The Ultimate Guide to Acne Treatments
The Ultimate Guide to Acne Treatments
How much do you know about acne treatments? Read our ultimate guide to learn more about the cure of inflamed or infected sebaceous glands in the skin.
Keyword(s): Acne Treatments
About 85% of people between the ages of 12 and 24 experience some form of acne.
But, if it's so common, why is it still so difficult to fix?
If you're struggling with acne treatments, you're in the right place.
Here's our official guide to everything you need to know about acne.
Types of Acne
Not all acne, or what we might perceive as acne, has the same root cause. Because of this, not all types of acne can be treated in the same way. This is why it's so important to see a professional and know for sure what type of acne you're dealing with.
Sometimes your acne could actually be a different skin condition like folliculitis, rosacea, or milia. Many of these other conditions can actually be made worse by traditional acne treatments. Ultimately, acne can be broken down into two categories: inflammatory and noninflammatory.
Noninflammatory acne is the less severe form of acne. It's mostly caused by a build-up of grime on the skin, not by an underlying health issue.
When people think of the classic "zit' they're usually referring to whiteheads. Depending on your skin tone, the color of a Whitehead will vary. But, they're typically a fleshy-colored bump or dot on the skin, surrounded by redness. The medical term for whiteheads is closed comedones.
Blackheads are clogged pores that look like small or large black dots on the skin. Blackheads are called open comedones. Their color is due to the oxidation of the dirt and pus when it's exposed to oxygen, at the surface of the skin.
Inflammatory acne is a little more serious. It's usually more widespread over the body and can cause more scarring. This type of acne can require more of a medical approach to resolve.
This is because inflammatory acne is not as straightforward as noninflammatory acne. There are a lot of different forms of inflammatory acne. There are even more reasons why someone can develop it.
Papules are small, solid, tender bumps on the skin. They appear to be raised and have no visible center (like with whiteheads and blackheads). Usually, the skin around a papule is red.
These bumps are similar to papules. But, the defining difference is a pus-filled center that can be yellow or white. Pustules look red on lighter-colored skin and brown on darker-colored skin.
Papules and pustules are considered to be "mild" forms of inflammatory acne. But, nodules are where acne enters the "severe" category. Nodules are very similar to papules in appearance. But, they are located much deeper in the skin and are often larger than they appear to be.
Cystic acne is the most severe form of acne. Cysts are painful, red or white lumps situated deep in the skin. There are many different types of cysts, which can all feel and look different.
For example, some cysts can be very large, soft with clear watery pus contents. Others can be small, feel hard to touch, and contain a build-up of dead skin cells that resemble cottage cheese when they are extracted.
Cysts can be shallow or very deep in the skin, and sometimes they can even attach to muscles, tissue, blood vessels, and other body parts. This is why it's very important to not attempt to remove a cyst yourself (save it for a dermatologist).
Acne happens for a lot of different reasons. Ultimately, there is an issue with exfoliation and shedding of skin cells on the face, which creates a clogged pore. This can be caused by many different factors that should all be treated differently.
Foods That Cause Acne
When you're trying to figure out the cause of your acne, the simplest place to start is your diet. Numerous studies have found that diets high in refined sugar, processed foods, and dairy are all linked to acne. These foods can disrupt your hormones or trigger an inflammatory response due to food intolerance.
Hormonal Changes Causing Acne
When hormones are disrupted, they can trigger your oil glands to overproduce. Hormones can change due to foods, cleaning products, hormone disruptors in skincare products, air pollutants, stress, illness, and disease. Hormones can also change naturally as we age or go through physiological changes like puberty, pregnancy, or menopause.
Acne Treatments for Oily Skin
Our skin produces oil to hydrate skin. You need some level of oil in the skin to keep it healthy, but bodies can overproduce oil. Excess oil clogs pores and causes acne.
If you don't wash your face daily, there's a good chance your acne is forming because dead skin is not being removed from the surface of the sin. Many people think of harsh physical scrubs when they think of "exfoliation," but the skin can benefit from chemical exfoliation too.
However, over-washing your face or washing it too harshly can cause your skin to become too dry, which can trigger your skin to produce even more oil.
The Best Acne Treatments
If you have non-inflammatory acne, your problems can usually be solved with a consistent skincare created by your health professional. Drugstore products all usually contain the same mixture of ingredients that can all treat and prevent whiteheads and blackheads - but unfortunately these ingredients are at small doses and not as active.
Salicylic acid, glycolic acid, azelaic acid, and adapalene all help exfoliate the skin at a chemical level.
Sulfur products help absorb oil and bring impurities to the surface of the skin. Wearing a physical based sunscreen, and washing your face with lukewarm or cold water before you put anything on your skin will also prevent acne.
More advanced skin care routines might also include products that contain compounds like retinoic acid, retinol, and retinal.
Minimally Invasive Cosmetic Procedures for Acne
There are more intensive treatments for more severe forms of acne. These types of acne treatments can be done by aestheticians, dermatologists, and plastic surgeons. These types of treatments are called "minimally invasive" because they do not require anyone cutting your skin open, and don't require much downtime (if any) after they are performed.
Light-based therapies are backed by some serious scientific acne treatment research. There are red, blue, and multispectrum lights that can be used to kill bacteria, heal skin, and reduce the appearance of scars and discoloration. There are at-home light therapy treatments available too.
Dermabrasion and Dermaplaning
Dermabrasion and dermaplaning are a mild form of skin scrapping that's effective at removing dead skin. It can help remove irregularities and make the skin smoother. It's usually followed by a chemical peel or face mask so that the "fresh" skin can absorb the full benefits of the skin treatment.
Chemical peels are most effective when they are applied after dermaplaning or microdermabrasion. A chemical peel is simply a solution that usually contains a chemical like salicylic acid, glycolic acid, and mandelic acid at higher concentrations than are available to the public. Chemical peels can help treat existing acne and improve the texture and pigmentation of the skin.
Laser Skin Resurfacing
There are many different types of laser skin treatments. Sometimes they can get a bit confusing because there are so many that can do different things. Erbium YAG lasers, pulsed-dye lasers, and carbon dioxide (CO2) lasers can all be used to help treat acne and reduce the appearance of acne scars. Laser treatments are typically the last line of defense before surgical and prescription options.
Prescription Acne Treatments
If at-home and cosmetic treatments fail to cure your acne, a dermatologist, primary care physician, or nurse practitioner may prescribe medication. Acne medications come in topical and pill forms and can treat a wide range of different types of acne.
But before they do this, a doctor may consider having some blood work done to ensure that there isn't an underlying issue causing your acne. Treating an underlying issue first, like an autoimmune disease, allergic reaction, endocrine disorder, or even a genetic mutation, will do a better job of solving the acne in the long term.
Topical Acne Prescriptions
Most prescribed topical acne treatments will be some form of a retinoid. Retinoids can be derived from synthetic and naturally occurring sources of vitamin A. You can find retinoids in over-the-counter products, but they are usually different types of retinoids or in much smaller doses, even in prescription retinols ordered by a physician. Education around retinoid/retinols is key when picking your products.
This topical acne treatment is an antibiotic (not a retinoid) used to treat severe acne caused by bacteria. It also has anti-inflammatory properties, which reduce swelling and redness caused by acne. It's usually prescribed in conjunction with another topical treatment (it comes in oral form, but it's more commonly used as a topical cream).
Oral Acne Perscriptions
Sometimes, like with your diet, the best approach to fighting acne is starting within. This is where oral acne treatments come into play.
Most physicians will consider antibiotics first since these usually have the least amount of negative side effects. Tetracycline, minocycline, doxycycline are the primary prescriptions health practitioners turn to. But, they may prescribe names like macrolide and erythromycin, azithromycin to people who cannot take the primary antibiotics used to treat acne (like children and pregnant women).
Oral Vitamin A
Isotretinoin, brand name Accutane, is one of the most well-known oral acne prescriptions. It's typically reserved as the last line of defense if all other prescriptions have failed. This is because the drug can have some serious negative side effects like severe birth defects, inflammatory bowel disease, and depression.
Injectable, Excision and Extraction Acne Treatments
Acne surgery may be a suggested treatment method alone or in addition to prescription treatments. Blemish excision is a procedure where a licensed physician essentially drains or extracts acne from the skin. For example, an abscess may only need to be cut and drained, whereas a cyst will need to be completely removed.
Extractions and Draining
Your doctor may choose to extract difficult or deep blackheads, whiteheads, and even milia. Depending on how deep a blemish is (and how much pressure they will have to use during the extraction), they may use a numbing injection. Most extractions are performed with a metal tool designed to use pressure to release the contents of an impurity.
They may also drain painful pus-filled blemishes that are difficult for you to drain yourself or to reduce the amount of scarring that draining it yourself could cause.
Extractions and draining only treat existing acne. They don't always prevent new acne from forming. This is why they are usually performed in conjunction with a prescription acne treatment plan.
Steroid injections are used to treat many skin conditions. For example, Hidradenitis suppurativa is an incurable skin condition that can be better managed with routine steroid injections. Injections can also help calm down severe acne by shrinking the size of blemishes and reducing redness.
Intralesional corticosteroid injections or cortisone injections are often what's being used when we say "steroid injection." They are often administered when all other attempts have failed or acne surgery can't be performed.
So, why not just do acne surgery yourself? You might be surprised how deep some cysts can get and close they can be in proximity to important arteries, sinus tracts, and even organs. Surgery at home can have devastating consequences.
If that doesn't scare you, removing blemishes yourself leads to unnecessary scaring. Scarring is very difficult to eliminate.
The Best Skincare Routine for Acne
The perfect skincare routine for acne may vary slightly between people. Some people may swear by one cleanser, while another group follows a different cleanser like a cult. Finding the products that work for you takes time and a bit of trial and error.
But there is a foolproof skincare routine that can work as an excellent starting place or base for you to build your perfect acne treatment routine. Just remember that routines are intended to be done consistently.
Washing your face one to two times daily can help decrease the intensity of your breakouts. This is because routine cleansing helps manage oil production and removes dead skin cells (which clog pores). A simple gel, foam, or cream cleanser works. Look for non-comedogenic and oil-free products that hydrate and contain chemical exfoliators like salicylic acid or glycolic acid.
You can exfoliate both physically and chemically. You might want to switch between using a gentle scrub and a face wipe or mask containing chemical exfoliators at this step. Exfoliating at both levels is important for achieving clear and smooth skin.
Toning is a helpful step that helps further clarify the skin. Simple spray toners containing ingredients like witch hazel, aloe, rose water and tea tree oil can help calm the skin and treat blemishes. Some people skip this step, while others swear by it.
This is the stage where you apply a serum with active ingredients. The treatment option you use during the day should not be the same one that you use at night. This not only can dry the skin but many topical prescriptions are sensitive to sunlight.
Use retinoids (and all of its siblings and cousins) during your evening skincare routine. Most over-the-counter products containing ingredients like lactic acid, glycolic acid, vitamins, herbs, and plants, are safe to apply in the morning. When choosing products to add to your routine, just check to make sure that their active ingredients play well with the other ingredients you use.
For example, the following compound combinations actually enhance the effectiveness of each chemical when they are applied together or layered on top of each other:
Vitamin C and ferulic acid
Vitamin C and vitamin E
Niacinamide and salicylic acid
Sunscreen and antioxidants
Green Tea and caffeine
Centella Asiatica and vitamin C
But there are some combinations that can have harmful effects when they are applied together or layered:
Retinoids and alpha or beta hydroxy acid
Retinoids and vitamin C
Benzoyl peroxide and vitamin C
Benzoyl peroxide and retinol
Too many acids (if there is an active acid in every product you use, you can dry out and damage your skin)
So, for example, if you use retinol as part of your evening routine, you wouldn't want to spot treat blemishes with an acne treatment containing benzoyl peroxide. You might instead opt for spot treating blemishes with acne patches or products containing salicylic acid or sulfur.
Hydration is a step where people with acne-prone skin can seriously struggle. Too often, "moisturizing" and "hydrating" are used interchangeably when they are not the same thing. But they can have a big difference on acne-prone skin.
Moisturizers are usually thicker emollients in the form of lotions that we think of when we think of hydrating or moisturizing. Most of the time, these products are thicker because they are designed to trap moisture in the skin. However, many (if not most) emollient moisturizers clog the pores of sensitive skin.
A lot of acne sufferers have only had experiences with moisturizers that worsen their acne. So, they have removed this step from their routine thinking it will improve their acne. But using acids and prescriptions without hydrating the skin can actually make your acne worse.
This is where products that contain hydrators like hyaluronic acid, aloe, glycerin, lactic acid, citric acid, honey, and (most of the time) ceramides are used. Most of these hydrators come in the form of a serum, which feels lighter on the skin.
There are a lot of reasons to include SPF in your skincare routine (cancer, wrinkles, skin discoloration etc.). But too much sun exposure can actually cause blackheads. Many acne sufferers have the same problem with SPF products as they do with "moisturizing" ones. Most sunscreens are thick, oily, and cause breakouts.
Thankfully, the industry has responded to this concern, and now there are many non-comedogenic sunscreens available for people who suffer from acne.
Acne Treatment Hacks
Need some more tips for building the perfect acne treatment routine? Following the steps above in addition to considering the skincare philosophies below will set you on the path for success.
Consistency Is Key
Whatever products or procedures you choose in your acne treatment plan, the key is to be consistent. Even if you have access to the best doctors and the most expensive products, if you fail to have a routine, they won't be effective.
Avoid Product Overload
The number of new products and "miracle" ingredients being marketed each year is overwhelming, to say the least. Each label you read promises glowing, fresh, flawless, youthful skin. So, why wouldn't you try it?
Finding the right routine and products can take time. The best thing to do is to establish a solid system that addresses all of your concerns first, and then only buy what fits within your specific needs.
Working with a dermatologist can help expedite this process. You are much more likely to stick to a simple routine than a complicated one.
Give Your Routine Time
Unfortunately, acne does not go away as quickly as it seems to appear. Don't expect to see lasting results within a week of trying a product. You need to stick to a routine for 8-12 weeks to ultimately see results.
Know When to Consult a Professional
Consulting with a professional can help you get to the right acne treatment plan much faster and more effectively than trying to figure it out yourself.
That's why we offer a complimentary 15-minute consultation to all of our clients.
Our team of medical doctors, naturopathic doctors, herbalists, dieticians, estheticians, and nurses is experienced at providing holistic acne treatments. Stop putting yourself through the stress and pain of acne. You deserve better!