All acne is not, actually, created equal. This makes perfect sense, seeing as there are so many factors — i.e. hygiene, hormones, and genetics — that can both lead to and exacerbate your breakouts. But knowledge is power, and just knowing that there are different types, and that each kind requires its own plan of attack, puts you ahead of the clear-skin curve. Once you figure out what you're working with, it gets far easier to treat. Here, your ultimate guide to identifying, and then taking down, every type of acne out there, according to dermatologists. Find out how to identify and deal with the different kinds of acne, including blackheads, whiteheads, blind pimples, and cystic zits.
All the dermatologists we talked to agreed that there is no one-size-fits-all solution to acne. Every patient responds to treatments differently, and sometimes it can get worse before it gets better. But with the help of your dermatologist, you can find an acne treatment regimen that works for you. And, yes, we do stress how helpful it is to work with a derm to get it right.

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.


“You unfortunately cannot determine the strength of a product strictly by the percentage of its active ingredients because how well a product works depends on how well its inactive ingredients help it penetrate the skin,” explains Dr. Green. “In other words, a 2 percent benzoyl peroxide may be more effective than another brand’s 5 percent benzoyl peroxide because there are other ingredients helping out.”
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Considerations: Ask your doctor before using any other products on your skin while using erythromycin, as it may be too irritating. This includes other prescriptions, over-the-counter medicines (including those listed on this site), and harsh or abrasive cleansers, perfumes, or make-up.2 People report burning as the most frequent side effect, and also peeling, dryness, itching, redness, and oiliness, among others.2
The Effaclar Medicated Cleanser from La Roche-Posay is made especially for users with oily skin. The 2% salicylic acid concentration slows down sebum production without completely stripping the skin of its natural oil. Therefore, it won’t dry out your face, but it does reduce shine. And the key ingredient, zinc pidolate, soaks up excess oil and removes impurities.
The first thing you need to do to take care of your skin is to use sunscreen. The best acne treatment never includes sunbathing and staying out in the sun unprotected will not reduce the number of blackheads or whiteheads you have. It will, however, lead to more skin problems down the road and can cause a breakout or two right now. Wrinkles, age spots and even skin cancer are on the agenda of someone who decides they don’t need to protect their skin.
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The Effaclar Medicated Cleanser from La Roche-Posay is made especially for users with oily skin. The 2% salicylic acid concentration slows down sebum production without completely stripping the skin of its natural oil. Therefore, it won’t dry out your face, but it does reduce shine. And the key ingredient, zinc pidolate, soaks up excess oil and removes impurities.
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.
Dermal or subcutaneous fillers are substances injected into the skin to improve the appearance of acne scars. Fillers are used to increase natural collagen production in the skin and to increase skin volume and decrease the depth of acne scars.[145] Examples of fillers used for this purpose include hyaluronic acid; poly(methyl methacrylate) microspheres with collagen; human and bovine collagen derivatives, and fat harvested from the person's own body (autologous fat transfer).[145]

The good news about oily skin is that it is less likely to wrinkle, is more supple and doesn’t show its age as soon as other skin types. The bad news is that pores get clogged with oil more frequently. Using a daily gentle exfoliator can balance your skin’s tone and texture and keep pores unplugged. There are also anti-bacterial exfoliators that can speed up healing for breakouts.


Protect your skin. Skin care doesn't end when you leave your bathroom. Wear a noncomedogenic (non-pore clogging) sunscreen with an SPF of 30 or more that offers both UVA and UVB protection to shield your sensitive skin against the sun's harsh rays. A water- or light liquid-based sunscreen is best for acne-prone skin. Limit your time in the sun, especially between the hours of 10 a.m. and 2 p.m. While outside, wear a hat with at least a 2-inch brim and clothing to cover exposed skin.
Low concentrations of salicylic acid, like 0.5 percent, are perfect for people who have both acne and sensitive skin. If you have sensitive skin, you know that most of the “best” acne medications just don’t work for you because they are too strong. Products that are too strong for you can cause increased inflammation, which can actually lead to more acne rather than less. Because of this, salicylic acid is our number one recommendation for sensitive skin.
Topical antibiotics deemed safe during pregnancy include clindamycin, erythromycin, and metronidazole (all category B), due to negligible systemic absorption.[46][137] Nadifloxacin and dapsone (category C) are other topical antibiotics that may be used to treat acne in pregnant women, but have received less study.[46][137] No adverse fetal events have been reported from the topical use of dapsone.[137] If retinoids are used there is a high risk of abnormalities occurring in the developing fetus; women of childbearing age are therefore required to use effective birth control if retinoids are used to treat acne.[19] Oral antibiotics deemed safe for pregnancy (all category B) include azithromycin, cephalosporins, and penicillins.[137] Tetracyclines (category D) are contraindicated during pregnancy as they are known to deposit in developing fetal teeth, resulting in yellow discoloration and thinned tooth enamel.[1][137] Their use during pregnancy has been associated with development of acute fatty liver of pregnancy and is further avoided for this reason.[137]
Acne scars are caused by inflammation within the dermal layer of skin and are estimated to affect 95% of people with acne vulgaris.[30] The scar is created by abnormal healing following this dermal inflammation.[31] Scarring is most likely to take place with severe acne, but may occur with any form of acne vulgaris.[30] 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.[32]

Globally, acne affects approximately 650 million people, or about 9.4% of the population, as of 2010.[157] It affects nearly 90% of people in Western societies during their teenage years, but can occur before adolescence and may persist into adulthood.[18][19][22] While acne that first develops between the ages of 21 and 25 is uncommon, it affects 54% of women and 40% of men older than 25 years of age,[46][158] and has a lifetime prevalence of 85%.[46] About 20% of those affected have moderate or severe cases.[2] It is slightly more common in females than males (9.8% versus 9.0%).[157] In those over 40 years old, 1% of males and 5% of females still have problems.[19]

Infused with salicylic acid from white willow bark and antioxidant-rich chamomile and gotu kola, this clarifying face wash is formulated for men and women of all skin types. It exfoliates and unclogs pores to boost cell turnover, soothes inflamed skin and counters free radical damage. Also works as a makeup remover and a deep-cleansing shaving cream!
First, let’s talk about what causes acne. Pimples form when the oil and dead skin cells on your skin combine to form a plug that blocks the pores. “As the P. acnes bacteria that naturally live on skin overgrow within this plugged follicle, the area becomes inflamed and this is when you start to see papules, pustules, and cystic lesions,” RealSelf dermatologist Sejal Shah, M.D., tells SELF. The treatments ahead work to exfoliate away dead skin cells, suck up excess oil, stop inflammation, and kill the P. acnes bacteria. There are even a few treatments that target hormonal acne specifically.
Cons: This is not actually a con, but their face wash is part of a comprehensive acne treatment system that effectively treats your skin while helping you save a bundle on the products that should be part of your skincare routine for best results. They have the best guarantee we have seen so far anywhere and you can read our review of the complete Exposed Skin Care kit here.

The relationship between diet and acne is unclear, as there is no high-quality evidence that establishes any definitive link between them.[51] High-glycemic-load diets have been found to have different degrees of effect on acne severity.[7][52][53] Multiple randomized controlled trials and nonrandomized studies have found a lower-glycemic-load diet to be effective in reducing acne.[52] There is weak observational evidence suggesting that dairy milk consumption is positively associated with a higher frequency and severity of acne.[50][51][52][54][55] Milk contains whey protein and hormones such as bovine IGF-1 and precursors of dihydrotestosterone.[52] 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.[52][56] Available evidence does not support a link between eating chocolate or salt and acne severity.[51][54] 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] One review linked a Western pattern diet, high in simple carbohydrates, milk and dairy products, and trans fats and saturated fats, along with a low omega-3 fatty acids, with acne.[56]
If you have oily, tight skin and tend to get age spots or sun spots, try an exfoliant made with glycolic acid right after you cleanse your skin, no more than 4 or 5 times a week. Aveeno Positively Radiant Cleansing Pads provides just a “dab” of exfoliant that will help lighten the spots without irritating your skin (which over the long run would create new brown spots).
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.
The recognition and characterization of acne progressed in 1776 when Josef Plenck (an Austrian physician) published a book that proposed the novel concept of classifying skin diseases by their elementary (initial) lesions.[163] In 1808 the English dermatologist Robert Willan refined Plenck's work by providing the first detailed descriptions of several skin disorders using a morphologic terminology that remains in use today.[163] Thomas Bateman continued and expanded on Robert Willan's work as his student and provided the first descriptions and illustrations of acne accepted as accurate by modern dermatologists.[163] Erasmus Wilson, in 1842, was the first to make the distinction between acne vulgaris and rosacea.[164] The first professional medical monograph dedicated entirely to acne was written by Lucius Duncan Bulkley and published in New York in 1885.[165][166]

Pharaohs are recorded as having had acne, which may be the earliest known reference to the disease. Since at least the reign of Cleopatra (69–30 BC), the application of sulfur to the skin has been recognized as a useful treatment for acne.[162] The sixth-century Greek physician Aëtius of Amida is credited with coining the term "ionthos" (ίονθωξ,) or "acnae", which is believed to have been a reference to facial skin lesions that occur during "the 'acme' of life" (puberty).[163]


Spot treatments are designed to give problem pimples a mega-dose of concentrated benzoyl peroxide — in a couple of regimens, like the Proactiv Teen Kit, the spot treatment had nearly three times the benzoyl peroxide as its all-over treatment. The logic: If benzoyl peroxide can be irritating to the skin in high concentrations, limiting its intensity to just the pimple itself could save the rest of your healthy skin.
The alkaline ingredients in Ivory Soap reach into the skin and dissolve the fats and ceramides that lock moisture in and keep the skin soft and flexible. Tight skin constricts pores, locking oil and acne bacteria inside. If you wash your face with Ivory Soap once or twice a day, you almost certainly will have no big pieces of dirt or grime lurking in enlarged pores, but you are likely to have an ongoing problem with whiteheads and blackheads, and the constant irritation will also make pimples redder and more inflamed.

The first thing you need to do to take care of your skin is to use sunscreen. The best acne treatment never includes sunbathing and staying out in the sun unprotected will not reduce the number of blackheads or whiteheads you have. It will, however, lead to more skin problems down the road and can cause a breakout or two right now. Wrinkles, age spots and even skin cancer are on the agenda of someone who decides they don’t need to protect their skin.
Acne is caused when the sebaceous glands in your skin get infected or inflamed. Blemishes and pimples are most commonly found on your face, chest and back. You have a system of oil glands under your skin, and this is where sebum is produced. Sebum is supposed to keep your skin healthily moisturized, but too much production of this oil can cause blackheads and whiteheads. When the oil is pushed out through your hair follicles, it can clog your pores if it attaches to bacteria or dead skin cells. If this happens, sebum will build up behind the plug and form a pimple. And we all know what that is.

Combined oral contraceptives. Four combined oral contraceptives are approved by the FDA for acne therapy in women who also wish to use them for contraception. They are products that combine estrogen and progestin (Ortho Tri-Cyclen, Yaz, others). You may not see the benefit of this treatment for a few months, so using other acne medications with it the first few weeks may help.
Retinoids: Retinoids are substances that are derived from vitamin A, which includes retinol, but also includes synthetic versions of retinol with activated retinoic acid which tends to be more effective in treating acne. Retinoic acid has been shown to reduce sebum production8 and regulate skin cell production9, which together can greatly reduce acne. These synthetic retinoids include adapalene, tretinoin, isotretinoin, and others. Although these synthetic options are more reliably effective, they also tend to have more side effects, like burning, itching, and dryness. Unlike retinol, which is available over-the-counter, nearly all synthetic retinoids are prescription-only. One of the main exceptions is Differin, which is a brand that sells a topical gel containing adapalene, a mild synthetic retinoid, over-the-counter.

All the dermatologists we talked to agreed that there is no one-size-fits-all solution to acne. Every patient responds to treatments differently, and sometimes it can get worse before it gets better. But with the help of your dermatologist, you can find an acne treatment regimen that works for you. And, yes, we do stress how helpful it is to work with a derm to get it right.

The Effaclar Medicated Cleanser from La Roche-Posay is made especially for users with oily skin. The 2% salicylic acid concentration slows down sebum production without completely stripping the skin of its natural oil. Therefore, it won’t dry out your face, but it does reduce shine. And the key ingredient, zinc pidolate, soaks up excess oil and removes impurities.

However, unlike the previously discussed treatment options, gender plays a role in how effective dapsone will be. Research has shown11 that female patients who use it get a much better response than male patients. It’s also a slow-working treatment. Studies among adolescents have shown that it is very effective, but it may take up to 12 weeks for improvements to show up, with more improvements taking place with continued use.
Recommended therapies for first-line use in acne vulgaris treatment include topical retinoids, benzoyl peroxide, and topical or oral antibiotics.[78] Procedures such as light therapy and laser therapy are not considered to be first-line treatments and typically have an adjunctive role due to their high cost and limited evidence of efficacy.[77] Medications for acne work by targeting the early stages of comedo formation and are generally ineffective for visible skin lesions; improvement in the appearance of acne is typically expected between six and eight weeks after starting therapy.[1]
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.
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