I have had cystic acne for about four years. I have been seeing a dermatologist for at least two of those years. It’s a long road, and one thing that I can absolutely guarantee does not help to treat acne in any way whatsoever is exercise. I know this because a) most dermatologists and doctors agree that if anything, exercise worsens acne; and b) I’ve been an athlete for most of my life – the harder I train, the worse my acne; and c) although I always wear clean lycra and shower straight after I finish my session, the acne on my back is in the shape of the cross-over straps of my sports bra.
The Pore Normalizing Cleanser is designed just to cleanse, not treat, which is a good thing: The Nurse Practitioner study emphasizes the importance of washing with mild cleansers in conjunction with topical acne medications to combat or avoid excessive skin irritation. This one is water-based and fragrance-free, and uses sodium laureth sulfate (as opposed to its harsh cousin sodium lauryl sulfate) to eliminate any chance for irritation.
How to Handle It: Pair two of the best-known acne-fighting ingredients, salicylic acid and benzoyl peroxide, in the week leading up to your period. (If you're feeling bloated, now's the time to do it.) The combo can help prevent hormonal acne from happening in the first place. Zeichner suggests following a salicylic acid wash, like fan-favorite Neutrogena Oil-Free Acne Wash Pink Grapefruit Facial Cleanser ($7), with a benzoyl peroxide spot treatment, such as Murad Acne Spot Fast Fix ($22). If you're still seeing zits, "visit your dermatologist to discuss prescription options, like birth control pills, oral spironolactone — which blocks oil — or topical Aczone 7.5 percent gel," says Zeichner. "It's shown to be particularly effective in adult women without causing irritation." Oral contraceptives level out those hormone fluctuations, keeping your oil production normal and your skin clear.
There’s evidence that eating a low glycemic diet, meaning one that doesn’t include lots of processed grains/flour products and added sugar, is one the best home remedies for acne because it can help prevent it. Glycemic index measures how quickly foods raise blood sugar. Processed and refined foods, like those common in the Western diet, are high-glycemic, while meats and whole plant foods are low on the glycemic scale.
Papaya is a natural remedy for the acne problems. It is an essential ingredient in various beauty products. Raw papaya, when used on face, removes dead cells and extra oil from the skin. The enzyme papain in papaya helps in preventing the formation of pus. Mash some papaya pulp and apply it on the face. Leave it for 15-20 minutes. Rinse your face with clean water and pat dry. This is a good acne remedy that work.
There's more to treating acne than just washing your face twice a day and applying layers and layers of zit cream to any blemishes that pop up — and it starts when you're sleeping. "If you are acne-prone, it is important to change your pillowcase every day or every few days as opposed to every week," advises Debra Jaliman M.D., board-certified NYC dermatologist and author of Skin Rules: Trade Secrets From A Top New York Dermatologist. And when it comes to choosing pillowcases, stick with cotton. "Cotton pillowcases are better than other fabrics because they are natural fabrics and they breathe," Jaliman says.
The only medication that can make an argument that it cures acne is isotretinoin, because research shows it permanently reduces skin oil production and provides "remission" of acne in 66% of people. However, even in the case of isotretinoin, relapse rates may be higher than we think. Also, isotretinoin is recommended only for severe acne that does not respond to other treatments because it comes with a litany of side effects, and leaves the skin and the entire body permanently altered.
In most cases, acne products need to be used for at least 30 days before you can begin to ascertain its efficacy. Some skin and acne types may see noticeable results in a few days and end up totally clear in just a few weeks. Others may take several weeks to see the slightest change, or need to have their regimen adjusted as their skin adapts. Treating acne can often be a months-long process.
Salicylic acid also has anti-inflammatory properties to help with inflamed cystic breakouts that can occur when blockages deep in the hair follicles rupture beneath the skin. Although it's totally fine to use salicylic acid in a face wash, you may find that you have better results when using it as a toner, moisturizer, or leave-on spot treatment because these give it more time to do its work. And keep in mind, salicylic acid can dry out the skin if over-applied, so it may be wise to choose only one product with the ingredient to use every day.
Lastly, one of the best preventative steps is to drink water everything all day. When you play properly hydrated, your body is able to process all the toxins that go in it a lot more efficiently. It is no surprise that one of the main ways your body gets rid of toxins is through the pores in your skin. If you don't regularly flush out your system, then you are paving the way to allowing a backup of gunk to clog your pores. Once your pores are clogged, you are one step closer to getting an acne breakout. Of course, you can help to avoid all this by staying properly hydrated.
Treatment of acne scars: For those patients whose acne has gone away but left them with permanent scarring, several options are available. These include surgical procedures to elevate deep, depressed acne scars and laser resurfacing to smooth out shallow acne scars. Newer forms of laser resurfacing ("fractional resurfacing") are less invasive and heal faster than older methods, although results are less complete and the procedures may need to be repeated three or more times. These treatments can help, but they are never completely successful at eliminating acne scars.
Just like over-washing your face dries out your skin, so can products that are far too strong for your skin type. According to board-certified dermatologist Margaret Ravits, M.D., people with sensitive skin should tread lightly when it comes to facial washes. "Avoid harsh exfoliants and physical scrubs which can irritate the skin," advises Ravits. She also suggests avoiding "alcohol-based products or products that make your face feel tingly and tight."
According to a 2016 review of research that examined how diet may impact breakouts, researchers concluded that “compelling evidence shows that high glycemic load diets may exacerbate acne.” Foods high on the glycemic index (GI) tend to be higher in refined carbs, like those found in white bread. Scientists suspect that raised insulin levels from the carbs may trigger a release of hormones that inflame follicles and increase oil production.
No one factor causes acne. Acne occurs when sebaceous (oil) glands attached to the hair follicles are stimulated at the time of puberty or due to other hormonal changes. Sebum (oil) is a natural substance that lubricates and protects the skin. Associated with increased oil production is a change in the manner in which the skin cells mature, predisposing them to plug the follicular pore. The plug can appear as a whitehead if it is covered by a thin layer of skin, or if exposed to the air, the darker exposed portion of the plug is called a "blackhead." The plugged hair follicle gradually enlarges, producing a bump. As the follicle enlarges, the wall may rupture, allowing irritating substances and normal skin bacteria access into the deeper layers of the skin, ultimately producing inflammation. Inflammation near the skin's surface produces a pustule; deeper inflammation results in a papule (pimple); if the inflammation is deeper still, it forms a cyst.
Isotretinoin: Accutane was the original brand name; there are now several generic versions in common use, including Sotret, Claravis, and Amnesteem. Isotretinoin is an excellent treatment for severe, scarring, persistent acne and has been used on millions of patients since it was introduced in Europe in 1971 and in the U.S. in 1982. It should be used for people with severe acne, chiefly of the cystic variety, that has been unresponsive to conventional therapies like those listed above. If taken in sufficient dosage, it should eliminate the need to continue the use of prescription drugs in most patients. The drug has many potential serious side effects and requires a number of unique controls before it is prescribed. This means that isotretinoin is not a good choice for people whose acne is not that severe but who are frustrated and want "something that will knock acne out once and for all." In order to use the drug, the prescribing physician, the patient, and the supplying pharmacy must be enrolled in the online "iPLEDGE PROGRAM." Used properly, isotretinoin is safe and produces few side effects beyond dry lips and occasional muscle aches. This drug is prescribed for five to six months at a dosage that has a high likelihood of preventing the return of acne. Fasting blood tests are monitored monthly to check liver function and the level of triglycerides, substances related to cholesterol, which often rise a bit during treatment but rarely to the point at which treatment has to be modified or stopped.
We suggest avoiding spot treatments. “Benzoyl peroxide, when placed on red spots, can actually cause more irritation and inflammation to the area. It’s best used to prevent red bumps and pustules, and applied all over the area you want to treat,” said Townsend, who was also quick to naysay a spot-treat-only approach: “Acne affects all of the pores. If someone is going to spot treat against my advice, I still suggest they spot treat one day and treat the whole face the next.”
Combined oral contraceptives. Four combined oral contraceptives are approved by the FDA for acne therapy in women who also wish to use them for contraception. They are products that combine estrogen and progestin (Ortho Tri-Cyclen, Yaz, others). You may not see the benefit of this treatment for a few months, so using other acne medications with it the first few weeks may help.