About Acne

What is Acne?

noreply@blogger.com (jacob) — Sun, 20 Mar 2011 18:36:00 -0700

Acne is the term for plugged pores (blackheads and whiteheads), pimples, and even deeper lumps (cysts or nodules) that occur on the face, neck, chest, back, shoulders and even the upper arms. Acne affects most teenagers to some extent. However, the disease is not restricted to any age group; adults in their 20s - even into their 40s - can get acne. While not a life threatening condition, acne can be upsetting and disfiguring. When severe, acne can lead to serious and permanent scarring. Even less severe cases can lead to scarring.

Types of Acne :
When you read about acne or other skin diseases, you encounter words or phrases that may be confusing. For example, the words used to describe the lesions of acne—comedo, papule, pustule, nodule and cyst—are understandable only if you know each word’s definition. It also is helpful to have a photo that is characteristic for each type of lesion.

Here is a brief summary of definitions of words used to describe acne, with accompanying photos. Let’s begin, though, with the definition of lesion, an all-purpose word:

Lesion—a physical change in body tissue caused by disease or injury. A lesion may be external (e.g., acne, skin cancer, psoriatic plaque, knife cut), or internal (e.g., lung cancer, atherosclerosis in a blood vessel, cirrhosis of the liver).

Thus, when you read about acne lesions you understand what is meant—a physical change in the skin caused by a disease process in the sebaceous follicle.

Acne lesions range in severity from comedones (blackheads and whiteheads) to nodules and cysts. Here is a brief definition of acne lesions:

Comedo (plural comedones)—A comedo is a sebaceous follicle plugged with sebum, dead cells from inside the sebaceous follicle, tiny hairs, and sometimes bacteria. When a comedo is open, it is commonly called a blackhead because the surface of the plug in the follicle has a blackish appearance. A closed comedo is commonly called a whitehead; its appearance is that of a skin-colored or slightly inflamed "bump" in the skin. The whitehead differs in color from the blackhead because the opening of the plugged sebaceous follicle to the skin’s surface is closed or very narrow, in contrast to the distended follicular opening of the blackhead. Neither blackheads nor whiteheads should be squeezed or picked open, unless extracted by a dermatologist under sterile conditions. Tissue injured by squeezing or picking can become infected by staphylococci, streptococci and other skin bacteria. The following photos are characteristic of acne with comedones:

Papule—A papule is defined as a small (5 millimeters or less), solid lesion slightly elevated above the surface of the skin. A group of very small papules and microcomedones may be almost invisible but have a "sandpaper" feel to the touch. A papule is caused by localized cellular reaction to the process of acne. This photo shows papules and comedones on the face of an acne patient:

Pustule—A dome-shaped, fragile lesion containing pus that typically consists of a mixture of white blood cells, dead skin cells, and bacteria. A pustule that forms over a sebaceous follicle usually has a hair in the center. Acne pustules that heal without progressing to cystic form usually leave no scars. This photo shows pustules, papules and comedones on the face of an acne patient:

Macule—A macule is the temporary red spot left by a healed acne lesion. It is flat, usually red or red-pink, with a well defined border. A macule may persist for days to weeks before disappearing. When a number of macules are present at one time they can contribute to the "inflamed face" appearance of acne. This photo shows the "red face" appearance of acne with macules:

Nodule—Like a papule, a nodule is a solid, dome-shaped or irregularly-shaped lesion. Unlike a papule, a nodule is characterized by inflammation, extends into deeper layers of the skin and may cause tissue destruction that results in scarring. A nodule may be very painful. Nodular acne is a severe form of acne that may not respond to therapies other than isotretinoin (Click on Acne Treatments)

Cyst—A cyst is a sac-like lesion containing liquid or semi-liquid material consisting of white blood cells, dead cells, and bacteria. It is larger than a pustule, may be severely inflamed, extends into deeper layers of the skin, may be very painful, and can result in scarring. Cysts and nodules often occur together in a severe form of acne called nodulocystic. Systemic therapy with isotretinoin is sometimes the only effective treatment for nodulocystic acne. Some acne investigators believe that true cysts rarely occur in acne, and that (1) the lesions called cysts are usually severely inflamed nodules, and (2) the term nodulocystic should be abandoned. Regardless of terminology, this is a severe form of acne that is often resistant to treatment and likely to leave scars after healing. These photos show nodular, cystic acne:

Who gets acne?Close to 100% of people between the ages of twelve and seventeen have at least an occasional whitehead, blackhead or pimple, regardless of race or ethnicity. Many of these young people are able to manage their acne with over-the-counter (nonprescription) treatments. For some, however, acne is more serious. In fact, by their mid-teens, more than 40% of adolescents have acne severe enough to require some treatment by a physician.

In most cases, acne starts between the ages of ten and thirteen and usually lasts for five to ten years. It normally goes away on its own sometime in the early twenties. However, acne can persist into the late twenties or thirties or even beyond. Some people get acne for the first time as adults.

Acne affects young men and young women about equally, but there are differences. Young men are more likely than young women to have more severe, longer lasting forms of acne. Despite this fact, young men are less likely than young women to visit a dermatologist for their acne. In contrast, young women are more likely to have intermittent acne due to hormonal changes associated with their menstrual cycle and acne caused by cosmetics. These kinds of acne may afflict young women well into adulthood.

Acne lesions are most common on the face, but they can also occur on the neck, chest, back, shoulders, scalp, and upper arms and legs.

Normal distribution of acne

Acne also has significant economic impact. Americans spend well over a hundred million dollars a year for nonprescription acne treatments, not even taking into account special soaps and cleansers. But there are also the costs of prescription therapies, visits to physicians and time lost from school or work.

Clearing Takes Time

noreply@blogger.com (jacob) — Sat, 21 Mar 2009 17:18:00 -0700

The truth is clearing takes time. Patients can expect to see results about three months after beginning to take an oral contraceptive. Before then, some women’s acne worsens. If acne flares, continue to take the oral contraceptive as prescribed. Repeatedly missing doses decreases the medication’s effectiveness.

While taking an oral contraceptive for acne treatment, it is important to follow your dermatologist’s entire acne treatment plan. An oral contraceptive targets only one cause of acne — excess sebum.

Now that you know the truth about oral contraceptives and acne, you may wonder if this treatment may be right for you. A dermatologist can help a woman decide if this is an appropriate treatment option.

Not for Every Woman

noreply@blogger.com (jacob) — Sat, 21 Mar 2009 17:16:00 -0700

While oral contraceptives can safely and effectively treat acne long term, this medication is not appropriate for every woman. Due to potential side effects, oral contraceptives are usually prescribed to women who:

• Are 35 years of age or younger
• Do not smoke
• Do not have a history of migraines
• Have normal blood pressure

Dermatologists recommend that their patients who take oral contraceptives examine their breasts regularly and see a gynecologist for regular examinations.

Taking Other Medication? Tell Your Dermatologist

noreply@blogger.com (jacob) — Sat, 21 Mar 2009 17:15:00 -0700

If an oral contraceptive is a potential treatment option, be sure to tell your dermatologist about other medication that you are taking. Medications can interact with each other — in some case producing undesirable side effects. Sometimes one medication can reduce the effectiveness of another medication. The anti-epilepsy drug, lamotrigine, can reduce the effectiveness of an oral contraceptive. A second form of birth control may be necessary to prevent pregnancy.

For Best Results: Use with Other Acne Treatment

noreply@blogger.com (jacob) — Sat, 21 Mar 2009 17:13:00 -0700

Oral contraceptives are effective because they target one of the four key causes of acne — excess sebum. Sebum, a natural oil that protects the skin against moisture loss, can clog pores when the body produces too much.

Since an oral contraceptive targets only one cause, it is generally not the only treatment used to clear acne. Here’s another key fact. Dermatologists generally do not prescribe an oral contraceptive until other acne medications have proven ineffective. Acne treatment usually begins with benzoyl peroxide and topical retinoids. Depending on the type and severity of the acne, an oral antibiotic also may be part of the treatment plan. If a woman’s acne does not respond to these treatments, an oral contraceptive may be considered.

Several Brands Effective

noreply@blogger.com (jacob) — Sat, 21 Mar 2009 17:10:00 -0700

Several brands of oral contraceptives can effectively control acne. A few brands have received approval from the U.S. Food and Drug Administration (FDA) for treating acne in women.

noreply@blogger.com (jacob) — Sat, 21 Mar 2009 17:08:00 -0700

The Truth About Oral Contraceptives and Acne

Yes, it’s true. An oral contraceptive, what many people call “the Pill,” can effectively clear acne in women. If you are using — or considering — an oral contraceptive to treat acne, here are a few other truths about oral contraceptives and acne that you should know:

Several Brands Effective

For Best Results: Use with Other Acne Treatment

Taking Other Medication? Tell Your Dermatologist

Not for Every Woman

Clearing Takes Time

Topical retinoids

noreply@blogger.com (jacob) — Sat, 21 Mar 2009 16:38:00 -0700

Here’s the lowdown on why these medications should not be used during pregnancy:

Topical retinoids. The topical (applied to the skin) retinoids adapalene, tazarotene and tretinoin carry warnings stating that it is not known if these medications can adversely affect a developing fetus or child that is being breast fed.

Oral tetracyclines

noreply@blogger.com (jacob) — Sat, 21 Mar 2009 16:35:00 -0700

Here’s the lowdown on why these medications should not be used during pregnancy:

Oral tetracyclines. Tetracycline as well as doxycycline and minocycline—which are synthetically derived from tetracycline—must not be used by women who are pregnant or breast feeding because of potential side effects. These broad-spectrum oral antibiotics can inhibit bone growth and discolor permanent teeth in both a fetus and a child being breast fed.

Isotretinoin

noreply@blogger.com (jacob) — Sat, 21 Mar 2009 16:29:00 -0700

Here’s the lowdown on why these medications should not be used during pregnancy:

Isotretinoin. Isotretinoin must not be used by a woman who is pregnant, trying to become pregnant or breast feeding.

This potent acne medication has revolutionized acne therapy due to its effectiveness in treating severe and therapy-resistant acne. However, isotretinoin also has the potential to cause some serious side effects. The most serious is the potential to cause severe birth defects in a developing fetus. For this reason, it is imperative that women taking isotretinoin follow the pregnancy-prevention program. This requires using 2 forms of birth control continuously beginning 1 month before therapy starts and not ending until 1 month after isotretinoin therapy is complete. A women taking isotretinoin must also be carefully monitored by her dermatologist during therapy. If pregnancy occurs, isotretinoin must be stopped immediately. Women planning a pregnancy should discontinue taking isotretinoin and maintain birth-control methods for at least 1 month before trying to become pregnant.

Hormone therapy

noreply@blogger.com (jacob) — Sat, 21 Mar 2009 16:23:00 -0700

Here’s the lowdown on why these medications should not be used during pregnancy:

Hormone therapy. The “female” hormone, estrogen, and the anti-androgens, flutamide and spironolactone, are sometimes used to treat acne in women. None should be taken while a woman is pregnant. Flutamide and spironolactone can cause birth defects. It is not known if these medications can be passed along when a woman is breast feeding so the medications must also not be used if a woman chooses to breast feed.

Prescription Medications for Treating Acne

noreply@blogger.com (jacob) — Sat, 21 Mar 2009 14:45:00 -0700

A variety of prescription medications are used today to clear acne. Topical (applied to the skin) medications may be prescribed for mild to severe acne. Systemic (works internally) therapy is needed to treat severe acne and may be used for moderate cases. These medications, which play an important role in acne treatment, attack the different factors that lead to acne. To achieve long-term control and resolution, dermatologists may combine therapies. The following describes the prescription medications used in the United States to treat acne:

Interlesional Corticosteroid Injection

When an acne cyst becomes severely inflamed, there is a good chance that it will rupture and scarring may result. To treat these severely inflamed cysts and prevent scarring, dermatologists may inject such cysts with a much-diluted corticosteroid. This lessens the inflammation and promotes healing. An interlesional corticosteroid injection works by "melting" the cyst over a period of 3 to 5 days.

Isotretinoin

Isotretinoin is a potent oral retinoid that is reserved for treatment of very severe cystic acne and severe acne that has proven itself resistant to other medications. For more information about isotretinoin, see Treating Severe Acne.

Oral Antibiotics

For patients with moderate to severe and persistent acne, oral antibiotics have been a mainstay of therapy for years. Like topical antimicrobials, oral antibiotics work to reduce the P. acnes population (a contributing factor in acne), which, in turn, decreases inflammation. Treatment with oral antibiotics usually begins with a higher dosage, which is reduced as acne resolves. Generally, antibiotics are prescribed for six months or less.

Over time, the P. acnes bacteria can become resistant to the antibiotic being used to treat it. When resistance occurs, acne is no longer controlled. Another antibiotic or alternative treatment can be prescribed. Numerous studies support the effectiveness of the following oral broad-spectrum antibiotics, which are used to treat acne in the United States:

Erythromycin. It is effective against a broad spectrum of bacteria, including P. acnes. The most common side effect is irritation of the gastrointestinal tract.
Tetracycline and derivatives. Tetracyclines reduce the papules and pustules (inflammatory lesions) of acne. These medications should not be taken by children younger than 8 years of age because they can affect growth and stain teeth. They should also not be taken by a woman who is pregnant or breast feeding. During pregnancy and breastfeeding, tetracyclines can affect the development of the child’s bones and teeth, leading to skeletal defects.

A typical tetracycline regimen for treating moderate to severe acne starts with a dose of 500 to 1000 milligrams a day, which is decreased as improvement occurs. Long-term, low-dose tetracycline therapy may be continued for many months to suppress acne. Higher doses may be prescribed for very severe acne.

Two synthetic derivatives of tetracycline used to treat acne are doxycycline and minocycline. Doxycycline proves especially effective in treating inflammatory acne. It can cause sun sensitivity in some patients. Minocyline has a long history of use in treating acne. It is often effective in treating acne that has not responded to other oral antibiotics. Minocycline also seems to produce fewer incidents of antibiotic resistance.

Oral Contraceptives

Oral contraceptives have been shown to effectively clear acne in women by suppressing the overactive sebaceous glands and can be used as long-term acne therapy. However, oral contraceptives should not be prescribed to women who smoke, have a blood-clotting disorder, are older than 35 or have a history of migraine headaches—without the advice of a gynecologist.

Topical Antimicrobials

Topical antimicrobials work to inhibit the P. acnes populations and are used to treat patients with mild to moderately severe inflammatory acne. They may be used alone or combined with a medication that works on another factor that leads to acne aside from P. acnes. A dermatologist can determine whether a topical antimicrobial is appropriate for a patient and if so which topical antimicrobial should be prescribed. Prescription topical antimicrobials used to treat acne vulgaris in the United States include:

Azelaic acid. Naturally occurring in the skin, azelaic acid is used to treat mild to moderate inflammatory and non-inflammatory acne. It is believed that azelaic acid clears acne by reducing the populations of P. acnes, decreasing the abnormal shedding of skin cells and reducing inflammation. This medication has also proven effective in treating the dark spots that develop in some acne patients with skin of color. Azaleic acid is well tolerated by most people and can be safely used for years. Side effects may include skin dryness and lightening of the skin where applied.
Benzoyl peroxide. Benzoyl peroxide works by killing P. acnes. However, it does not have anti-inflammatory abilities. It is available in a wide range of strengths and can be found as a gel, lotion, cleanser, cream and wash. Many acne preparations include benzoyl peroxide because research shows that benzoyl peroxide increases the effectiveness of some medicines, such as erythromycin and clindamycin. When used in combination with antibiotics, benzoyl peroxide also reduces the likelihood of a patient developing resistance to the antibiotic. The most common side effects are skin irritation, the potential to bleach hair and fabrics as well as possible allergic reaction.
Clindamycin. A semi-synthetic antibiotic, topical clindamycin has a long history of successfully treating acne. It works by reducing P. acnes and decreasing inflammation. In topical form, clindamycin has proven safe and is well tolerated. Skin dryness and irritation are possible side effects. It is important to use as directed to decrease bacterial resistance that can occur with antibiotic use.
Erythromycin. This topical antibiotic is active against a broad spectrum of bacteria, including P. acnes. Topical erythromycin, which is an antimicrobial and anti-inflammatory, is used primarily to treat acne. When topical erthyromycin is combined with benzoyl peroxide, the combination proves to be quite effective as the patient gets the effects of two antimicrobial agents. Like topical clindamycin, erythromycin may cause skin dryness and possible irritation. It is important to use as directed to decrease bacterial resistance that can occur with antibiotic use.
Sodium sulfacetamide. A topical antibiotic that inhibits P. acnes and opens clogged pores, sodium sulfacetamide is effective in treating inflammatory acne. Many products containing sodium sulfacetamide include sulfur. Some patients do not like the smell of the sulfur or its grittiness. Usually, the newer products that contain sulfur do not have these problems.

Topical Retinoids

Prescribed to treat acne ranging from mild to moderately severe, topical retinoids are a derivative of vitamin A and considered a cornerstone in acne treatment. Retinoids work to unclog pores and prevent whiteheads and blackheads from forming. Topical retinoids can irritate the skin and increase sun sensitivity so it is important to use sun protection and follow the dermatologist’s directions to maximize effectiveness. An added benefit in using topical retinoids is that they may help diminish the signs of aging, such as fine lines and wrinkles. Topical retinoids currently prescribed for acne treatment in the United States include:

Adapalene. A synthetic retinoid applied as a gel or cream, adapalene unclogs pores and possesses moderate to potent anti-inflammatory abilities. Improvement is usually seen in 8 to 12 weeks. Side effects include minor skin irritation and dryness.
Tazarotene. A synthetic retinoid available as a gel or cream, it works to keep the skin’s pores clear and has proven effective in treating acne. This medication should not be used by women who are pregnant, and effective contraception is needed while taking tazarotene because the medication has produced birth defects in animals. Skin irritation is a possible side effect.
Tretinoin. The first retinoid developed for topical use, tretinoin is a natural retinoid. It works to gradually unclog pores and keep them unplugged. In the past, many patients found tretinoin too harsh for their skin; however, the newer forms are proving less irritating. Side effects include redness, scaling, dryness, itching and burning. If these occur, talk with the dermatologist who prescribed tretinoin as these side effects can be managed by adjusting the amount applied and when it is applied.

Oral Contraceptives

noreply@blogger.com (jacob) — Sat, 21 Mar 2009 14:38:00 -0700

Oral contraceptives have been shown to effectively clear acne in women by suppressing the overactive sebaceous glands. Oral contraceptives can be used as long-term acne therapy; however, this medication should not be prescribed to women who smoke, have a blood-clotting disorder, are older than 35 or have a history of migraine headaches—without the advice of a gynecologist.

Spironolactone, a synthetic steroid, may be used in combination with oral contraceptives to treat acne in adult females. Spironolactone inhibits androgen production. Side effects include irregular menstruation, breast tenderness, headache and fatigue.

Oral Antibiotics

noreply@blogger.com (jacob) — Sat, 21 Mar 2009 14:34:00 -0700

Oral antibiotics have been a mainstay of therapy for severe acne for many years. Like topical antibiotics, oral antibiotics work to reduce the P. acnes population (a contributing factor in acne), which, in turn, decreases inflammation. Treatment with oral antibiotics usually begins with a high dosage, which is reduced as the acne resolves. Over time, the P. acnes bacteria can become resistant to the antibiotic being used to treat it. When this happens, another antibiotic can be prescribed. Numerous studies support the effectiveness of the following broad-spectrum oral antibiotics that are used to treat acne in the United States: doxycline, erythromycin, minocycline and tetracycline. For information about each of these oral antibiotics, see

Prescription Acne Medications

Isotretinoin

noreply@blogger.com (jacob) — Sat, 21 Mar 2009 14:07:00 -0700

Isotretinoin is a potent drug reserved for treating severe cystic acne and acne that has proven itself resistant to other medications. Isotretinoin is a synthetic (man-made) retinoid (form of vitamin A) that comes in pill form. It is usually taken once or twice a day for 16 to 20 weeks

Today, it is the most effective acne treatment available because it is the only acne treatment that works on all four factors that predispose a person to acne - excess oil production, clogged skin pores, P. acnes and inflammation. The remissions achieved with isotretinoin usually last for many months to many years. For many patients, only one course of isotretinoin therapy is needed.

The effectiveness of isotretinoin in treating severe acne is shown in the following before-and-after photos:

While isotretinoin is the most effective acne treatment available, it cannot be prescribed to everyone due to a number of potential side effects—some serious. One of the most serious side effects is the potential to cause severe birth defects in a developing fetus. For this reason, the U.S. Food and Drug Administration (FDA) requires that women not be (or become) pregnant while taking isotretinoin. FDA regulations require women of childbearing age to take 2 pregnancy tests prior to beginning isotretinoin therapy and use 2 forms of birth control for 1 month before therapy begins, while taking the drug and for 1 full month after therapy. It is also important that women not breast feed during this time. Women who wish to become pregnant after taking isotretinoin should talk to their dermatologist and gynecologist about when it is safe to get pregnant after receiving isotretinoin therapy.

Other possible severe side effects that may occur while taking isotretinoin include:

Severe pain in the chest or abdomen
Trouble swallowing or painful swallowing
Severe headache, blurred vision or dizziness
Bone and joint pain
Nausea or vomiting
Diarrhea or rectal bleeding
Depression
Dryness of the skin, eyes and nose
Thinning hair

If any side effect occurs, the patient’s dermatologist or other healthcare practitioner should be contacted immediately because some of these side effects can lead to serious health problems.

While taking isotretinoin, patients are regularly monitored for side effects through follow-up visits. For most people, these side effects are tolerable and not a reason to discontinue therapy before remission is achieved. However, it is important to keep appointments for follow-up visits because monitoring can reveal conditions that a patient might not notice. For example, a patient may not realize a rapid increase in bad cholesterol that is detected through a blood test.

The decision to use isotretinoin should be made jointly by patient and dermatologist. When used with all due caution under close medical supervision, isotretinoin can resolve severe acne that has not responded to other therapy. It has proven especially effective in resolving cystic acne, a severe form of acne that usually does not respond to other therapies.

For a substantial number of patients, one course of isotretinoin therapy is all they will ever need. A small number of patients require more than one course of isotretinoin therapy to control severe acne.

It is important to take isotretinoin as prescribed—even if the skin clears before all of the pills have been taken—to prevent relapse. At the end of an effective course of isotretinoin therapy, all or most of the acne lesion will have cleared. Patients may notice residual erythematous (reddish) macules (flat spots) where acne lesions were present. These macules are not scars, and they will fade in 6 to 8 weeks.

After therapy, patients should continue to follow the 12 Ways to Get Better Results from Acne Treatment.

Interlesional Corticosteroid Injection

noreply@blogger.com (jacob) — Sat, 21 Mar 2009 14:04:00 -0700

When an acne cyst becomes severely inflamed, there is a good chance it will rupture and scarring may result. To treat these severely inflamed cysts and prevent scarring, dermatologists may inject such cysts with a much-diluted corticosteroid. This lessens the inflammation and promotes healing. An interlesional corticosteroid injection works by "melting" the cyst over a period of 3 to 5 days.

Drainage and Surgical Excision

noreply@blogger.com (jacob) — Sat, 21 Mar 2009 13:58:00 -0700

Some large cysts do not respond to medication and may require drainage and extraction. Drainage and extraction, or “acne surgery” as it is also called, should not be performed by patients. Dermatologists are trained in the proper technique and perform acne surgery under sterile conditions. Patient attempts to drain and extract comedones by squeezing or picking, can lead to infection, worsening of the acne and scarring.

12 Ways to Get Better Results from Acne Treatment

noreply@blogger.com (jacob) — Sat, 21 Mar 2009 12:51:00 -0700

Effective Acne Treatment Often Requires More Than Medication

Do you wish that your acne medication left you with clearer skin? Better results may not come from trying the latest acne treatment or a stronger acne-fighting cream — but from making some simple changes.

For those seeing a dermatologist

Use your acne treatments exactly as prescribed. Acne only clears when the treatment targets everything that is causing the acne. Since most acne medications target only 1 or 2 causes, 2 or 3 products are often necessary. To see clearer skin, these products must be used as prescribed.
Stop using acne treatments not prescribed by your dermatologist. Using acne products that are not part of the treatment plan prescribed by your dermatologist can irritate your skin. Irritated skin usually leads to more breakouts. For best results, dermatologists recommend using only the acne-fighting products and medications in your treatment plan.
Speak up. Dermatologists do not want patients to feel confused about acne treatment. If you do not understand something, ask about it. If an acne treatment option not prescribed by your dermatologist interests you, be sure to mention it. Asking questions is often the answer to effective acne treatment.

For everyone treating acne, including those seeing a dermatologist
Never pop, squeeze, or pick acne. Popping and squeezing pimples, whiteheads, blackheads, and cysts tends to make acne worse. All this does is make the acne last longer. This can make it difficult to see clearer skin no matter what treatment you are using. Trying to get rid of a pimple by popping or picking also can lead to scarring, which can be permanent.
Avoid abrasive soap, facial scrub, toner, astringent, and masks. These can irritate the skin, and irritated skin is more likely to break out. Irritated skin also makes it more difficult to tolerate acne medication. A mild cleanser used twice a day to wash the skin is actually more effective for controlling acne and preventing breakouts.
Do not scrub your skin clean. While scrubbing away oil and grime may seem like a good idea, scrubbing actually irritates acne-prone skin. Irritating the skin generally leads to breakouts.

When washing the skin, use lukewarm (not hot) water and gently apply a mild cleanser with your fingertips. Washcloths and puffs tend to be too abrasive. Limiting washing to twice a day can help reduce irritation and dryness.
Wait 5 to 15 minutes to apply acne medication. Applying acne medication right after you shower or wash your face can irritate the skin and lead to breakouts. Wet skin is most absorbent. To avoid irritation, dermatologists recommend waiting 5 to 15 minutes before applying acne medication.
Use only oil-free skincare and hair care products. Makeup, hair gel, and other products used by people with acne-prone skin should not contain oil. Oil tends to clog pores and lead to breakouts. Look for products that are labeled “oil free,” “nonacnegenic,” or “noncomedogenic.” This means the product does not clog pores.
Apply acne medication before makeup. Wearing an oil-free makeup is fine, but make sure it does not prevent the acne medication from working. Makeup should always be applied after topical acne medication.
Continue using the medication when skin clears. To keep skin blemish free, most people with acne need to continue using at least 1 acne medication. If you have been using an over-the-counter product, you may be able to taper your use to a few times a week.
Gently cleanse skin after sweating. Sweating, especially under a hat or helmet, can aggravate acne-prone skin. Gently cleansing the skin as quickly as possible afterwards can help prevent breakouts. When cleansing the skin, avoid the temptation to rub or scrub sweat from the skin. This can irritate the skin and cause breakouts.
Give acne-fighting products enough time to work. As a rule of thumb, it takes 6 to 8 weeks before you begin to see an improvement. Improvement does not mean blemish-free skin, but a noticeable difference. It generally takes about 6 months to see clear skin.

Effective Treatment Possible

Tremendous gains have been made in acne treatment. Today, virtually every case of acne can be resolved. If these tips do not help clear your skin, speak with a dermatologist.