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In 2015, acne was estimated to affect 633 million people globally, making it the 8th most common disease worldwide.[9][17] Acne commonly occurs in adolescence and affects an estimated 80–90% of teenagers in the Western world.[18][19][20] Lower rates are reported in some rural societies.[20][21] Children and adults may also be affected before and after puberty.[22] Although acne becomes less common in adulthood, it persists in nearly half of affected people into their twenties and thirties and a smaller group continue to have difficulties into their forties.[2]

Meanwhile, salicylic acid, which is derived from willow tree bark, wintergreen oil or sweet birch and occurs naturally in fruits like raspberries, cantaloupe and granny smith apples, works well for most skin types. Aside from being an exfoliant that sloughs away dead skin cells and other pore-clogging impurities, it has anti-inflammatory properties that help to address inflammation, which is thought to be the primary cause of acne.


The earliest pathologic change is the formation of a plug (a microcomedone), which is driven primarily by excessive growth, reproduction, and accumulation of skin cells in the hair follicle.[1] In normal skin, the skin cells that have died come up to the surface and exit the pore of the hair follicle.[10] However, increased production of oily sebum in those with acne causes the dead skin cells to stick together.[10] The accumulation of dead skin cell debris and oily sebum blocks the pore of the hair follicle, thus forming the microcomedone.[10] This is further exacerbated by the biofilm created by P. acnes within the hair follicle.[44] If the microcomedone is superficial within the hair follicle, the skin pigment melanin is exposed to air, resulting in its oxidation and dark appearance (known as a blackhead or open comedo).[1][10][19] In contrast, if the microcomedone occurs deep within the hair follicle, this causes the formation of a whitehead (known as a closed comedo).[1][10]
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]
No single product can contain all of the necessary acne-fighting ingredients, despite what some may claim. Some chemicals shouldn’t be used together, while others work together to totally eradicate acne and all the blemishes that come with it. The best acne treatment systems can do that for you, but because everyone’s skin is unique, what works for one person may not work for another. The key lies in finding the right system, a combination of products, that work best for your unique skin.
Oh, hello old friend. Salicylic acid is the go-to fix for pimply preteens. And cruising through the aisles at the drugstore, you’ll find it as the active ingredient on the majority of products labeled “acne wash” or “spot treatment.” Salicylic acid is a beta-hydroxy acid that works by dissolving excess oil and gently exfoliating away dead skin cells. Salicylic also has anti-inflammatory properties to help with inflamed cystic breakouts that can occur when blockages deep in the hair follicles rupture beneath the skin. It’s best to apply this ingredient as a toner, moisturizer, or leave-on spot treatment instead of a face wash to give it time to do its work. And keep in mind, salicylic acid can dry out the skin if over-applied, so maybe choose only one product with the ingredient to use every day.
Thanks to its special MicroClear technology, Neutrogena Oil-Free Acne and Redness Facial Cleanser helps boost the delivery of active ingredient salicylic acid, in order to help reduce the appearance of acne. The inclusion of aloe and chamomile help to calm irritation while visibly reducing facial redness, a source of emotional stress for many acne sufferers.
@ brazen i also get exposed to sunlight a lot and would recommend Cetaphil as it has no photosensitive effects. I use Cetaphil wash and it has really been a great help with my acne. it cleans your skin thoroughly while still being gentle. i would recommend using this with a cleansing brush (clarisonic, luna, spin brush etc) and following with a toner preferably one with witch hazel. these combination of things has worked wonders for my skin. 3 months down the line the improvement has been fantastic. All I’m dealing with now is the scars (Hyperpigmentations).
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.
To properly use sunscreen, you should put it on about 30 minutes before you plan to go outside. You will also need to reapply it if you sweat a lot. Be generous when you put it on and consider looking for a lip balm sunscreen specially made to protect your lips. Finally, make sure you are drinking enough fluid, so you don’t dehydrate your skin while outside.
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Hydroquinone lightens the skin when applied topically by inhibiting tyrosinase, the enzyme responsible for converting the amino acid tyrosine to the skin pigment melanin, and is used to treat acne-associated postinflammatory hyperpigmentation.[34] By interfering with new production of melanin in the epidermis, hydroquinone leads to less hyperpigmentation as darkened skin cells are naturally shed over time.[34] Improvement in skin hyperpigmentation is typically seen within six months when used twice daily. Hydroquinone is ineffective for hyperpigmentation affecting deeper layers of skin such as the dermis.[34] The use of a sunscreen with SPF 15 or higher in the morning with reapplication every two hours is recommended when using hydroquinone.[34] Its application only to affected areas lowers the risk of lightening the color of normal skin but can lead to a temporary ring of lightened skin around the hyperpigmented area.[34] Hydroquinone is generally well-tolerated; side effects are typically mild (e.g., skin irritation) and occur with use of a higher than the recommended 4% concentration.[34] Most preparations contain the preservative sodium metabisulfite, which has been linked to rare cases of allergic reactions including anaphylaxis and severe asthma exacerbations in susceptible people.[34] In extremely rare cases, repeated improper topical application of high-dose hydroquinone has been associated with an accumulation of homogentisic acid in connective tissues, a condition known as exogenous ochronosis.[34]
Perioral dermatitis Granulomatous perioral dermatitis Phymatous rosacea Rhinophyma Blepharophyma Gnathophyma Metophyma Otophyma Papulopustular rosacea Lupoid rosacea Erythrotelangiectatic rosacea Glandular rosacea Gram-negative rosacea Steroid rosacea Ocular rosacea Persistent edema of rosacea Rosacea conglobata variants Periorificial dermatitis Pyoderma faciale
Both salicylic acid and benzoyl acid are commonly found in the top acne treatments for getting rid of mild to severe acne. They work in tandem to getting rid of the dead skin and killing bacteria, which are two of the main contributors to the spread of acne. Salicylic acid breaks up the skin to clear pores from skin, oil and bacteria and benzoyl peroxide kills the bacteria slowly over a 48-hour period.
One of the most gentle face cleansers we selected is this one from Paula’s Choice. It won’t dehydrate sensitive skin because it has just 0.5% salicylic acid. But it still contains enough to unclog pores and exfoliate dead skin. You’ll hardly know that it’s working because it’s so pleasant to use. The silky texture glides on and lathers away oil and grime. Furthermore, there are no parabens or artificial fragrances in the formula.
Clean your face really well using a mild face cleanser and gently pat dry. Let your skin further air dry and don’t put anything else on it. Don’t put anything else on your face like moisturizer, serum, toner, etc. After a half hour, carefully check your cheeks, chin, forehead and nose, with a hand mirror, for any shine. Also, check if your skin feels tight when you smile or make exaggerated facial expressions.
Accutane (isotretinoin) has a mixed reputation, but among dermatologists it’s the finisher for patients with severe acne. “If you have an acne patient that doesn’t respond to anything, [Accutane] can really be a game changer,” board-certified dermatologist Adam Friedman tells SELF. Accutane is an oral retinoid, and it has all the same benefits of a topical retinol but is even more effective.
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]
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.

Shah often recommends over-the-counter retinols or prescription retinoids to her acne-prone patients. “I find that compared to other treatments they are beneficial for not just treating acne but also preventing new acne from forming as they help prevent that initial stage of the follicle getting clogged,” she says. “They can also help with some of the post acne [problems] such as hyperpigmentation.” But keep in mind if you have sensitive skin (or eczema or rosacea), a prescription retinoid might be too strong an option. However, your dermatologist can recommend an over-the-counter retinol with a low concentration (0.1 to 0.25 percent), which might be better tolerated. Retinol also isn’t a quick fix. It takes time to see results, and it’s something you’ll have to keep using to maintain its benefits. Shah also mentions that retinol plays well with other acne treatments on the list. "Retinol can be combined with other over-the-counter or prescription medications such as benzoyl peroxide, topical antibiotics, and oral medications. The right combination depends on the severity of the acne and your skin type."
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]
We suggest avoiding spot treatments. “Benzoyl peroxide, when placed on red spots, can actually cause more irritation and inflammation to the area. It’s best used to prevent red bumps and pustules, and applied all over the area you want to treat,” said Townsend, who was also quick to naysay a spot-treat-only approach: “Acne affects all of the pores. If someone is going to spot treat against my advice, I still suggest they spot treat one day and treat the whole face the next.”
Combined oral contraceptive pills contain progesterone and estrogen and help to balance out the levels of testosterone in the body12 One obvious effect of this is birth control, but dermatologists have also found it very useful for treating hormonal acne. Testosterone doesn’t directly cause acne, but when hormone levels fluctuate and testosterone increases above its baseline level, it can lead to increased acne for some. This is because increases in testosterone and other androgens leads to an increase in sebum production, which can cause more clogged pores and more p. acnes bacteria, leading to blackheads, whiteheads, pimples, or even cysts.
Having a specific type of skin now doesn’t mean you will be stuck with it the rest of your life. As you get older, your skin can change. It may be oily when you are younger but become dry as you age. Plus, skin can become more or less sensitive over time. It’s always a good idea to retest for your skin type if you notice any changes. We’ve included a guide above to help you recognize what kind of acne you have, what the average causes are, and how to treat it (or at least not aggravate it).
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.
Topical and oral preparations of nicotinamide (the amide form of vitamin B3) have been suggested as alternative medical treatments.[134] It is thought to improve acne due to its anti-inflammatory properties, its ability to suppress sebum production, and by promoting wound healing.[134] Topical and oral preparations of zinc have similarly been proposed as effective treatments for acne; evidence to support their use for this purpose is limited.[135] The purported efficacy of zinc is attributed to its capacity to reduce inflammation and sebum production, and inhibit P. acnes.[135] Antihistamines may improve symptoms among those already taking isotretinoin due to their anti-inflammatory properties and their ability to suppress sebum production.[136]

The other downside to Proactiv+ is that the bottles are small — like, half the size of Paula’s Choice small. Combine that with its recommended two or three-times daily application, and you’re going to be going through a lot of kits, which ultimately means spending more money on your treatment. If Proactiv is the only thing that works for you, it may very well be worth the investment, but we recommend starting with Paula’s Choice to see if you can get the same results at a cheaper price.

Beyond making sure the system contains safe combinations of ingredients, a system can also treat all aspects of acne. By picking and choosing individual products, you may miss an important step. Plus, treatment systems contain ingredients like glycolic acid that help smooth acne scars, something you might not think about when you are shopping for products. Did you know probiotics help reduce inflammation? Or that kojic acid and arbutin can lighten brown spots? When it comes to treating acne, you should leave the mixing to professionals. You still can try out a variety of systems to find the one that works best for you.
Although there is no one single cure for acne, we based our reviews first on what doctors are saying about these products and their ingredients. Then we did some digging into all the reviews. We ruled out those products that had primarily negative responses. After all that, we consulted natural product experts to see which system they felt were the best acne treatment.
The severity of acne vulgaris (Gr. ἀκµή, "point" + L. vulgaris, "common")[23] can be classified as mild, moderate, or severe as this helps to determine an appropriate treatment regimen.[19] Mild acne is classically defined by the presence of clogged skin follicles (known as comedones) limited to the face with occasional inflammatory lesions.[19] Moderate severity acne is said to occur when a higher number of inflammatory papules and pustules occur on the face compared to mild cases of acne and are found on the trunk of the body.[19] Severe acne is said to occur when nodules (the painful 'bumps' lying under the skin) are the characteristic facial lesions and involvement of the trunk is extensive.[19][24]
Acne appears when a pore in our skin clogs. This clog begins with dead skin cells. Normally, dead skin cells rise to surface of the pore, and the body sheds the cells. When the body starts to make lots of sebum (see-bum), oil that keeps our skin from drying out, the dead skin cells can stick together inside the pore. Instead of rising to the surface, the cells become trapped inside the pore.
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