The Ultimate Guide to the Best Acne Treatments - The Dermatology Review

The Ultimate Guide to the Best Acne Treatments

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09.28.18 AD DISCLOSURE

It’s estimated that approximately 85 percent of people between the ages of 12 and 24 will experience acne at some point in their lives. But even beyond the teenage and young-adult years—30s and even into one’s 50s—it’s possible to experience adult-onset acne. Because so many people are affected by pimples, the anti-acne struggle is big business, which means shelves are loaded with the best skincare products for acne—along with not-so-good options. There are as many treatment options as there are types of acne, all targeting different root causes. But which are truly the best acne treatments?

Many acne treatments will target clogged pores, which are the initial causes of most types of acne. If pores never got clogged with oil and dead skin cells, acne would certainly be less of an issue. Bacteria is another trigger, as it lives inside pores and feeds on the natural sebum (oil) there. Bacteria can infect clogged pores and cause inflammation, which is essentially what pimples are.

13 Best Acne Treatments in 2016

There are various ways you can remedy clogged pores, from applying acids like salicylic acid and glycolic acid to getting regular professional facials where the blackheads will be physically extracted and laser therapy. You can also combat pimples by changing your lifestyle, tweaking your diet, using over-the-counter treatments like retinol and benzoyl peroxide and trying different types of laser treatments.

In this article, we’ll discuss the best acne treatments for teenagers and the best acne treatments for adults by explaining what may be causing your acne and how you can tailor the way you live to help reduce lesions, but also recommend certain ingredients and products to incorporate into your skincare routine.

8 Different Types of Acne

Before we get into the best types of acne treatments to consider, it’s important to first understand the different types of acne in order to determine which you’re experiencing–and how to specifically tackle it. A whitehead, for example, may need a certain ingredient while cystic acne may require a combination of topical retinol and laser therapy.

For many people, the term acne is a loosely used word to describe what many of us dealt with during the years of our youth. We typically don’t associate the erratic pimples that occur when we’re under stress with acne and you won’t find many women who experience breakouts around their cycle claiming to be dealing with acne. It’s also unlikely for the person who habitually uses their favorite pore strips to clear out blackheads to realize they are fighting acne as well. The truth is, all of these instances, in some way or another, is a different type of acne.

There are many different types of acne that affect millions of people around the world. From some of the most subtle occurrences that barely affect the person to more severe cases that can cause more serious effects. To truly understand this complex condition, you have to start with getting a deeper understanding of the different types of acne. Once you’re clear on the type of acne you are experiencing, you can work on a plan to treat, reduce, and possibly even prevent it. Let’s briefly go through each type of acne taking into account what causes it, how to spot it, and even what to do about it.

Acne Vulgaris
Let’s start at the beginning with acne vulgaris. Acne vulgaris sounds much more serious than it is. Medically speaking, acne vulgaris is simply the technical term for normal acne. Acne vulgaris covers many different types of acne including many listed here. It is considered to be a mild type of acne so more severe types of acne would not fall under this category. Acne vulgaris is easily treated using a number of methods and over-the-counter treatments with many people finding success using salicylic based gels or cleansers. It’s very normal to experience acne vulgaris on various areas of the body, but the face, back, and shoulders are the areas most commonly affected.

Hormonal Acne
Acne breakouts can be caused by many different factors. When the cause of acne, regardless of which type, is the result of a hormonal change or imbalance it is considered hormonal acne. Hormonal acne occurs when your body’s hormones produce excess oil. Hormonal acne generally tends to follow a schedule and occur around the same times specifically during menstruation for women, pregnancy, and even menopause. Hormonal acne usually appears around the mouth or along the jawline and can range from very mild to severe. Treating hormonal acne can be tricky due to the fact that for the most part, it is out of your control. To effectively treat hormonal acne, you’ll need to be consistent. It’s not uncommon to go through a few cycles of different treatments before you find the one that works for you.

Cystic and Severe Acne
Of all the different types of acne a person may encounter during their lives, cystic acne is the most severe of them all. Fortunately, though, while cystic acne is the most severe, it is also the least common of the different types of acne. With cystic acne, the cause is typical of many different types of acne: clogged pores. The difference with cystic acne is that the clogged pores remain blocked which ultimately leads to an infection. This infection and inflammation at the blocked pore creates a cyst, and the most painful and noticeable cysts are considered cystic acne. The appearance of cystic acne stands out against different types of acne because of the extreme inflammation and likely the quantity of cysts in a small area. For cystic acne, the best way to get effective treatment is to consult a dermatologist. There are many prescription grade treatments that can help get cystic acne under control.

Papules and Pustules
Other types of acne that are created as the result of inflammation are papules and pustules. Although their names sound similar and they have similar causes, they are each a different type of acne in their own right. Papules are a type of acne that forms as a result of a clogged pore that develops into a bump (also known as a comedone) and becomes inflamed. Typically papules are small, sensitive when touched, and are mainly found on the face or the back. When papules become excessive it can develop into cystic acne. The good news is that papules are relatively easy to treat with many over-the-counter creams helping to kill bacteria. There are also some antibiotics that can be used to treat more severe papule acne as well as anti-inflammatory treatments which may help as well.

Pustules, on the other hand, are also a type of inflamed bump but it’s the appearance and cause that differs with this type of acne. Pustules are small, pus-filled bumps that look similar to whiteheads. You’ll commonly find this type of acne on the face, back, or chest area and frequently in clusters on specific areas of the body. Pustules acne generally occur as a result of hormonal changes, hormonal imbalances, or possibly even an allergic reaction. Treating pustules acne is the easiest of them all: you wait it out. Pustules generally go away on their own with proper skin care habits. If you really want to feel like you’re doing something to treat this type of acne, over-the-counter acne cleansers can’t hurt.

Whiteheads
Remember we talked about comedones? Those bumps that develop from a clogged pore? Well, whiteheads are formed when comedones stay closed on the skin’s surface and have a whitish appearance. Whiteheads are a type of acne that is typically caused by hormonal changes and women going through various life phases (puberty, pregnancy, and menopause) are most likely to experience whiteheads during their life. Since this type of acne is hormonal based, it’s hard to prevent and can’t be “cured” in the same sense as other types of acne. Thankfully, whiteheads are generally a very mild type of acne and can be easily treated with over-the-counter creams and salicylic acid cleansers.

Blackheads
Blackheads are a type of acne that many people may not realize falls under this condition due to its stark contrast to many other kinds mentioned here. Blackheads are opposites of whiteheads by the fact that they are open on the skin’s surface, not closed. Blackheads are very small bumps that look black in appearance due to the oil and dead skin that may be clogging the pores. Blackheads are another type of acne that is commonly caused by hormonal changes or imbalances but, there are many other factors that can contribute as well. Anything that can potentially cause a blockage of pores including certain types of cosmetics and even perspiration can be the cause of a blackhead. Fortunately, treatment for this type of acne is fairly easy with salicylic acid and the popular blackhead clearing strips being the go-to courses of action. Other lifestyle adjustments may be helpful in preventing blackheads from occurring. Using cosmetics that are non-comedogenic meaning they won’t clog pores is a great place to start.

Nodular Acne
While cystic acne is the most severe type of acne, nodular acne is one of the most difficult types to treat. Nodular acne typically occurs at the end of an acne cycle and can prolong the process. Nodular acne is characterized by a large bump under the skin that is painful to the touch. What makes nodulars such a tricky type of acne is the fact they can lie dormant under the skin for a long period of time before flaring up. It’s also not surprising to see nodular acne appear multiple times in the same place due to it being unresolved. Treating nodular acne will take some time and you may find yourself trying a few different things before landing on something that works. If you’re heading the over-the-counter route anything with benzoyl peroxide or salicylic acid can help calm a nodular acne flare up. There are also more advanced dermatological procedures involving cortisone that can help to treat a particularly stubborn nodular if needed.

Adult Acne
It’s important to understand that different types of acne can occur at any age in life. Though it is more common in adolescence through early adulthood, it’s not an anomaly for an adult to have acne. Whenever a person experiences acne in adulthood it is considered adult acne. Adult acne can fall under any one of these conditions and can be caused by everything from stress to hormones.

The Best Acne Treatments

1. Lifestyle and Environment
Your lifestyle and environment can have a considerable effect on your acne. The healthier your lifestyle, the healthier your skin (and the rest of your body). Of course certain foods will keep your skin more clear than others, but in this case you can also follow some general guidelines to target acne problems. These solutions work well for adults and teens.

  • Get Your Vitamin D – Even just ten minutes a day under the sun can give you the proper amount of vitamin D you need to stay healthy. Vitamin D is important because it has antimicrobial properties. Moreover, having enough vitamin D in your body can help prevent inflammation, which is one of the top causes of acne. One study actually found that individuals with vitamin D deficiency were far more likely to have nodulocystic acne (the painful, deep-in-the-skin kind of acne) than those with adequate levels of vitamin D. You can also incorporate vitamin D into your diet by taking supplements.
  • Keep Your Devices Clean – Wiping your cell phone regularly throughout the day with an antibacterial wet wipe can go a long way in preventing acne-causing bacteria from proliferating on your face. Think of how often your cell phone is pressed against your skin, and you’ll realize that keeping it clean is crucial. This also pertains to anything that you might hold against your skin besides a cell phone.
  • Don’t Touch Your Face – Touching your face (and picking at your existing acne) is a big no-no. When you touch your face not only do you transfer bacteria from your hands onto your facial skin, but you also make all that oil and dirt already on your face spread. This makes your face a breeding ground for acne lesions like inflamed pimples. Moreover, actually picking at your blackheads or popping your pimples can not only make the inflammation worse, it can also create scarring (post-inflammatory hyperpigmentation) that can be hard to get rid of, sometimes taking up to six months to fade away, and sometimes never fully going away at all.

2. Tweak Your Diet
Eating fresh, whole foods will give you more energy and strength—and it will also impact your skin from the inside out. There are certain foods, like dark chocolate, that have been shown to actually cause more acne lesions on your skin and body. One study found that dark chocolate exacerbates acne by causing more lesions to form on the skin of individuals who consume it. The study stated that consuming dark chocolate at regular amounts for four weeks in acne-prone persons can increase the number of acne lesions. Suffice it to say, dark chocolate is something you might want to steer clear of if you are prone to getting pimples and breakouts.

On the other hand, there are foods you can consume to help prevent acne formation. Probiotics, for example, can be helpful to keeping your skin stay clearer. That’s because probiotics (found naturally in foods like sauerkraut, yogurt, kefir, kimchi and other fermented foods) are basically live bacteria and yeasts that are good for you. There are tons of bacteria in our gut, both good and bad. If there is an imbalance of this good and bad bacteria, it can cause complications, and one of these complications is the formation of acne on skin. When bad bacteria outnumber the good bacteria (for example, by taking antibiotics you can actually “kill” some of that good bacteria), acne lesions can appear on your face and other common areas, like the chest and back. Consuming probiotics can help alleviate this problem. Probiotics basically return the proper balance to your gut, thereby helping to eliminate acne or prevent it from forming in the first place. Moreover, probiotics can even be applied topically. There are an increasing number of acne treatment products that contain probiotics to help treat acne from the outside. Consider incorporating foods like yogurt into your regular diet to always make sure you have the proper amount of probiotics in your system.

Finally, you should generally avoid refined or processed foods, fast foods, overly greasy foods, trans fats and saturated fats, dairy (for many, dairy can be a big acne trigger), white sugar. Other foods that are recommended as anti-inflammatories that can fight against acne include fresh fruits and vegetables, lean meats like salmon, nuts, fish oils or fish oil supplements and healthy oils like olive oil.

3. Professional Facial
Professional acne facials performed regularly are among the best acne treatments for teenagers and adults. They can be executed by dermatologists or licensed and experienced aestheticians. Facials are not a cure (in fact, there is no actual “cure” for acne, only extremely effective ways to prevent or minimize it), but they can help calm inflammation, reduce the number of lesions and keep skin healthy overall.

Dermatologists and aestheticians who offer facials will usually cleanse, exfoliate, complete extractions if needed and apply a peel. Of course, it really depends on the type of acne you have. If you mostly suffer from blackheads or whiteheads, your aesthetician will probably apply a steaming to help soften skin so that the following extractions of the comedones will be easier and less painful. Typically, an aesthetician will use some type of extracting tool or their own fingers to unclog pores.

If you have inflammatory acne, the aesthetician may use LED therapy (consisting of white, red and blue infrared light) to improve tone, increase collagen and fight off acne-causing bacteria. LED therapy will help reduce inflammation and prevent further problems. This type of facial is great for regular red pimples.

Peels in general are also popular because they use ingredients like acids and enzymes to encourage the sloughing off of dead skin cells, which can clog pores and eventually lead to them being infected with bacteria. An unclogged, normal pore will usually not become infected by bacteria, so it’s the clogged pores you need to watch out for.

Before you go in for a facial, make sure your dermatologist is board-certified or that your aesthetician is properly licensed.

4. Laser Therapy
According to the American Academy of Dermatology, laser therapy is a good option in your acne treatment routine, although it’s not a perfect method. Like many non-prescription acne treatments, it may not necessarily clear your acne 100%, but it will provide some relief. The academy recommends that laser therapy treatments be combined with other treatments for best results. For example, for optimal results, your dermatologist may recommend an over-the-counter medication like benzoyl peroxide to be used in conjunction with regular laser therapy.

In studies of laser therapy on acne, researchers have stressed that multiple treatments are necessary for an individual to truly see some results. One treatment of laser therapy will usually not be enough. In one study, according to the AAD, individuals treated with a type of light therapy called photodynamic therapy had 50% fewer lesions after four weeks of treatment. But twelve weeks after their last treatment, they had 72% fewer lesions. This is pretty significant and explains why multiple treatments will work to your best advantage.

Some common laser therapy treatments include blue, red and blue and red light therapies. These are great options for run-of-the-mill pimples, but not whiteheads or blackheads, cystic or nodular acne. Infrared light treatment has been FDA-approved for pimples, but it also cannot treat comedones or cystic or nodular acne. Photodynamic therapy, on the other hand, is effective against painful cystic acne. It involves applying a solution onto the skin that makes it more sensitive to light before the laser is then employed. Finally, photopneumatic therapy is good for comedones like blackheads and whiteheads. It combines intense pulsed light laser with a vacuum that removes excess oil and blackheads, helping to unclog pores. Some pimples can also be treated with this procedure, but not cystic or nodular acne.

5. Know Your Ingredients
There is no one-size-fits-all treatment for acne. Every individual is different, and may need different types of treatment to fit their needs. Still, there are some typical treatments you can get over-the-counter to help you fight off comedones, blemishes and breakouts of all kinds. This list will go in-depth into some of the most common and effective ingredients that can help treat and prevent different kinds of acne.

Salicylic Acid
Salicylic acid is a beta-hydroxy acid. In essence, salicylic acid helps unclog pores. If you apply it on a breakout right away, you may find that it has shrunk in size overnight. Salicylic acid is oil-soluble, which allows it to penetrate deep into pores where it can do the most good – essentially removing all the gunk stuck in your pores that has the potential to turn into a pimple.

Though it can shrink inflamed pimples (because it’s also an anti-inflammatory), salicylic acid is especially great for blackheads and whiteheads because of its pore-unclogging ability. Once it’s inside a pore, it helps dissolve the dead skin cells and sticky oil that are clinging to each other for dear life.

It is believed that acne forms because dead skin cells do not shed properly or efficiently enough. Thus, they get trapped in pores. Salicylic acid helps loosen these dead skin cells and helps slough them away so that they don’t even get a chance to cause clogging. You can use salicylic acid as a preventative treatment if you’re prone to acne. However, be wary of overdoing it because it can sensitize skin, causing redness, flakiness and peeling.

Benzoyl Peroxide
Benzoyl peroxide directly targets acne-causing bacteria called P. acnes. It kills this bacteria instead of simply slowing down its growth. It can work rather quickly, showing changes in your acne in as little as five days. That may not seem like it’s fast, but with acne being as stubborn as it is, this is quite remarkable in terms of speed and efficacy. It is even able to prevent antibiotic resistance.

Benzoyl peroxide also helps exfoliate, similarly to salicylic acid. It sloughs away dead skin cells to unclog pores and help treat and prevent blackheads, whiteheads, and inflamed breakouts. Drawbacks to benzoyl peroxide include its ability to bleach hair and fabric, as well as the fact that it can sensitize skin – causing redness and irritation.

Retinol
Retinol is a derivative of vitamin A. It is also an extremely popular acne treatment because of its ability to help dead skin cells shed more efficiently and dissolve the plugs that keep pores clogged. People with enlarged pores and oily skin who suffer often from breakouts can benefit greatly from OTC retinol.

Unfortunately, retinol can be very irritating and it may prevent some people from using the product long enough for it to be effective. Dermatologists recommend staying properly hydrated while using retinol to prevent some of the redness and peeling. Dermatologists also caution to avoid sun exposure when using retinol. As a bonus, retinol can also help with wrinkles and dark spots by resurfacing and refining skin.

Glycolic Acid
Glycolic acid is an alpha-hydroxy acid that also exfoliates like salicylic acid. However, it is water-soluble and doesn’t penetrate as deeply into pores. Nevertheless, it is a powerful ingredient that can be a great treatment for clogged pores and other types of acne.

Glycolic acid helps “unglue” dead skin cells that are stuck to skin’s natural oils inside pores, in addition to other debris. It also helps smooth skin overall for a more refined texture. If you have large pores, glycolic acid can help shrink them in size and also give you a lovely glow. Furthermore, glycolic acid, like retinol, can help with dark spots and wrinkles.

16 Best Acne Treatments: List of Skincare Products for Acne

The following is a list of the 16 best acne treatments over-the-counter based on the above-mentioned ingredients that should significantly reduce acne lesions when used regularly and correctly. Some trial-and-error may be necessary before you land on the exact right product for you. Remember not to overdo it with these treatments as it can lead to irritation like redness, dryness, itchiness, peeling and sometimes, paradoxically, even more acne.

Neutrogena Oil-Free Acne Wash – This cleanser is often recommended by dermatologists. It contains 2% salicylic acid to help dissolve oil and unclog pores. It can be used in the morning and night to prep skin for other products.

Glossier Solution – This product from cult favorite beauty brand Glossier works like a toner to rid skin of clogged pores and breakouts. It contains 0.5% salicylic acid in addition to other types of acids that all team up to shrink existing pimples and prevent new ones from forming.

Philosophy Clear Days Ahead Oil-Free Salicylic Acid Acne Treatment and Moisturizer – If you need a moisturizer (and even those with oily skin do), this is a great choice. It not only provides hydration, but also helps treat breakouts because it contains salicylic acid 1%.

Clinique Acne Solutions Clinical Clearing Gel – You can use this as a spot treatment, but also as an allover treatment. Apply a thin layer to your face twice a day after cleansing.

Neutrogena Rapid Clear Stubborn Acne Daily Leave-On Face Mask – Featuring 2.5% benzoyl peroxide, this face mask is gentle enough to use on a daily basis without causing irritation. It is a gel formula that dries clear and can be left on underneath a moisturizer.

La Roche-Posay Effaclar Duo Dual Action – This is a best acne spot treatment featuring 5.5% benzoyl peroxide. It’s great because it’s safe for sensitive skin that can react to high percentages of benzoyl peroxide.

Glossier Zit Stick – Another best acne spot treatment option, this one from Glossier also includes tea tree oil (known for fighting acne) in addition to 5% benzoyl peroxide. This is great for use on the go.

Differin Daily Deep Cleanser with Benzoyl Peroxide – For a daily cleanser that will work wonders, opt for this one from Differin that will be effective without causing irritation or dryness. It also helps hydrate without clogging pores.

Drunk Elephant A-Passioni Retinol Cream – Drunk Elephant continues to grow in popularity because of products that work. It features vegan retinol and is very gentle on skin. You can wear it during the day as long as you cover up with sunscreen.

First Aid Beauty Skin Lab Retinol Serum 0.25% Pure Concentrate – This contains 0.25% retinol, which is low enough to be gentle but high enough to be effective. This formula also contains vitamins C and E and aloe and colloidal oatmeal to help calm and soothe irritation.

The Ordinary Granactive Retinoid 5% in Squalane – The Ordinary’s products are particularly great because they are affordable but don’t skimp on efficacy. This product is a serum you can apply all over your face or use as a spot treatment.

Dr. Brandt 2% Retinol Complex Serum – If you think you can handle something a little more powerful, you can try this retinol serum from Dr. Brandt. It features time-release retinol to give your skin tiny doses of retinol for best results.

SkinCeuticals LHA Cleanser Gel – This one contains glycolic acid and salicylic acid for a double-whammy punch against acne. Together, these two acids will thoroughly dissolve the debris in clogged pores and help shrink pimples and reduce blackheads.

Mario Badescu Glycolic Foaming Cleanser – This cleanser should be used twice or three times a week for best results. Herbal extracts combined with the active ingredient of glycolic acid work together to reduce acne while keeping skin hydrated.

NeoStrata Resurface High Potency Cream AHA 20 – Containing 18% glycolic acid, this cream from NeoStrata is very powerful and effective. In addition to reducing acne it can also help fade away acne scars left by long-healed pimples.

Dr. Dennis Gross Alpha Beta Universal Daily Peel – A peel is a great way to fight acne while also helping to restore radiance to skin. This peel is followed by a neutralizer to prevent irritation. It also comes in gentler and stronger options depending on your skin needs.

Bottom Line

As we previously mentioned, an effective acne treatment must be tailored to an individual’s needs. We are all different, with different types of skin and the issues that come along with them. Some of us may simply suffer from acne like blackheads, while others may be more prone to cystic and nodular acne that is often very painful and much harder to treat. Furthermore, the chances are that one type of treatment may not always be enough. If you have severe acne, you will most likely need a combination of therapies like regular (weekly or monthly) professional facials, some laser therapy done in conjunction with using products that contain salicylic acid, benzoyl peroxide, glycolic acid or retinol. Even more, you may have to take a long, hard look at your lifestyle and eating habits, ascertain whether you are getting enough vitamin D, etc. to give yourself an advantage in the fight against acne. Acne is tenacious and stubborn. It needs you to be the same way if you are going to successfully fight it off and keep it from reappearing. Stay positive, though it will be tough if acne is constantly recurring, and stay stubborn and vigilant. With the right combination of the best acne treatments, you can be successfully keep blemishes at bay.

References: Dermato Endocrinology, “Preliminary Evidence for Vitamin D Deficiency in Nodulocystic Acne”; International Journal of Dermatology, “Dark Chocolate Exacerbates Acne”; International Journal of Women’s Dermatology, “The Effect of Probiotics on Immune Regulation, Acne, and Photoaging”; American Academy of Dermatology, “Lasers and Lights: How Well Do They Treat Acne?”

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