Acne and stress aren’t connected. FALSE. Scientific studies have shown the opposite to be true. Students with acne were examined before and after major exams at school, and their acne got worse when they experienced stress before exams. It is a double-edged sword. Acne can cause stress, but it can also get worse with stress. Stress hormones such as cortisol can overstimulate the oil glands in your skin. And we already know that oil, bacteria and dead skin cells are what really cause acne. So try to keep away from stressors while you try to get your skin healthier.
According to Dr. Bailey, the best facial cleansers for acne should have at least one of these key ingredients: salicylic acid, glycolic acid or benzoyl peroxide. Cleansers with these ingredients can penetrate your pores and eliminate pore-clogging impurities—like dead skin cells, makeup, excess oil and bacteria—that irritate skin and make acne worse.

The best acne-fighting ingredients will offer several benefits, including reducing or eliminating excess oil and removing the dead skin that builds up and clogs your pores. There are two main chemical ingredients that are FDA approved for fighting acne and you can find them in a range of acne-fighting products, including the ones in the chart above. The natural ingredients, on the other hand, have been proven to work by scientific studies but not all have been approved by the FDA as a guaranteed acne-fighting ingredient, like tea tree oil for example. Nonetheless, you will still find a combination of these chemical and natural ingredients in many skin care products on the market, and many of them work amazingly on the right skin type.

Acne isn’t just a problem for teens. According to studies, those pesky zits and pimples can pop up at any age. Whether it’s your diet, environment or stress that’s to blame, you don’t have to suffer helplessly. To get the skinny on acne, we talked to board-certified dermatologist Cynthia Bailey, M.D., president and CEO of Advanced Skin Care and Dermatology Physicians, Inc. and founder of DrBaileySkinCare.com. Here, she shares her best tips on how to choose the right acne cleanser for you, as well as how to use it to get the best results.
Acne is caused by what you eat. SOMEWHAT FALSE. This isn’t a complete lie, but studies are still being done. To date, there have only been small studies done on a few people that have shown a possible connection between acne and high carbohydrate foods like bread, pastries and sodas. There are also studies involving more people, but they relied on adults remembering their acne and eating habits when they were in high school. There just isn’t enough evidence to link any food with breakouts. Some people swear that certain foods make their acne worse. The best way to determine if a food is causing your pimples to appear is by keeping a food/skin diary. Keep track of everything you eat and assess your skin condition in the morning and evening of each day. If you find a pattern, it can’t hurt to avoid the foods that lead to more blackheads and whiteheads. Keep in mind that eating a balanced diet is always a good idea.
This type of skin can be oily and dry or oily and normal. Different places on your face will have different symptoms. The good news is that you probably won’t have acne on your cheeks since the skin there is usually less oily. You may have to use different treatments on different areas of your face, though. The T-Zone area of the forehead, nose and chin may be oilier, so exfoliating with a gentle cleanser each day should keep your facial skin balanced. You should look for a moisturizer that isn’t too heavy but that will hold in your skin’s moisture. Gel-like moisturizers are absorbed into combination skin quickly, but don’t over moisturize or your pores may become clogged. You may need to try several brands before finding one that works for you.
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.
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Oral antibiotics are recommended for no longer than three months as antibiotic courses exceeding this duration are associated with the development of antibiotic resistance and show no clear benefit over shorter courses.[87] Furthermore, if long-term oral antibiotics beyond three months are thought to be necessary, it is recommended that benzoyl peroxide and/or a retinoid be used at the same time to limit the risk of P. acnes developing antibiotic resistance.[87]


The best acne treatment system will include a cleanser, exfoliant and a treatment product that can be used daily. The idea is to have a product that cleans and clears clogged pores, kills bacteria, exfoliates to remove dead cells and spot treats trouble spots to combat stubborn blemishes and reduces inflammation and redness. For those with oily skin, a toner may be useful. For those with black heads, deep cleansing pore strips will help. If you have dry skin, foaming face wash would be something you want to avoid. The point is, a carefully tailored system is the best approach to an effective acne treatment.
Resorcinol – Almost always found coupled with sulfur, this ingredient breaks down hardened, rough or scaly skin, while disinfecting and fighting infections5. This ingredient is often used topically to treat pain and itching stemming from small injuries like scrapes and cuts, burns, bug bites, sunburn, poison ivy and more. It’s also used to treat skin conditions like eczema, seborrhea, psoriasis, warts, corns and other disorders. It is generally found in strengths of up to 2%.
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.
Dapsone is not a first-line topical antibiotic due to higher cost and lack of clear superiority over other antibiotics.[1] Topical dapsone is not recommended for use with benzoyl peroxide due to yellow-orange skin discoloration with this combination.[10] While minocycline is shown to be an effective acne treatment, it is no longer recommended as a first-line antibiotic due to a lack of evidence that it is better than other treatments, and concerns of safety compared to other tetracyclines.[88]
In severe cases, oral isotretinoin may be considered. This medication can be very effective but can also cause serious side effects including severe birth defects. Strict protocols must be followed. Monthly appointments with the treating doctor must be kept throughout the treatment period to monitor for any side effects. In females of child-bearing age, protocol includes two forms of birth control. The treatment period is usually five months.

However, salicylic acid isn’t just for those of us with sensitive skin. It can also help those of you with tougher skin, through higher concentrations. Over-the-counter, you can find salicylic acid in concentrations up to 2 percent, but if you want something even more intense, many spas and dermatology offices offer salicylic acid chemical peels with 20-30 percent salicylic acid. Beware, these peels will likely leave your face very photosensitive for a few days, but they have been known to significantly reduce sebum for a few weeks at a time.
Considerations: Cigarette smoking with oral contraceptive use increases the risk of serious heart disease.2 There are many negative side effects and positive side effects to taking birth control pills for acne. Talk to your doctor to decide if it is right for you.1-3 While it is a widely held belief, evidence does not show a correlation between pregnancy rates and concurrent administration of birth control pills and oral antibiotics. [With the exception of anti-tuberculosis drugs like rifampin.]
Retinoids are medications which reduce inflammation, normalize the follicle cell life cycle, and reduce sebum production.[44][83] They are structurally related to vitamin A.[83] The retinoids appear to influence the cell life cycle in the follicle lining. This helps prevent the accumulation of skin cells within the hair follicle that can create a blockage. They are a first-line acne treatment,[1] especially for people with dark-colored skin, and are known to lead to faster improvement of postinflammatory hyperpigmentation.[35]
If your acne is severe, painful, or refusing to get lost, you may just be beyond what an over-the-counter treatment can do. Not only can a professional set you up with the really powerful stuff, but also Fitz Patrick explains that “working closely with an aesthetician or dermatologist means you can keep tweaking a routine to make it work best for you.”
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.
Hypertrophic scars are uncommon, and are characterized by increased collagen content after the abnormal healing response.[31] They are described as firm and raised from the skin.[31][33] Hypertrophic scars remain within the original margins of the wound, whereas keloid scars can form scar tissue outside of these borders.[31] Keloid scars from acne occur more often in men and people with darker skin, and usually occur on the trunk of the body.[31]
The best acne-fighting ingredients will offer several benefits, including reducing or eliminating excess oil and removing the dead skin that builds up and clogs your pores. There are two main chemical ingredients that are FDA approved for fighting acne and you can find them in a range of acne-fighting products, including the ones in the chart above. The natural ingredients, on the other hand, have been proven to work by scientific studies but not all have been approved by the FDA as a guaranteed acne-fighting ingredient, like tea tree oil for example. Nonetheless, you will still find a combination of these chemical and natural ingredients in many skin care products on the market, and many of them work amazingly on the right skin type.
Our favorite for banishing blemishes on the fly, Glossier's zit stick is not only effective, but it's portable. Just stash it in your purse for any unexpected breakouts! Packed with acne-fighting benzoyl peroxide, this convenient roll-on works extremely quickly. In a clinical trial, 83% of test subjects said that it lessened the appearance of pimples in just 3 hours. We've tried it ourselves and can confirm the 3-hour claim is true.
P. acnes also provokes skin inflammation by altering the fatty composition of oily sebum.[44] Oxidation of the lipid squalene by P. acnes is of particular importance. Squalene oxidation activates NF-κB (a protein complex) and consequently increases IL-1α levels.[44] Additionally, squalene oxidation leads to increased activity of the 5-lipoxygenase enzyme responsible for conversion of arachidonic acid to leukotriene B4 (LTB4).[44] LTB4 promotes skin inflammation by acting on the peroxisome proliferator-activated receptor alpha (PPARα) protein.[44] PPARα increases activity of activator protein 1 (AP-1) and NF-κB, thereby leading to the recruitment of inflammatory T cells.[44] The inflammatory properties of P. 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.[44] These free fatty acids spur production of cathelicidin, HBD1, and HBD2, thus leading to further inflammation.[44]
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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 main hormonal driver of oily sebum production in the skin is dihydrotestosterone.[1] Another androgenic hormone responsible for increased sebaceous gland activity is DHEA-S. Higher amounts of DHEA-S are secreted during adrenarche (a stage of puberty), and this leads to an increase in sebum production. In a sebum-rich skin environment, the naturally occurring and largely commensal skin bacterium P. acnes readily grows and can cause inflammation within and around the follicle due to activation of the innate immune system.[10] P. acnes triggers skin inflammation in acne by increasing the production of several pro-inflammatory chemical signals (such as IL-1α, IL-8, TNF-α, and LTB4); IL-1α is known to be essential to comedo formation.[44]

Our favorite for banishing blemishes on the fly, Glossier's zit stick is not only effective, but it's portable. Just stash it in your purse for any unexpected breakouts! Packed with acne-fighting benzoyl peroxide, this convenient roll-on works extremely quickly. In a clinical trial, 83% of test subjects said that it lessened the appearance of pimples in just 3 hours. We've tried it ourselves and can confirm the 3-hour claim is true.
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.
Acne and stress aren’t connected. FALSE. Scientific studies have shown the opposite to be true. Students with acne were examined before and after major exams at school, and their acne got worse when they experienced stress before exams. It is a double-edged sword. Acne can cause stress, but it can also get worse with stress. Stress hormones such as cortisol can overstimulate the oil glands in your skin. And we already know that oil, bacteria and dead skin cells are what really cause acne. So try to keep away from stressors while you try to get your skin healthier.
The best acne treatment system will include a cleanser, exfoliant and a treatment product that can be used daily. The idea is to have a product that cleans and clears clogged pores, kills bacteria, exfoliates to remove dead cells and spot treats trouble spots to combat stubborn blemishes and reduces inflammation and redness. For those with oily skin, a toner may be useful. For those with black heads, deep cleansing pore strips will help. If you have dry skin, foaming face wash would be something you want to avoid. The point is, a carefully tailored system is the best approach to an effective acne treatment.
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What it is: You may have heard of tretinoin in reference to "Retin-A" wrinkle treatments. Tretinoin is retinoic acid and vitamin A acid combined, and comes in various strengths in creams, gels, and liquids for topical use on the skin. It is used to treat acne and also to treat sun damaged skin or wrinkles and is usually applied once per day.1Learn more from the U.S. National Library of Medicine.
Aside from the obvious fact that a good face wash can help heal acne and pimple-prone skin, your choice of facial cleanser really matters when you’re trying to get rid of acne. For starters, the wrong face washes can cause acne, or at least, make yours a lot worse. Throughout the day, your skin does come into contact with a lot of dirt and grime, and it also secretes sebum – an oily, waxy, fatty substance that keeps your skin waterproof and lubricated. Oily skin is the result of an excessive amount of sebum secretion, and most soaps are designed to remove that oil from your skin. However, your skin actually needs some of that sebum to function normally. Without it, you end up with dry skin that tightens to create clogged pores and, ultimately, acne.
“Acne cleansers with these ingredients will gradually unclog pores, reduce the size of existing blackheads and slow or stop the formation of new ones,” she says. “Benzoyl peroxide is also the best ingredient for treating the acne-causing bacteria called p. acnes. In fact, study after study continues to show that benzoyl peroxide is more effective than prescription topical antibiotics at treating p. acnes.”
Skincare is an extra challenge for those with sensitive skin because certain ingredients might cause irritation or inflammation. Spending too much time out in the wind and sun can also increase reactions. You can have oily, dry or combination skin and still have sensitive skin, too. For both skincare products and cosmetics, try out only one product at a time to see what effects it will have on your skin. The best way to start out is by patch-testing the product on your inner forearm. If you see no negative impact, you can apply it to the area behind your ear before trying it on your face. There are many products on the market now that advertise as effective for sensitive skin, but testing them is the only way to determine which is best for your skin.
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The idea behind using antibiotics for acne is that they can help reduce the number of p. acnes on the skin and relieve an acute case of severe acne. After the person stops taking the antibiotics, the hope is that the reduced numbers of p. acnes will prevent the pimples or cysts from getting out of hand again. However, in reality, most people simply end up taking the antibiotics much longer than they should, and the acne almost always comes back. That’s because, according to The Lancet: Infectious Diseases, over 50 percent of p. acnes strains are resistant to antibiotics7. If your doctor tries to prescribe you antibiotics for your acne, we recommend asking about other courses of action.
This single cleanser unclogs pores, clears up blackheads, reduces blemishes, brightens skin tone, smoothes texture, moisturizes, and shrinks the appearance of pores. The ingredients that make all this happen include moisturizers like hyaluronic acid, aloe, and cucumber. Then, there are grapefruit and orange oils to revitalize dull skin. Plus, peptides and panthenol help rebuild texture while Clary Sage purifies.

Decreased levels of retinoic acid in the skin may contribute to comedo formation. To address this deficiency, methods to increase the skin's production of retinoid acid are being explored.[10] A vaccine against inflammatory acne has shown promising results in mice and humans.[49][180] Some have voiced concerns about creating a vaccine designed to neutralize a stable community of normal skin bacteria that is known to protect the skin from colonization by more harmful microorganisms.[181]
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.
Once you hit your 30s, there's a good chance you'll still occasionally battle the same breakouts you've had since your teen years at the same time you're trying to stave off the fine lines that come with age. But you don't have to choose between a facial cleanser that only fights dull, aging skin or clears up zits. Plenty of products fight both—you just need to know what to look for. 
Acne, also known as acne vulgaris, is a long-term skin disease that occurs when hair follicles are clogged with dead skin cells and oil from the skin.[10] It is characterized by blackheads or whiteheads, pimples, oily skin, and possible scarring.[1][2][11] It primarily affects areas of the skin with a relatively high number of oil glands, including the face, upper part of the chest, and back.[12] The resulting appearance can lead to anxiety, reduced self-esteem and, in extreme cases, depression or thoughts of suicide.[3][4]
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