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)
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.
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]
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Clascoterone is a topical antiandrogen which has demonstrated effectiveness in the treatment of acne in both males and females and is currently in the late stages of clinical development.[120][121][122][123] It has shown no systemic absorption or associated antiandrogenic side effects.[122][123][124] In a direct head-to-head comparison, clascoterone showed greater effectiveness than topical isotretinoin.[122][123][124] 5α-Reductase inhibitors such as finasteride and dutasteride may be useful for the treatment of acne in both males and females, but have not been thoroughly evaluated for this purpose.[1][125][126][127] In addition, the high risk of birth defects with 5α-reductase inhibitors limits their use in women.[1][126] However, 5α-reductase inhibitors can be combined with birth control pills to prevent pregnancy, and are frequently used to treat excessive hair in women.[125] There is no evidence as of 2010 to support the use of cimetidine or ketoconazole in the treatment of acne.[128]
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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.
A BHA product often cited includes salicylic acid, it must be between a pH between 3 and 4 to work. A BHA works to slough (to get rid of) off dead skin cells and encourage new skin growth. As a result, you may experience dry skin and scaliness around your acne, but this will dissipate over time as your skin begins to regenerate faster. Use this in a cleanser or spot treatment daily on the acne-affected areas of your skin.[6]

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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.
Isotretinoin (previously known as Accutane) is the most effective form of acne therapy and the only one that can actually result in a cure for your acne. After finishing a course 80 percent of people never see acne again. It works so well because it unclogs pores, kills bacteria, reduces oil production and reduces inflammation. It's taken as a daily pill. Isotretinoin has numerous rare and potential side effects that has made it a controversial choice, but for patients with severe acne there is often no other option. Patients taking isotretinoin must also be on highly effective birth control as the drug can cause birth defects. Isotretinoin can only be taken under close medical supervision.

Salicylic acid is a topically applied beta-hydroxy acid that stops bacteria from reproducing and has keratolytic properties.[132][133] It opens obstructed skin pores and promotes shedding of epithelial skin cells.[132] Salicylic acid is known to be less effective than retinoid therapy.[20] Dry skin is the most commonly seen side effect with topical application, though darkening of the skin has been observed in individuals with darker skin types.[1]


Coconut oil is all the rage, with uses ranging from hair conditioning to cooking. But some swear by it as a natural acne treatment. To use coconut oil as an acne treatment, you can include it as part of a healthy diet. The fatty acids like lauric acid and caprylic acid are metabolized into antibacterial agents in the body. Or, you can apply a very small amount and rub directly onto your skin after cleansing for an extra hydrating boost.
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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.
How to Handle It: Pair two of the best-known acne-fighting ingredients, salicylic acid and benzoyl peroxide, in the week leading up to your period. (If you're feeling bloated, now's the time to do it.) The combo can help prevent hormonal acne from happening in the first place. Zeichner suggests following a salicylic acid wash, like fan-favorite Neutrogena Oil-Free Acne Wash Pink Grapefruit Facial Cleanser ($7), with a benzoyl peroxide spot treatment, such as Murad Acne Spot Fast Fix ($22). If you're still seeing zits, "visit your dermatologist to discuss prescription options, like birth control pills, oral spironolactone — which blocks oil — or topical Aczone 7.5 percent gel," says Zeichner. "It's shown to be particularly effective in adult women without causing irritation." Oral contraceptives level out those hormone fluctuations, keeping your oil production normal and your skin clear.

Keep in mind that even if some products market themselves toward severe acne breakouts, all the kits we looked at are definitely designed for mild to moderate acne. Not sure if you fit on that scale? You’re not alone! When you’re in the middle of a breakout, all acne seems severe, so it can be difficult to self-diagnose your symptoms. We talked to dermatologists and cosmetic chemists to better understand the differences between the various types of acne (see below).


Scarring from severe cystic acne can have harmful effects on a person's self esteem, happiness and mental health. Thankfully, there are many different acne scar treatment options available, ranging from chemical peels and skin fillers to dermabrasion and laser resurfacing. According to the American Academy of Dermatology, these are all safe and effective acne scar treatment methods. However, Baldwin says it's important to first clarify what you mean by "scar." "Many people point to red or brown spots leftover from old zits and call them scars," she says. "These are marks, not scars and they'll fade with time. Scars have textural changes and are not flush with the surface of the skin. There are two types of acne scars—innies and outies. Outies can be injected with corticosteroids and flattened. Innies can be either deep and narrow or broad, sloping and relatively shallow. Deep and narrow scars need to be cut out, but broader sloping scars can be made better by fillers, laser resurfacing and dermabrasion."
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.[128] Hormone therapy is effective for acne even in women with normal androgen levels.[128]
Genetics is thought to be the primary cause of acne in 80% of cases.[2] The role of diet and cigarette smoking is unclear, and neither cleanliness nor exposure to sunlight appear to play a part.[2][13][14] In both sexes, hormones called androgens appear to be part of the underlying mechanism, by causing increased production of sebum.[5] Another frequent factor is excessive growth of the bacterium Cutibacterium acnes, which is normally present on the skin.[15]
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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.
C. acnes also provokes skin inflammation by altering the fatty composition of oily sebum.[45] Oxidation of the lipid squalene by C. acnes is of particular importance. Squalene oxidation activates NF-κB (a protein complex) and consequently increases IL-1α levels.[45] Additionally, squalene oxidation leads to increased activity of the 5-lipoxygenase enzyme responsible for conversion of arachidonic acid to leukotriene B4 (LTB4).[45] LTB4 promotes skin inflammation by acting on the peroxisome proliferator-activated receptor alpha (PPARα) protein.[45] PPARα increases activity of activator protein 1 (AP-1) and NF-κB, thereby leading to the recruitment of inflammatory T cells.[45] The inflammatory properties of C. acnes can be further explained by the bacterium's ability to convert sebum triglycerides to pro-inflammatory free fatty acids via secretion of the enzyme lipase.[45] These free fatty acids spur production of cathelicidin, HBD1, and HBD2, thus leading to further inflammation.[45]

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.


Microneedling is a procedure in which an instrument with multiple rows of tiny needles is rolled over the skin to elicit a wound healing response and stimulate collagen production to reduce the appearance of atrophic acne scars in people with darker skin color.[140] Notable adverse effects of microneedling include postinflammatory hyperpigmentation and tram track scarring (described as discrete slightly raised scars in a linear distribution similar to a tram track). The latter is thought to be primarily attributable to improper technique by the practitioner, including the use of excessive pressure or inappropriately large needles.[140][147]
A snoring partner can be one of the most difficult things to sleep through. Snoring tends to be position-specific so many doctors recommend switching positions to stop the snoring. Rather than sleeping on your back doctors recommend turning onto your side. Changing positions can cut down on noise and breathing difficulties for any snorer. Using a white noise fan, or sound machine can also help soften the impact of loud snoring and keep both partners undisturbed.
Hydrated skin provides the right moisture and balance the skin needs to thrive. Additionally, water helps flush out toxins, something we need on a daily basis. And those omega-3s are pretty awesome at providing a reduction in inflammation. Wild-caught salmon is one of my favorite sources, in addition to sardines, walnuts, flaxseed oil and almonds. (10)

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.
Shower twice a day. Take a shower or bath in the morning and at night. Alternatively, take a shower in the morning and then again after physical activity, like exercise, or sweating. Wash your entire body with a mild cleanser and use shampoos that limit oil production in your hair. Be sure to always shower after exercising to remove the dead skin cells your body has sloughed off through sweating.
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What to know about hormonal imbalances While it is natural to experience hormonal imbalances at certain times in life, such as puberty, menopause, and pregnancy, some hormonal changes are related to underlying medical conditions. This article looks at the causes and symptoms of hormonal imbalances in men and women, as well as treatment and home remedies. Read now
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