Acne medications work by reducing oil production, speeding up skin cell turnover, fighting bacterial infection or reducing inflammation — which helps prevent scarring. With most prescription acne drugs, you may not see results for four to eight weeks, and your skin may get worse before it gets better. It can take many months or years for your acne to clear up completely.
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.
Any acne treatment is a weeks-long experiment that you’re conducting with your skin. Acne is slow to heal, and in some cases, it can get worse before it gets better (nearly every benzoyl peroxide product we looked at emphasized the likeliness of irritating acne further, and starting off with a lighter application). April W. Armstrong, a doctor at the University of California Davis Health System, recommends waiting at least one month before you deem a product ineffective.
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. 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.
Acne removal: Your dermatologist may perform a procedure called “drainage and extraction” to remove a large acne cyst. This procedure helps when the cyst does not respond to medicine. It also helps ease the pain and the chance that the cyst will leave a scar. If you absolutely have to get rid of a cyst quickly, your dermatologist may inject the cyst with medicine.