Everything You Need to Know About Treating Acne

Relief from breakouts and ongoing acne is in sight. These guidelines will help you get to the root of your skin woes, and you'll learn about the different types of acne and how to effectively treat, minimize, and prevent it.

Image courtesy of Getty.
Image courtesy of Getty.

What Causes Acne?

The source of acne is different for everyone, but many people struggle with outbreaks throughout certain periods in their lives—whether it's a small pimple before a project meeting or long-term cystic acne that causes pain even when sleeping. Dr. Harold Faber, a certified dermatologist at Faber Dermatology in Philadelphia, says that acne can be caused by genetics, hormonal imbalance, dietary factors, and even stress. But there are treatments to address each individual's acne source. Getting into a proper skincare regimen and good habits that benefit the resolution of acne is the mainstay of therapy, Ferber says.

Age is also a factor. Acne is extremely normal to see, especially in young people, says Dr. Valerie Goldburt, a board-certified dermatologist in New York. Teenagers struggle with hormonal acne in particular because their bodies are producing more hormones as they go through puberty, and their oil glands are more active.

People have this idea that acne an abnormal thing, and it isn't, particularly for younger people, Goldburt says. "If their lifestyles are a bit more variable, and they are not eating so great, then all these factors can contribute to acne. In particular, younger women have hormonal acne, as well. It's normal."

What Are The Different Types of Acne?

There are two main categories of acne, and each one needs to be treated differently. According to Dr. Lindsey Bordone—a board-certified dermatologist in the Department of Dermatology at Columbia University Medical Center—the most common type of zit is superficial acne, which remains close to the skin's surface and does not cause long-term scarring. Whiteheads and blackheads also fall under the umbrella of superficial acne.

The second broad type of acne category is cystic acne, which is recognized as "big red painful pimples" that can lead to atrophic scarring under the skin's surface. In the case of cystic acne, a licensed dermatologist can help you diagnose your specific acne type and outline a treatment plan. In both cases, Bordone says, picking at the skin or popping zits at home will only cause more inflammation, and more scarring. The same rule applies to deeper cystic legions, which are already likely to leave scars, even if you don't touch it at all.

How Should I Start Treating Acne?

If you're dealing with new outbreaks, try a daily over-the-counter face wash with benzoyl peroxide or salicylic acid.

Neutrogena's Oil-Free Salicylic Acid Pink Grapefruit Pore Cleansing Acne Wash, $5.98

, is a favorite because it banishes oily skin but doesn't smell medicinal.

For a basic topical treatment, Bordone recommends 

Differin, 

$24.47 for a 60-day supply

, which contains the active ingredient Adapalene. Now available over-the-counter, Differin is a gel that regulates cell turnover to keep pores from clogging and turning into acne outbreaks. It can be applied as an OTC spot treatment or on key acne areas, but it can dry out skin. "Differin is a retinol, and retinol is kind of like a light chemical peel," Bordone says. Start by using it every other day, and step it up to every day if your skin doesn't show signs of irritation. 

Follow the Differin with a noncomedogenic moisturizer that won't clog pores (try a brand like CeraVe). A light moisturizer can refresh the skin and help rebuild the skin's protective barrier while the Differin treats acne under the surface.

Do Natural, At-Home Acne Remedies Work?

Many beauty enthusiasts swear by certain natural acne treatments and at-home remedies, but they can rarely compete with over-the-counter treatments. "There are much better things than diluted vinegar to put on your face," Goldburt says. She also cautions that there are rarely scientific studies to back up natural acne remedies, and that some popular at-home treatment trends can actually cause more harm than good.

One patient put vinegar on her skin overnight after seeing a YouTuber suggest it—and woke up with a minor burn on her face. Using lemons to lighten acne scars can also be dangerous; the fruit's acidity can cause pigment stains on the skin instead. 

Though it might be tempting to reach for a tube of toothpaste to spot-treat zits, the safer bet is to use salicylic acid in a gel form.

What Are the Best Prescription Acne Treatments?

In certain cases, natural treatments and over-the-counter options are not strong enough. Goldburt says a prescription topical retinoid—like tretinoin or tazarotene—can be most effective because of the prescription strength not found in over-the-counter products. Both of these topical retinoids are much stronger versions of a Retinol, which increases cell turnover and helps reduce signs of aging. Though they'll require a bit of supervision from your dermatologist because they can be drying and increase skin's sensitivity to the sun, they can clear up acne more rapidly and effectively than drugstore products.

If you're hung up on the cost of prescription acne meds, consider this: prescribed acne medications can actually be the "biggest money saver" for somebody with severe outbreaks since they can permanently fix the acne, says Bordone. She recommends meeting with a dermatologist to learn about more advanced options, like the prescription drug Accutane, to resolve persistent acne issues.

What Is the Best Treatment for Acne Scars?

If you already have cystic acne or severe scarring, it's important to consult a dermatologist before beginning at-home treatments that could further aggravate the existing acne. "It's better to address acne before you have scars than to try to treat them later," Bordone says. She recommends patients wear daily sunscreen to avoid getting dark marks from pimples and reduce the formation of acne scars.

Other dermatology treatments, including laser surgery, can also effectively minimize and erase acne scars.