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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There are a number of mild chemical peels available over the counter, but acne scar removal requires a stronger peel typically administered by a doctor or dermatologist. Trichloroacetic acid (TCA) peels are slightly stronger than alpha hydroxy acid (AHA) peels and may be used for acne scar treatment. The strongest type, phenol peels, may cause significant swelling and require up to two weeks of recovery time at home. Neither are recommended for people with active severe acne.
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]

^ Jump up to: a b c Zaenglein, AL; Graber, EM; Thiboutot, DM (2012). "Chapter 80 Acne Vulgaris and Acneiform Eruptions". In Goldsmith, Lowell A.; Katz, Stephen I.; Gilchrest, Barbara A.; Paller, Amy S.; Lefell, David J.; Wolff, Klaus (eds.). Fitzpatrick's Dermatology in General Medicine (8th ed.). New York: McGraw-Hill. pp. 897–917. ISBN 978-0-07-171755-7.
Acne scars are caused by inflammation within the dermal layer of skin and are estimated to affect 95% of people with acne vulgaris.[31] The scar is created by abnormal healing following this dermal inflammation.[32] Scarring is most likely to take place with severe acne, but may occur with any form of acne vulgaris.[31] 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.[33]
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Green Tea: Green tea delivers a multitude of benefits, including lower blood pressure, reduced cholesterol levels, improved bone density, improved memory and even the prevention of cancer. With regards to your skin, its anti-inflammatory properties can help fight acne when consumed orally, but its treatment is more effective when applied topically directly onto skin using BioClarity’s three-step process.
If you notice that you’re breaking out right around your period every month, your acne might be linked to hormones. “A sensitivity to the hormones called androgens manifests in the form of cystic acne,” says Linkner. Androgens, namely testosterone, cause the skin to produce more sebum. More sebum equals more acne. Birth control, which has estrogen and progestin, helps keep hormones balanced and skin clear. Ortho Tri-Cyclen, Estrostep, and YAZ are all FDA-approved as acne treatments.
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.
Hypertrophic scars are uncommon, and are characterized by increased collagen content after the abnormal healing response.[32] They are described as firm and raised from the skin.[32][34] Hypertrophic scars remain within the original margins of the wound, whereas keloid scars can form scar tissue outside of these borders.[32] Keloid scars from acne occur more often in men and people with darker skin, and usually occur on the trunk of the body.[32]
Acne is at least in part due to hereditary factors. Those whose parents have a history of acne are likely to struggle with the same condition. Your genetic makeup can determine how to get rid of pimples, how sensitive your skin is, how reactive you are to hormonal fluctuations, how quickly you shed skin cells, how you respond to inflammation, how strong your immune system is to fight off bacteria, how much oil your sebaceous glands produce, and the list goes on and on. All of these determinants can cause acne to develop more easily and determine what’s good for pimples in your complexion.

The Pore Normalizing Cleanser is designed just to cleanse, not treat, which is a good thing: The Nurse Practitioner study emphasizes the importance of washing with mild cleansers in conjunction with topical acne medications to combat or avoid excessive skin irritation. This one is water-based and fragrance-free, and uses sodium laureth sulfate (as opposed to its harsh cousin sodium lauryl sulfate) to eliminate any chance for irritation.


What's Going On: If it's big, red, and painful, you're probably experiencing cystic acne, one of the more severe types. "Cystic pimples are caused by genetics and hormonal stimulation of oil glands," says Zeichner. Not only are they large, but they're also notoriously tough to treat. They often recur in the same place, because even if you manage to get rid of one, it can keep filling up with oil again and again, like an immortal pimple.
Similar to the above natural acne remedies, these acne treatments can be inexpensive and worth giving a try. Best of all, these use products you probably already have in your household, like apple cider vinegar and toothpaste. Use home remedies for acne with caution if you have cystic acne, open sores or inflammatory acne, which are best treated with medical supervision.
There has been a long-observed link between higher stress levels and the incidence of breakouts, and studies have shown that stress can worsen acne’s frequency and severity. Sebaceous glands contain receptors for stress hormones, making them upregulated and kicking sebum production into overdrive. Unfortunately, those with stress sometimes fall victim to a vicious acne cycle. Anxious types have a tendency to pick their skin and pop pimples under stress. This bad habit can exacerbate blemishes by pushing the buildup deeper into the pore, inducing cellular damage, rupturing cellular walls, and spreading bacteria. In extreme cases, sometimes people become so worried or embarrassed about their skin that they compulsively pick at every little thing that shows up. This condition is called acne excoriee, and can turn mild acne into severe scars.

Frankincense oil is a personal favorite for me and my wife, Chelsea. Containing antibacterial and anti-inflammatory properties, it’s amazing for almost all skin types and perfect for acne-prone skin. Frankincense invites new cell growth, which can help reduce the appearance of scars. It also helps prevent or eliminate bacteria, part of what can cause acne in the first place.


It is widely suspected that the anaerobic bacterial species Cutibacterium acnes (formerly Propionibacterium. acnes) contributes to the development of acne, but its exact role is not well understood.[2] There are specific sub-strains of C. acnes associated with normal skin, and moderate or severe inflammatory acne.[50] It is unclear whether these undesirable strains evolve on-site or are acquired, or possibly both depending on the person. These strains have the capability of changing, perpetuating, or adapting to the abnormal cycle of inflammation, oil production, and inadequate sloughing of dead skin cells from acne pores. Infection with the parasitic mite Demodex is associated with the development of acne.[30][51] It is unclear whether eradication of the mite improves acne.[51]
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.
But Accutane has mixed reviews for a reason. It makes the skin super dry and sensitive, which means it’s important to keep moisturizers and lip balm nearby while you’re on the treatment. Oh, and don’t even think about waxing your eyebrows (just imagine your skin ripping off). There’s another downside to Accutane: It requires a lot of paperwork and office visits. Since isotretinoin can cause birth defects, you have to come into the dermatologist once a month to get a pregnancy test and take a lengthy survey with embarrassing questions about your sex life to prove that you are using sufficient birth control. These precautions are intense, but dermatologists agree that the final results for Accutane are like no other. “This is one of the few medicines that I can look [patients] in the eye and guarantee them it will work,” says Friedman.
What's Going On: If it's big, red, and painful, you're probably experiencing cystic acne, one of the more severe types. "Cystic pimples are caused by genetics and hormonal stimulation of oil glands," says Zeichner. Not only are they large, but they're also notoriously tough to treat. They often recur in the same place, because even if you manage to get rid of one, it can keep filling up with oil again and again, like an immortal pimple.
“Sometimes I see people try over-the-counter products just for a couple of weeks, they get frustrated, they say it’s not working, and they discontinue them,” Arthur says. “But it really does take a while to see the effectiveness. So unless you’re having a problem with the medication, like it’s causing severe irritation or dryness, it’s recommended to give it at least 2-3 months before switching to something else.”
The two laser treatment options above are great for acne scar removal, but aren't generally recommended as acne treatment. If you're still experiencing active acne breakouts and wondering how to get rid of acne with laser treatments, check out photodynamic therapy. It combats active moderate to severe acne while also diminishing older acne scars by using light energy to activate a powerful acne-fighting solution. Patients may require 2 or 3 treatments over several weeks and should expect some redness, peeling and sun sensitivity. This treatment will cost between $2000 to $3500 per series.
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Comedones associated with acne vulgaris are usually easy to clear using OTC products, but papules and pustules are a little tougher to treat. Since they arise from trapped, infected pores, the first step in their treatment is to remove the inflammation and reduce the swelling so the pore can heal and breathe. Nodules are one of the few acne conditions that actually demand treatment, as some risk the potential of becoming cancerous. Medical treatment with traditional antibiotic therapy will relieve the symptoms of your acne nodule and gradually decrease its size.
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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)
Rosemary oil has been around for years and used topically for acne and inflamed skin. (15) A Chinese study concluded that rosemary essential oil helps decrease acne due to its antibacterial effects. To better understand the effects, the study increased the concentration of the rosemary essential oil, resulting in severely damaged bacterial bodies. Treated bacteria eventually led to bacterial death. (16) 
Oral isotretinoin is very effective. But because of its potential side effects, doctors need to closely monitor anyone they treat with this drug. Potential side effects include ulcerative colitis, an increased risk of depression and suicide, and severe birth defects. In fact, isotretinoin carries such serious risk of side effects that all people receiving isotretinoin must participate in a Food and Drug Administration-approved risk management program.
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