How to Handle It: If you've tried the usual anti-acne ingredients, like salicylic acid and benzoyl peroxide (which, we should warn you, rarely work for this), you should consider paying your dermatologist a visit. "You may need a cortisone injection or an oral medication, like an antibiotic, in addition to topical formulas," says Zeichner. He's also a fan of a prescription topical medication called Epiduo Forte Gel, since, he says, it's been shown to be effective at controlling severe acne without the help of oral treatments.
Another once-daily gel your dermatologist might prescribe for acne is Aczone 7.5 percent. The active ingredient, dapsone, is both antimicrobial and anti-inflammatory, and it’s proven to help with blackheads, whiteheads, and deeper painful pimples. Oftentimes, Aczone is used alongside other acne treatments. And like many of those other remedies, Aczone can cause skin to dry out.
Meanwhile, salicylic acid, which is derived from willow tree bark, wintergreen oil or sweet birch and occurs naturally in fruits like raspberries, cantaloupe and granny smith apples, works well for most skin types. Aside from being an exfoliant that sloughs away dead skin cells and other pore-clogging impurities, it has anti-inflammatory properties that help to address inflammation, which is thought to be the primary cause of acne.
While a face mask isn’t totally necessary to clear your acne, sticking to just once a week won’t further irritate or dry out your skin if you like using one. This drugstore treatment from L’Oreal utilizes the power of kaolin clay, which absorbs excess oil, draws out impurities from the skin, and gently exfoliates to speed the healing process of breakouts, according to a review of research published in International Geology Review. It won’t completely wipe out your acne overnight, but it can help control the oil that leads to more pimples and dry out bumps that are particularly stubborn. Plus, it gives you an excuse to pamper yourself.
Cortisone is a quick fix for acne emergencies. We mean got a big board meeting tomorrow kind of quick. Go into the dermatologist’s office for a shot of this corticosteroid, and acne will disappear in 24 to 48 hours. The treatment works to curb inflammation, which makes it best for cystic breakouts and can be really good at combatting hormonal flare-ups. If done incorrectly, a cortisone shot can leave a small depression in the skin that lasts about eight weeks. “It’s a rare side effect that happens if dosage of cortisone is too high,” explains Linkner. “You want to go to someone who knows what they’re doing.”
The other downside to Proactiv+ is that the bottles are small — like, half the size of Paula’s Choice small. Combine that with its recommended two or three-times daily application, and you’re going to be going through a lot of kits, which ultimately means spending more money on your treatment. If Proactiv is the only thing that works for you, it may very well be worth the investment, but we recommend starting with Paula’s Choice to see if you can get the same results at a cheaper price.
Dry Skin – Skin that doesn’t produce enough sebum, so it doesn’t retain moisture well and dries out. Dry skin tends to crack, peel, and become itchy, flaky, irritated or inflamed easily. Acne is caused by dead skin cells and bacteria clogging pores, while dryness tightens the pores to clog them further. The best acne face washes should exfoliate your skin, but shouldn’t dry it out further.
If you notice that you’re breaking out right around your period every month, your acne might be linked to hormones. “A sensitivity to the hormones called androgens manifests in the form of cystic acne,” says Linkner. Androgens, namely testosterone, cause the skin to produce more sebum. More sebum equals more acne. Birth control, which has estrogen and progestin, helps keep hormones balanced and skin clear. Ortho Tri-Cyclen, Estrostep, and YAZ are all FDA-approved as acne treatments.
Begin with benzoyl peroxide. If you're not sure which acne product to buy, start with one that contains benzoyl peroxide. It's effective and well-tolerated by most people. Give it a few days before expecting to see results. Check product labels for the type and amount of its active ingredient. Stronger isn't always better with benzoyl peroxide. In some cases, a 2.5 percent product works as well as those with stronger concentrations — and with fewer side effects.
The Exposed Facial Cleanser is our top pick. This cleanser is one of the very best on the market and it works for all skin types. The gentle yet rich formula is ideal for anyone, and it’s especially good for those with sensitive skin. It’s non-comedogenic, hypoallergenic, and soap free, with just 0.5% salicylic acid. Plus, it’s made with a combination of natural ingredients, including sage leaf extract, and vitamins like pro b5.
“I followed the directions for the patch and after washing my face at night I applied the patch on top of the forming acne cyst. It still had not produced a full head and was just an inflamed bump so I wasn't really sure how well it would work. The patch itself is clear but after leaving it on overnight it turns whitish where the acne was. I put it on Friday night and then left it on for most of Saturday while cleaning my apartment. When I removed it that night to put on my makeup to go out, the patch pulled out the plug and the bump was completely flat.
Retinoids and retinoid-like drugs. These come as creams, gels and lotions. Retinoid drugs are derived from vitamin A and include tretinoin (Avita, Retin-A, others), adapalene (Differin) and tazarotene (Tazorac, Avage). You apply this medication in the evening, beginning with three times a week, then daily as your skin becomes used to it. It works by preventing plugging of the hair follicles.