Acne scars are caused by inflammation within the dermal layer of skin and are estimated to affect 95% of people with acne vulgaris. The scar is created by abnormal healing following this dermal inflammation. Scarring is most likely to take place with severe acne, but may occur with any form of acne vulgaris. Acne scars are classified based on whether the abnormal healing response following dermal inflammation leads to excess collagen deposition or loss at the site of the acne lesion.
If you have acne that's not responding to self-care and over-the-counter treatments, make an appointment with your doctor. Early, effective treatment of acne reduces the risk of scarring and of lasting damage to your self-esteem. After an initial examination, your doctor may refer you to a specialist in the diagnosis and treatment of skin conditions (dermatologist).
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.
Baby acne generally goes away on its own after a month or so. As far as actual baby acne treatment, your pediatrician may suggest that you wash your baby’s face with warm water and a gentle soap, says Dr. Kahn. (There is no proof that breast milk, which some moms swear by as a homeopathic remedy, actually works.) Don’t pick at your baby’s acne; you’ll cause scarring, she warns.
The use of antimicrobial peptides against C. acnes is under investigation as a treatment for acne to overcoming antibiotic resistance. In 2007, the first genome sequencing of a C. acnes bacteriophage (PA6) was reported. The authors proposed applying this research toward development of bacteriophage therapy as an acne treatment in order to overcome the problems associated with long-term antibiotic therapy such as bacterial resistance. Oral and topical probiotics are also being evaluated as treatments for acne. Probiotics have been hypothesized to have therapeutic effects for those affected by acne due to their ability to decrease skin inflammation and improve skin moisture by increasing the skin's ceramide content. As of 2014, studies examining the effects of probiotics on acne in humans were limited.
Dermatologists aren’t sure why azelaic acid is so effective at clearing up inflammation, but it’s often used as an option for sensitive skin or pregnant patients. Linkner says the ingredient is good at treating malasma, acne, and rosacea. Your dermatologist can prescribe a foam product with azelaic acid, and you can also find beauty products with very small amounts of this active ingredient.
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.