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Affecting up to 50 million people in the United States each year, acne is the most common skin condition in the nation, according to the American Academy of Dermatology. Acne usually begins in puberty, but some people experience acne breakouts and flares well into their 30s and 40s – this is particularly true for women. In addition to embarrassing whiteheads, blackheads, bumps and pimples, acne can cause painful, pus-filled lumps under the skin and scarring. Acne can cause mental health issues too – the skin condition is associated with higher risk of depression, anxiety, feelings of inferiority, and more.

Clearly, curing acne once and for all is important for healthy skin and self-confidence. Acne can be tough to treat, however, and it often comes back.

Learn about acne

Understanding acne is the first step towards clearer skin. Acne starts when oil and dead skin cells clog up pores in the skin. Each pore is a tiny hole in the skin that connects to a sebaceous gland that produces sebum, an oily, waxy substance that lubricates and protects skin. Pores clogged with sebum create a rich environment for the growth of bacteria. The body’s immune system reacts to the presence of bacteria, and this can lead to skin inflammation and the development of acne.

Assess risk factors

Certain factors increase the risk of acne. These risk factors include:

  • Genetics
  • Diet
  • Hormone changes
  • Stress
  • Infections

While you cannot always change some risk factors, such as genetics and hormone changes, you can take action to prevent and control breakouts.

Choose a non-prescription treatment that addresses the underlying cause(s) of your acne

Bacteria, excess oil, clogged pores, and inflammation can all cause acne, so choose a treatment that targets the underlying cause of your skin problem. Benzoyl peroxide decreases the bacteria that cause acne, P. acnes. Over-the-counter products that contain retinoids can unclog pores and reduce oiliness. Salicylic acid eases inflammation and unclogs pores.

Always use over-the-counter acne medications as directed to avoid skin irritation and acne flares. Unless directed otherwise, apply the medication to the entire acne-prone area and not just on active blemishes.

Try different treatments

Be sure to give each treatment at least 4 weeks to work before starting another treatment. Acne treatments need time to work – usually two to three months or longer – but you should be able to notice improvement in 4 to 6 weeks if a particular treatment is working. Adding a new treatment too soon can irritate the skin to trigger breakouts.

Consider adding a second treatment

Each treatment should target a different cause of acne. If you are already using benzoyl peroxide to address bacteria but still have flares, for example, add retinols to unclog pores or salicylic acid to ease inflammation.

Wash your face twice a day and after perspiring

Washing your face removes bacteria and sweat along with excess oil and sebum. Acne-prone skin is sensitive, though, so washing too often can irritate the skin to make acne worse. Avoid scrubbing your face or other acne prone skin, even if it feels greasy, grimy, or dirty – a gentle washing action is always best. For best results, wash your face when you first wake up, are ready to go to bed, or have a sweaty face.

Use non-irritating skin products

Look for the following words and phrases on the label:

  • Won’t clog pores
  • Non-comedogenic
  • Non-acnegenic
  • Oil free

Resist picking, popping, or touching your acne

Squeezing pimples can push bacteria and pus deeper into the skin, which may cause more swelling and redness. Popping pimples can also lead to scabs and permanent pits or scars.

Wash pillowcases, hats, and other surfaces that touch acne-prone skin

Bacteria, dead skin cells, and bacteria can build up on surfaces and clog your pores. Change your sheets weekly and put on a fresh pillowcase two to three times a week to reduce breakouts.

Consult with a dermatologist

Your skin doctor can determine your risk factors, underlying causes, and potential treatment options for your acne. Prescription acne medications include topical and oral medications along with other treatments.

Topical acne medications available by prescription include:

  • Retinoids and retinoid-like drugs – prevent the plugging of pores
  • Antibiotics – kills excess skin bacteria and reduces redness and inflammation
  • Azelaic acid and salicylic acid – have antibacterial properties and help prevent clogged pores
  • Dapsone – works on acne resulting from inflammation

Oral medications include:

  • Antibiotics – kills skin bacteria
  • Combined oral contraceptives – corrects hormone imbalances in women with acne
  • Anti-androgen agents – blocks the effects of androgen hormones on oil-producing glands; for women and adolescent girls for whom oral antibiotics do not work
  • Isotretinoin – a form of Vitamin A that treats acne

Other treatments include:

  • Light therapy – has an antimicrobial effect that kills bacteria
  • Chemical peels – removes dead skin cells
  • Drainage and extraction – gently removes blackheads and whiteheads
  • Steroid injections – reduces inflammation

Acne is a complex condition that requires careful treatment. For more information about curing acne once and for all, consult with your dermatologist.