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Misperceptions about acne's causative and aggravating factors are common, and those affected by it are often blamed for their condition. Such blame can worsen the affected person's sense of self-esteem. Until the 20th century, even among dermatologists, the list of causes was believed to include excessive sexual thoughts and masturbation. Dermatology's association with sexually transmitted infections, especially syphilis, contributed to the stigma.
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 and retinoid-like drugs. These come as creams, gels and lotions. Retinoid drugs are derived from vitamin A and include tretinoin (Avita, Retin-A, others), adapalene (Differin) and tazarotene (Tazorac, Avage). You apply this medication in the evening, beginning with three times a week, then daily as your skin becomes used to it. It works by preventing plugging of the hair follicles.
The Anti-Redness Exfoliating Solution is mostly water, but its 2 percent salicylic acid is enough to eat through oil and remove the dead skin cells clogging your pores — and it boasts a higher concentration than nearly every other kit we looked at. Sodium hyaluronate, the super-moisturizing humectant we fell in love with in our review on the Best Face Moisturizer, also caught our eye sitting smack dab in the middle of the ingredients list.
Cortisone is a quick fix for acne emergencies. We mean got a big board meeting tomorrow kind of quick. Go into the dermatologist’s office for a shot of this corticosteroid, and acne will disappear in 24 to 48 hours. The treatment works to curb inflammation, which makes it best for cystic breakouts and can be really good at combatting hormonal flare-ups. If done incorrectly, a cortisone shot can leave a small depression in the skin that lasts about eight weeks. “It’s a rare side effect that happens if dosage of cortisone is too high,” explains Linkner. “You want to go to someone who knows what they’re doing.”
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Warning: Sulfur smells like rotten eggs. But it is an effective ingredient at drying up pus-filled pimples and whiteheads (you’ve gotta take the good with the bad). It works by sucking up the oil. Sulfur is typically mixed with other active ingredients to get the most efficacy and fragrances to mask the strong scent. You can often find it in masks and spot treatments.
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.
Benzoyl Peroxide – A strong compound that kills the bacteria that causes acne1. It also gets rid of excess oil and the build-up of dead skin cells which clog your pores. This ingredient is exceptionally strong, and it can cause some side effects like redness, dry skin, burning or stinging and scaling. You’ll only find it in products at 2.5% to 10% strength. However, dermatologists recommend that adults stick to a low-dose of benzoyl peroxide, at around 3% for minimal irritation and to avoid bleaching your skin, hair or clothing.
^ Hay, RJ; Johns, NE; Williams, HC; Bolliger, IW; Dellavalle, RP; Margolis, DJ; Marks, R; Naldi, L; Weinstock, MA; Wulf, SK; Michaud, C; Murray, C; Naghavi, M (October 2013). "The Global Burden of Skin Disease in 2010: An Analysis of the Prevalence and Impact of Skin Conditions". The Journal of Investigative Dermatology. 134 (6): 1527–34. doi:10.1038/jid.2013.446. PMID 24166134.
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.
If you’re looking for a hormonal solution to your acne but don’t want to take a combined oral contraceptive, spironolactone may be the answer. This oral medication is a potassium-sparing diuretic originally designed to treat high blood pressure, but is now also used to treat acne. It mainly functions by reducing sebum production, leading to less acne formation13. If you are able to get pregnant, you don’t necessarily need to take a combined oral contraceptive, but you will want to use some form of birth control since spironolactone, like Accutane, is a well-known teratogen and is known for causing birth defects.
Azelaic acid is a natural acid that is derived from various grains like wheat and barley. It helps reduce acne by preventing skin cell buildup, killing p. acnes bacteria, and reducing inflammation4. This means it can help reduce all kinds of acne, from blackheads to pimples. Blackheads and whiteheads form when dead skin cells combine with sebum, the oil our skin naturally produces and get clogged in a pore. To get rid of this kind of acne, it helps to regulate your skin cell production and exfoliate your skin to remove excess dead skin cells. Azelaic acid is a great way to do both of these things, while also decreasing inflammation and killing bacteria. When the skin is inflamed, it swells slightly, causing the pores to constrict. This traps dead skin cells and sebum inside, leading to blackheads and whiteheads, and if bacteria get trapped as well, then pimples can also form.
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.
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