Ways to Treat Stubborn Acne

Acne occurs when hair follicles become clogged with oil and dead skin cells. Acne can range in severity from minor whiteheads and blackheads to pus-filled cystic nodules beneath the skin. Although acne can occur anywhere on the body, it most often develops on the face, chest, shoulders, and back. While acne is not life-threatening, it can result in significant emotional distress and skin scarring if not treated.

Acne affects approximately 50 million Americans each year, which makes it the most common dermatological condition in the United States. Up to 85 percent of individuals experience at least minor acne during their teens and early 20s. According to a report published in the British Journal of Dermatology, Americans spend approximately $3 billion annually on acne treatments.

Acne is most common during the teenage years when hormones become more active. The condition is the result of hormone sensitivity combined with increased fatty acids within the oil-producing glands of the skin and bacteria on the surface of the skin. Other factors may contribute to the development or exacerbation of acne outbreaks, including heredity, emotional stress, medications, changes in hormone levels just prior to menstruation, hats and other clothing that trap sweat and dirt against the surface of the skin, and picking or popping acne lesions. Adult women may also experience acne flares as they approach menopause and hormone levels start to fluctuate erratically.

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Treatments for Mild Acne

Mild acne is characterized by whiteheads, blackheads, and no more than a few pimples and non-inflamed lesions. Most cases of mild acne can be treated using over-the-counter remedies and regular skin hygiene. However, it’s important to note that results are not guaranteed. Different skin types and lifestyles will react to treatments differently, thus it’s safe to temper your expectations when trying any of the following skin care regimens.

Proper Skin Cleansing

Washing the affected area of the body several times a day with a gentle soap and warm water will help remove the oil, dead skin cells, and bacteria that can clog the pores and lead to an acne flare. Harsh astringents, toners, and soaps should be avoided since they can dry and irritate the skin. It is also important to avoid scrubbing too vigorously since this can damage the skin, which can make it more susceptible to breakouts and infections.

Choose Cosmetics and Moisturizers Carefully

The oils and fragrances found in most cosmetics and moisturizers worsen acne symptoms by clogging pores and irritating the skin. When choosing moisturizers and cosmetics, you should look for products that are labeled oil-free or for sensitive skin.

Eat a Healthy Diet

Although a link between diet and acne has not been definitively proven, avoiding greasy and sugary foods may help improve overall skin quality. If you notice that your breakouts worsen after eating certain foods, go ahead and avoid them.

Over-the-Counter Remedies

Most over-the-counter acne treatments contain either benzoyl peroxide or salicylic acid. Benzoyl peroxide works by killing the bacteria on the skin and comes in gel, cream, and liquid forms. Salicylic acid reduces the appearance of acne by penetrating into pores and breaking down the oils and fats that clog the pores. Alpha hydroxy acids treat acne by reducing inflammation and removing dead skin cells to stimulate the growth of new, healthy skin.

Treatments for Moderate to Severe Acne

Moderate acne is characterized by numerous inflammatory pimples and non-inflammatory lesions. Individuals with severe acne may also have multiple cystic nodules beneath the surface of the skin. Because of the extent of the breakouts and the risk of scarring, a more aggressive treatment approach is normally required in cases of moderate to severe acne.

Prescription Topical Gels and Creams

Azelaic acid, which is available in a cream or gel, reduces the bacteria that cause acne flares, promotes the shedding of dead skin cells, and reduces inflammation. Retinoids, which are derived from synthetic vitamin A, exfoliate the skin so that the pores are less likely to become clogged

Topical and Oral Antibiotics

Topical antibiotics, typically clindamycin or erythromycin, may be combined with a retinoid or another topical treatment to reduce acne inflammation and inhibit bacteria growth on the skin. A multi-month course of oral antibiotics, such as tetracycline, doxycycline, erythromycin, or minocycline may also be used.

Oral Contraceptives

Certain forms of birth control pills may be effective in reducing acne in some women by reducing the amount of androgen hormones in the body.

Treatments for Acne Scars

Acne produces three types of scars:

  • small, deep pits known as ice pick scars;
  • shallow or deep scars with sharp edges and angles known as boxcar scars; and
  • rolling scars, which are wide, shallow, and have a wavy appearance.

Depending on the type and severity of the scarring, a variety of methods may be used to improve the appearance of the skin.

Skin Resurfacing

Laser therapy, dermabrasion, and chemical peels reduce the appearance of scars by removing the damaged layers of skin.


Collagen or fat may be injected into the scar to puff up the skin and create a smooth surface.


This technique involves rolling a device covered in very small needles over the surface of the skin. The damage to the skin caused by the needles stimulates the body’s healing response and the growth of new tissue.


In extreme cases of acne involving deep cysts or scars, surgery may be necessary to remove the damaged tissue. A piece of skin from elsewhere on the body is then used to repair the area.

It is important to remember that treatments for acne and acne scars take time and may require multiple rounds of treatment to achieve maximum results.