Chemical peels can be used to reduce the appearance of acne scars.[31] Mild peels include those using glycolic acid, lactic acid, salicylic acid, Jessner's solution, or a lower concentrations (20%) of trichloroacetic acid. These peels only affect the epidermal layer of the skin and can be useful in the treatment of superficial acne scars as well as skin pigmentation changes from inflammatory acne.[31] Higher concentrations of trichloroacetic acid (30–40%) are considered to be medium-strength peels and affect skin as deep as the papillary dermis.[31] Formulations of trichloroacetic acid concentrated to 50% or more are considered to be deep chemical peels.[31] Medium-strength and deep-strength chemical peels are more effective for deeper atrophic scars, but are more likely to cause side effects such as skin pigmentation changes, infection, and small white superficial cysts known as milia.[31]

If a pore is open, it’s called a blackhead or “open comedo”. Because of the opening, contact with the air oxidizes the dead skin cells inside the pore. The air contact turns the melanin inside them darker in color, similar to the way a peeled banana left exposed to the air will darken. This is how the blackhead forms. The color of a blackhead is not because of dirt. It’s a mixture of air and the skin pigment called melanin.


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.[140] 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.[140][146]
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.
For those with acne-prone skin, it can be tough finding a sunscreen that doesn’t clog pores and meshes well with your skincare regimen. Oily sunscreens often lead to breakouts. In addition to the wash, toner, moisturizer and treatments, the Clear Start kit includes an acne-safe (read: oil-free) sunscreen in its lineup — perfect for those wanting the best of both worlds in avoiding all types of red faces.
The costs and social impact of acne are substantial. In the United States, acne vulgaris is responsible for more than 5 million doctor visits and costs over US$2.5 billion each year in direct costs.[13] Similarly, acne vulgaris is responsible for 3.5 million doctor visits each year in the United Kingdom.[19] Sales for the top ten leading acne treatment brands in the US in 2015, have been reported as amounting to $352 million.[175]
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You really don’t need to pay more than $25 per month to get the best acne treatment system. Systems priced higher than that are, in our opinion, overpriced. Unless you have serious types of acne that require medical attention, it’s better to stay out of the dermatologists office. It’s inconvenient, expensive, potentially uncomfortable (think side-effects from medication), and no more effective than a good, complete acne treatment system you can use at home. Finally, you can go cheaper and treat your acne with homemade remedies. But the treatment experience and the results are very unlikely to be as good as they are with a treatment system.

Scientists initially hypothesized that acne represented a disease of the skin's hair follicle, and occurred due to blockage of the pore by sebum. During the 1880s, bacteria were observed by microscopy in skin samples affected by acne and were regarded as the causal agents of comedones, sebum production, and ultimately acne.[163] During the mid-twentieth century, dermatologists realized that no single hypothesized factor (sebum, bacteria, or excess keratin) could completely explain the disease.[163] This led to the current understanding that acne could be explained by a sequence of related events, beginning with blockage of the skin follicle by excessive dead skin cells, followed by bacterial invasion of the hair follicle pore, changes in sebum production, and inflammation.[163]
Benzoyl peroxide attacks the P. acnes bacteria. However, one of its main side effects is dryness: If you’re going to use anything with benzoyl peroxide, make sure to moisturize afterwards. Sulfur and azelaic acid are less common and less severe alternatives to benzoyl peroxide. Dr. Peter Lio, assistant professor of clinical dermatology at Northwestern University, says sulfur-based treatments are “a good fit for patients who can’t tolerate the side effects of benzoyl peroxide.”

A 2013 study on acne vulgaris in The Nurse Practitioner concurred that a multidimensional approach to acne is usually necessary because most people have a combination of symptoms. Based on the advice of dermatologists and aestheticians, we turned our focus to regimen sets, analyzing the ingredients of more than 40 kits before finding our top picks.
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.

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.

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!
Misperceptions about acne's causative and aggravating factors are common, and those affected by it are often blamed for their condition.[176] Such blame can worsen the affected person's sense of self-esteem.[176] Until the 20th century, even among dermatologists, the list of causes was believed to include excessive sexual thoughts and masturbation.[165] Dermatology's association with sexually transmitted infections, especially syphilis, contributed to the stigma.[165]
“Sometimes I see people try over-the-counter products just for a couple of weeks, they get frustrated, they say it’s not working, and they discontinue them,” Arthur says. “But it really does take a while to see the effectiveness. So unless you’re having a problem with the medication, like it’s causing severe irritation or dryness, it’s recommended to give it at least 2-3 months before switching to something else.”

Sometimes birth control alone isn’t enough to really make a difference in hormonal acne. That’s when your doctor might recommend adding in an androgen blocker such as Spironalactone. Spiro (as it’s called) minimizes the amount of androgen hormones in circulation by blocking the receptors that bind with testosterone. When these pills are taken at the same time as an oral contraceptive, 90 percent of women see an improvement in breakouts, according to Linkner. The drug is sometimes prescribed to women with PCOS (polycystic ovarian syndrome) to relieve androgen-related symptoms like excessive hair growth, hypertension, oily skin, and acne.
Acrokeratosis paraneoplastica of Bazex Acroosteolysis Bubble hair deformity Disseminate and recurrent infundibulofolliculitis Erosive pustular dermatitis of the scalp Erythromelanosis follicularis faciei et colli Hair casts Hair follicle nevus Intermittent hair–follicle dystrophy Keratosis pilaris atropicans Kinking hair Koenen's tumor Lichen planopilaris Lichen spinulosus Loose anagen syndrome Menkes kinky hair syndrome Monilethrix Parakeratosis pustulosa Pili (Pili annulati Pili bifurcati Pili multigemini Pili pseudoannulati Pili torti) Pityriasis amiantacea Plica neuropathica Poliosis Rubinstein–Taybi syndrome Setleis syndrome Traumatic anserine folliculosis Trichomegaly Trichomycosis axillaris Trichorrhexis (Trichorrhexis invaginata Trichorrhexis nodosa) Trichostasis spinulosa Uncombable hair syndrome Wooly hair Wooly hair nevus
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.
Aside from adding bacteria to your skin, these forms of contact can irritate the skin, adding to the appearance of redness and causing increased inflammation. In the event that your pimples get ruptured during this process, the oil and bacteria that was trapped inside could spread to the surrounding skin on your face, which causes acne to spread. So, not only will rubbing, squeezing and scratching leave your acne-ridden skin further irritated, it will increase the amount of acne you will have to deal with.
Benzoyl peroxide attacks the P. acnes bacteria. However, one of its main side effects is dryness: If you’re going to use anything with benzoyl peroxide, make sure to moisturize afterwards. Sulfur and azelaic acid are less common and less severe alternatives to benzoyl peroxide. Dr. Peter Lio, assistant professor of clinical dermatology at Northwestern University, says sulfur-based treatments are “a good fit for patients who can’t tolerate the side effects of benzoyl peroxide.”
First, it’s a cleansing oil, not the typical gel wash or liquid. Next, it has a potent blend of salicylic, glycolic, and lactic acid for superior exfoliation. Third, it contains natural ingredients that repair damage to the skin and get rid of acne. For example, soapwort extract dissolves oil without the need for drying sulfates. Then, vitamin B and lavender combine to reduce oil secretion and inflammation. Finally, watercress is full of antioxidant vitamins that heal damage caused by the sun.
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
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Even though it may be convenient to wash your face with whatever you have in your bathroom, there are a lot of reasons why you want to avoid that like the plague. Summed up in one word, those reasons are; ingredients. Because different people have different skin types, not all ingredients will work the same for everybody, but the general principle remains the same.
The three-piece set doesn’t come with a sun protection treatment, but Paula’s Choice has one in the line, the Clear Ultra-Light Daily Fluid SPF 30+. “Sun protection is really important, especially with acneic skin,” says Townsend. “In many cases, stronger acne products can make the skin photosensitive to the sun.” This isn’t your normal gloppy white sunscreen. Its fluid formula slips over tender skin, doesn’t need a ton of rubbing in, and also leaves a mattifying finish.
A lot of people have an urge to rub, squeeze or scratch the blemishes on their skin, and who can really blame them? Pimples can hurt, throb and itch, all the while being a sore sight to see. It’s only natural that we seek to remove these blemishes in any way possible, but some methods of removal are more harmful than others. When it comes to rubbing, squeezing and scratching your pimples, it can only make your skin worse.
Comedones (blackheads and whiteheads) must be present to diagnose acne. In their absence, an appearance similar to that of acne would suggest a different skin disorder.[27] Microcomedones (the precursor to blackheads and whiteheads) are not visible to the naked eye when inspecting the skin and can only be seen with a microscope.[27] There are many features that may indicate a person's acne vulgaris is sensitive to hormonal influences. Historical and physical clues that may suggest hormone-sensitive acne include onset between ages 20 and 30; worsening the week before a woman's period; acne lesions predominantly over the jawline and chin; and inflammatory/nodular acne lesions.[1]
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.
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.

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.
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.
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.
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