Considerations: THERE IS AN EXTREMELY HIGH RISK THAT A DEFORMED INFANT CAN RESULT IF PREGNANCY OCCURS WHILE TAKING ACCUTANE IN ANY AMOUNT AND EVEN FOR SHORT PERIODS OF TIME. FEMALES WHO ARE PREGNANT OR WHO MAY BECOME PREGNANT WHILE UNDERGOING TREATMENT SHOULD NOT TAKE ACCUTANE. There are many other warnings as well.1-3 Side effects of Accutane are many, some of which include dry and cracked lips, dry skin, dry nose and mouth, mild to moderate muscle or joint aches.1-2,4-7
With the right formula, acne is simple to treat. The key is being gentle with your skin because inflammation will cause more acne – always. That’s why the best acne treatment systems in 2019 include as many natural ingredients as possible to offset the drying effect of the (necessary) scientific, stronger components, combining the best science and nature has to offer.
That’s why, no matter how uncomfortable your skin may feel while plagued with acne, you must resist the urge to touch your skin. If the irritating sensations become unbearable, there are other methods of treating your skin, such as cooling it with ice packs or aloe vera gel. You can even use medicated creams designed to soothe irritated skin – given that your dermatologist says it’s okay.

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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.
If you take a close look at the acne-fighting ingredients, you will find that no single ingredient does all the work to get rid of acne. Each one has a unique effect that plays a role in the elimination of acne, but only when they are used combined or in sequence in a system do they have ability to get rid of acne altogether. This is why it is so important to use an effective system for fight acne, not just a single product.
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.
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. 
But the side effects of targeted breakout cream treatments aren’t always worth it. “So many products instruct consumers to use benzoyl peroxide spot treat red bumps and pustules. I don’t recommend it,” says Dr. Lawrence Green, board-certified dermatologist and assistant clinical professor of dermatology at George Washington University. Such high concentrations of benzoyl peroxide cause added irritation and inflammation to already sensitive skin, so with this in mind, we cut kits that included spot treatments.

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]
Another once-daily gel your dermatologist might prescribe for acne is Aczone 7.5 percent. The active ingredient, dapsone, is both antimicrobial and anti-inflammatory, and it’s proven to help with blackheads, whiteheads, and deeper painful pimples. Oftentimes, Aczone is used alongside other acne treatments. And like many of those other remedies, Aczone can cause skin to dry out.

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]
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.
Many treatment options for acne are available, including lifestyle changes, medications, and medical procedures. Eating fewer simple carbohydrates such as sugar may help.[7] Treatments applied directly to the affected skin, such as azelaic acid, benzoyl peroxide, and salicylic acid, are commonly used.[8] Antibiotics and retinoids are available in formulations that are applied to the skin and taken by mouth for the treatment of acne.[8] However, resistance to antibiotics may develop as a result of antibiotic therapy.[15] Several types of birth control pills help against acne in women.[8] Isotretinoin pills are usually reserved for severe acne due to greater potential side effects.[8][16] Early and aggressive treatment of acne is advocated by some in the medical community to decrease the overall long-term impact to individuals.[4]

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.

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 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.
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
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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]
Accutane is especially good for cystic acne in women and body acne in men. “Oral vitamin A basically shuts down your sebaceous glands. If you suppress [them] for a long enough period, you can cure someone of their acne, and about 50 percent do hit that cure rate,” says Linkner. A course of Accutane can take about six to nine months. Sometimes patients need to repeat the course at a higher dosage in order to truly eliminate acne.
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.
Benzoyl peroxide (BPO) is a first-line treatment for mild and moderate acne due to its effectiveness and mild side-effects (mainly skin irritation). In the skin follicle, benzoyl peroxide kills P. acnes by oxidizing its proteins through the formation of oxygen free radicals and benzoic acid. These free radicals are thought to interfere with the bacterium's metabolism and ability to make proteins.[79][80] Additionally, benzoyl peroxide is mildly effective at breaking down comedones and inhibiting inflammation.[78][80] Benzoyl peroxide may be paired with a topical antibiotic or retinoid such as benzoyl peroxide/clindamycin and benzoyl peroxide/adapalene, respectively.[35]
The third phase of the life cycle of acne is inflammation. At this point, your body’s immune system may deal with the problem, but if it doesn’t, different bacteria can move into the pore. Detecting an enemy bacterial invader, your body responds by emitting white blood cells to the infected area. In some cases, the white blood cells have a difficult time fighting the bacteria, and some die, contributing to the oily buildup and creating pus.

Retinoids – Recommended for people with moderate to severe acne, retinoids can unclog your pores, allowing for your other medicated acne treatments to penetrate deeper. They can reduce your potential for outbreaks and the formation of acne scarring2. You can also use a retinoid cream directly as a treatment after your face cleanse, or even take it in the form of a retinoid pill to treat oil/sebum production and to treat inflammation and acne-causing bacteria.
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]
Harsh soaps have ingredients that strip your skin of oil will put anyone at risk of pimples and clogged pores due to dry, tightened skin. Almost all body washes, no matter how gentle they claim to be, are designed to remove excess oils from your body quickly and easily. That includes removing dirt and oil from around tougher bodily hairs and pores. But the skin and hair on your face is nothing like the rest of your body. Facial skin is thinner than body skin, even though it has more sebaceous glands (glands that secrete sebum). This makes it more tender, more prone to acne and even more susceptible to aging. Thus, it has to be treated differently than the rest of your body.

Risk factors for the development of acne, other than genetics, have not been conclusively identified. Possible secondary contributors include hormones, infections, diet and stress. Studies investigating the impact of smoking on the incidence and severity of acne have been inconclusive.[2][37][38] Sunlight and cleanliness are not associated with acne.[14]
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.
Sodium sulfacetamide-sulfur is another acne medications often found in over-the-counter treatments, and it works especially well for those with mild-moderate acne that is largely made up of pimples. This is because it effectively dries out excess sebum without drying out the skin, and some studies suggest that this combination of sodium sulfacetamide and sulfur has antibacterial properties. According to one study published in The Journal of Clinical and Aesthetic Dermatology, sodium sulfacetamide 10 percent-sulfur 5 percent can significantly reduce the size of p. acnes colonies when used as an emollient foam6. This treatment option is also available as a facewash, topical gel, and topical cream, and can be found at most drugstores.
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]
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."

Contrary to the marketing promises of “blemish banishers” and “zit zappers,” immediate results are not the trademark of acne treatments — a frustrating truth to anyone suffering through a breakout. And while pimples are personal (your stress-induced spots will look and act differently than your best friend’s breakout), the best acne treatments will include a regimen of products to hit all of acne’s root causes. We tested 43 kits to find the most well-rounded breakout-fighting solutions on the market.
Tea Tree Oil – Another anti-bacterial ingredient that is common in over-the-counter treatments, tea tree oil combats acne-causing bacteria. While the FDA hasn’t officially approved it for acne treatment, some dermatologists say it’s almost as effective as benzoyl peroxide for clearing skin, although it doesn’t work quite as fast. It can be used for spot treatment as well.

What it does: Benzoyl peroxide is the only known substance which can bring oxygen under the skin surface. Since bacteria cannot survive in the presence of oxygen, when used in an adequate dosage, benzoyl peroxide eradicates 99.9% of these bacteria almost immediately. It also exerts a mild drying and peeling effect, which is thought to help prevent breakouts.1-6 Benzoyl peroxide also helps lessen inflammation.7-9 2.5% benzoyl peroxide is just as effective as higher concentrations with less side effects.6,10


Acne vulgaris is a chronic skin disease of the pilosebaceous unit and develops due to blockages in the skin's hair follicles. These blockages are thought to occur as a result of the following four abnormal processes: a higher than normal amount of oily sebum production (influenced by androgens), excessive deposition of the protein keratin leading to comedo formation, colonization of the follicle by Propionibacterium acnes (P. acnes) bacteria, and the local release of pro-inflammatory chemicals in the skin.[49]
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]
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