reduce the size of pimples over night. Simply apply some to the affected area before sleep and wash it off in the morning.
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The severity of acne vulgaris (Gr. ἀκµή, "point" + L. vulgaris, "common")[24] can be classified as mild, moderate, or severe as this helps to determine an appropriate treatment regimen.[20] There is no universally accepted scale for grading acne severity.[15] Mild acne is classically defined by the presence of clogged skin follicles (known as comedones) limited to the face with occasional inflammatory lesions.[20] 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.[20] 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.[20][25]

In women, acne can be improved with the use of any combined birth control pill.[89] These medications contain an estrogen and a progestin.[90] They work by decreasing the production of androgen hormones by the ovaries and by decreasing the free and hence biologically active fractions of androgens, resulting in lowered skin production of sebum and consequently reduced acne severity.[10][91] First-generation progestins such as norethindrone and norgestrel have androgenic properties and can worsen acne.[15] Although oral estrogens can decrease IGF-1 levels in some situations and this might be expected to additionally contribute to improvement in acne symptoms,[92][93] combined birth control pills appear to have no effect on IGF-1 levels in fertile women.[90][94] However, cyproterone acetate-containing birth control pills have been reported to decrease total and free IGF-1 levels.[95] Combinations containing third- or fourth-generation progestins including desogestrel, dienogest, drospirenone, or norgestimate, as well as birth control pills containing cyproterone acetate or chlormadinone acetate, are preferred for women with acne due to their stronger antiandrogenic effects.[96][97][98] Studies have shown a 40 to 70% reduction in acne lesions with combined birth control pills.[91] A 2014 review found that antibiotics by mouth appear to be somewhat more effective than birth control pills at decreasing the number of inflammatory acne lesions at three months.[99] However, the two therapies are approximately equal in efficacy at six months for decreasing the number of inflammatory, non-inflammatory, and total acne lesions.[99] The authors of the analysis suggested that birth control pills may be a preferred first-line acne treatment, over oral antibiotics, in certain women due to similar efficacy at six months and a lack of associated antibiotic resistance.[99]
Wear sunscreen everyday and do not tan. Ultraviolet Radiation is the number one cause of premature aging. It also leads to skin cancer in high enough doses. Treat the sun like the death ray that it is. Exposing your skin to harmful UVA and UVB rays damages skin and prolongs post inflammatory erythema(PIE)--red acne marks, as the sunlight stimulates pigment-producing cells.

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This article was medically reviewed by Hilary Baldwin, MD. Baldwin, medical director of the Acne Treatment Research Center, is a board-certified dermatologist with nearly 25 years of experience. Her area of expertise and interest are acne, rosacea and keloid scars. Baldwin received her BA and MA in biology from Boston University. She became a research assistant at Harvard University before attending Boston University School of Medicine. She then completed a medical internship at Yale New Haven Hospital before becoming a resident and chief resident in dermatology at New York University Medical Center. 

Chemical peels can be used to reduce the appearance of acne scars.[32] 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.[32] Higher concentrations of trichloroacetic acid (30–40%) are considered to be medium-strength peels and affect skin as deep as the papillary dermis.[32] Formulations of trichloroacetic acid concentrated to 50% or more are considered to be deep chemical peels.[32] 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.[32]
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.
Wear sunscreen everyday and do not tan. Ultraviolet Radiation is the number one cause of premature aging. It also leads to skin cancer in high enough doses. Treat the sun like the death ray that it is. Exposing your skin to harmful UVA and UVB rays damages skin and prolongs post inflammatory erythema(PIE)--red acne marks, as the sunlight stimulates pigment-producing cells.
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.
Accutane is especially good for cystic acne in women and body acne in men. “Oral vitamin A basically shuts down your sebaceous glands. If you suppress [them] for a long enough period, you can cure someone of their acne, and about 50 percent do hit that cure rate,” says Linkner. A course of Accutane can take about six to nine months. Sometimes patients need to repeat the course at a higher dosage in order to truly eliminate acne.
That’s good news because the British Medical Journal reports that acne affects more than 80 percent of teenagers and continues in adult life in 3 percent of men and 12 percent of women. In fact, it seems to be increasing, which could be due to autoimmune disease, leaky gut syndrome or allergies, for example. Hormonal factors may play a role in breakouts as well. (1)
Most people find themselves suffering from an acne outbreak at some point usually during their adolescence when they go through puberty. Whether it's due to hormones or stress. Contrary to popular belief, pimples don't necessarily mean your skin is dirty or unclean — in fact, over-cleansing can irritate your skin even more. However, hormones aren't uncontrollable, and there are simple changes you can make to eliminate your breakouts. You can have your glowing, healthy, and pimple-free skin back in no time.
Hormonal fluctuations and an imbalance of estrogen and testosterone levels have proven to be a direct cause of acne. For this reason, many experience an onslaught of breakouts during puberty and pregnancy. The brain releases a GnRH hormone when an adolescent begins puberty, which in turn signals the pituitary gland to release two additional androgens. Androgens make the sebaceous glands produce more sebum, causing it to occupy too much space within the pore and preventing the full expulsion of dead skin cells and debris. Fluctuations in hormones also cause many women to experience acne during pregnancy and a worsening of breakouts during menstrual cycles.
Antiandrogens such as cyproterone acetate and spironolactone have been used successfully to treat acne, especially in women with signs of excessive androgen production such as increased hairiness or skin production of sebum, or baldness.[10][47] Spironolactone is an effective treatment for acne in adult women, but unlike combined birth control pills, is not approved by the United States Food and Drug Administration for this purpose.[1][36][100] The medication is primarily used as an aldosterone antagonist and is thought to be a useful acne treatment due to its ability to additionally block the androgen receptor at higher doses.[36] Alone or in combination with a birth control pill, spironolactone has shown a 33 to 85% reduction in acne lesions in women.[91] The effectiveness of spironolactone for acne appears to be dose-dependent.[91] High-dose cyproterone acetate alone has been found to decrease symptoms of acne in women by 75 to 90% within 3 months.[101] It is usually combined with an estrogen to avoid menstrual irregularities and estrogen deficiency.[102] The medication has also been found to be effective in the treatment of acne in males, with one study finding that a high dosage reduced inflammatory acne lesions by 73%.[103][104] However, the side effects of cyproterone acetate in males, such as gynecomastia, sexual dysfunction, and decreased bone mineral density, make its use for acne in this sex impractical in most cases.[103][104][105] Hormonal therapies should not be used to treat acne during pregnancy or lactation as they have been associated with birth disorders such as hypospadias, and feminization of the male babies.[47] In addition, women who are sexually active and who can or may become pregnant should use an effective method of contraception to prevent pregnancy while taking an antiandrogen.[106] Antiandrogens are often combined with birth control pills for this reason, which can result in additive efficacy.[36][107]
Acne appears when a pore in our skin clogs. This clog begins with dead skin cells. Normally, dead skin cells rise to surface of the pore, and the body sheds the cells. When the body starts to make lots of sebum (see-bum), oil that keeps our skin from drying out, the dead skin cells can stick together inside the pore. Instead of rising to the surface, the cells become trapped inside the pore.
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