As far as skin concerns go, acne is a great equalizer of sorts. Whether you dealt with it as a teen, it cropped up after college, or you are experiencing it as an adult, the American Academy of Dermatology (AAD) estimates that acne affects some 50 million Americans annually. If you’ve ever had a pimple (when you consider that 85 percent of people between the ages of 12 and 24 experience at least minor acne, there is a very high likelihood that you have at some point), we don’t need to tell you that no two breakouts are the same. As such, clearing up acne can be challenging – to say the least.
The good thing about acne is that there are a lot of ways to treat it, and the bad thing about acne is that there are a lot of ways to treat it. From at-home skincare to in-office treatments, there are no shortage of remedies marketed as acne solutions. But it can take a lot of trial and error to figure out what works best for you. That’s why we’re here.
Dermatologists treat countless patients with acne, and they’ve certainly developed an opinion on what works and what doesn’t. To help you make sense of it all, we tapped eight top derms to get their go-to at-home and professional picks for treating, clearing, and preventing acne. Read on for their tips.
1. The Expert: Marisa Garshick, MD
- Philosophy: The two main tenets of treating and clearing acne: Patience and consistency, says Marisa Garshick, MD, a board certified dermatologist in New York City. “Of course it is normal to want your skin to clear up immediately, but many acne treatments work to prevent new breakouts from forming – not just by treating existing breakouts – so it can take time for them to kick in to be most effective,” she shares. “Additionally, it is important to continue treatment even after the breakouts have subsided to help maintain and prevent new breakouts from forming.”
- In-Office Treatments: Dr. Garshick is a fan of in-office chemical peels because they can be customized to exactly what the patient needs. “Chemical peels work to exfoliate the skin to eliminate dead skin cells which helps to prevent clogged pores,” she explains. “For those with acne, salicylic acid chemical peels are often recommended as this beta hydroxy acid is oil-soluble and can penetrate deep into pores to help unclog them and reduce overall oil production.” But that’s not all. “Additionally, chemical peels can help to lessen scarring by helping to even out skin tone and smooth overall texture,” she notes.
- At-Home Remedies: “Retinoids are one of my favorite at-home acne treatments, as it is an important part of any acne regimen regardless of the severity,” she says. “Retinoids work to regulate skin cell turnover which helps to prevent clogged pores and reduce breakouts.” Once you start on a retinoid regimen, you can pretty much stick with it through every phase of life. “Retinoids are also great because, in addition to helping improve overall skin tone and the appearance of blemishes, they can also help to boost collagen production,” she explains. This can improve the appearance of acne scars and other age-related skin concerns. “This is why I always recommend continuing a retinoid even after the acne has subsided,” she adds.
2. The Expert: Adriana Lombardi, MD
- Philosophy: “Acne is frustrating, but I wish everyone knew that manipulating acne causes scarring,” cautions Adriana Lombardi, MD, a board certified dermatologist in New Jersey. “I also wish patients knew how important it is to wear a daily sunscreen with acne.” As she explains, sunscreen helps prevent the post-inflammatory pigmentation (PIH) that makes a pimple linger long after the bump goes away.
- In-Office Treatments: HydraFacial™ and chemical peels are her two go-to treatments. “HydraFacial™ is a device that cleans the pores out using hydrating suction followed by an infusion with various serums that can target acne prone skin,” she explains. “Salicylic acid peels are an effective way to treat acne, scarring as well as post inflammatory pigmentation all at the same time.” In March, the FDA cleared AviClear™, a laser treatment that Dr. Lombardi says her office will be getting later this year to “close the biggest gap” for acne patients. “This laser targets the pilosebaceous unit and is giving patients close to 90 percent acne clearance after three sessions,” she shares.
- At-Home Remedies: At home, Dr. Lombardi says curating the proper skincare regimen is the most important thing. “When our patients leave the office, they have a sheet written with a daily regimen based on their type of acne and skin type and following this regimen is the most important factor in acne improvement,” she notes.
3. The Expert: Brendan Camp, MD
- Philosophy: There are a lot of over-the-counter products and prescription acne treatments available to patients, says NYC-based board certified dermatologist Brendan Camp, MD. “Some patients make the mistake of thinking that the more products they use, the better their acne will be, but the reality is that using more products is likely to irritate the skin and potentially make acne worse,” he cautions. “It is a good idea to edit your skincare routine to help address acne, as it will be less likely to irritate your skin and easier with which to comply.”
- In-Office Treatments: Dr. Camp says many of his patients are concerned not just with acne but the hyperpigmentation and scarring that accompanies it. Radiofrequency (RF) microneedling is his go-to for such cases. “It is a procedure that helps address these changes by stimulating the skin healing process,” he shares. “It is well tolerated, has little downtime, and can be performed in patients of all skin types.” This last feature is particularly important, he says, because “certain lasers or peels may not be appropriate for skin with more pigment.”
- At-Home Remedies: “I am a big fan of acne patches or stickers,” he says. “Most of these types of products contain hydrocolloid, which draws moisture out of the pimple causing it to shrink or flatten.” It should be noted, however, that they are not for all types of acne. “While acne patches may not be as helpful for deeper cysts that may require prescription medication or an in-office injection, they are an easy way to treat superficial acne papules,” he notes. “They can also help prevent people from picking at their acne.”
4. The Expert: Amanda Doyle, MD
- Philosophy: “Even if you’ve felt discouraged or if routines or treatments haven’t worked in the past, we now have an incredible amount of options and a lot of ways we can approach acne,” says Amanda Doyle, MD, a board certified dermatologist at Russak Dermatology in NYC. “ It’s an exciting time to be a dermatologist because we can do so much for our patients.”
- In-Office Treatments: When it comes to in-office acne treatment options, Dr. Doyle has a trio of favorites. “I love chemical peels and acne extractions and cyst injections,” she says. Chemical peels “can really help to improve the skin by targeting acne and reducing breakouts and decreasing hyperpigmentation,” she shares. As she explains, acne extractions and cyst injections can “acutely help reduce actively inflamed lesions” and “be great treatments if you get a breakout right before an event or if you have more stubborn acne that just needs a bit more to go away.” Extractions can also reduce whiteheads and blackheads, she adds.
- At-Home Remedies: Generally speaking, she doesn’t love a lot of over-the-counter acne treatments “because most of them are either ineffective” or “too harsh for the skin.” As a result, they often aren’t a good fit for most patients with acne who have sensitive skin. Instead, she tends to recommend a combination of a “personalized, at-home skincare regimen” and “in-office procedures and treatments.”
5. The Expert: Dendy Engelman, MD
- Philosophy: “I wish patients knew that acne is not their fault,” says Dendy Engelman, MD, a board certified dermatologist and Mohs surgeon at Shafer Clinic in NYC. “They are not getting breakouts because they ate that slice of pizza or that candy bar.” As she explains, some people are more prone to acne, and it forms “when sebum, the oily substance on skin, combines with dead skin cells and clogs pores.”
- In-Office Treatments: Add Dr. Engelman to the list of derms excited about AviClear™. “I have so many patients who want a safe, effective, and drug-free treatment option, and AviClear™ offers all of that,” she shares. “AviClear™ is safe for all skin types and tones and can be done year round – meaning patients can be treated during the summer and go back to school or work in the fall with clear skin.”
- At-Home Remedies: “My favorite at-home acne treatment is Effaclar Duo by La Roche-Posay,” she says. “With 5.5 percent micronized benzoyl peroxide and lipo-hydroxy acid, this spot treatment helps quickly and effectively reduce and clear blemishes.”
6. The Expert: Samer Jaber, MD
- Philosophy: “If you are struggling with acne please see a board certified dermatologist,” says Samer Jaber, MD, a board certified dermatologist and founder of Washington Square Dermatology in NYC. “I am a big believer that acne should be treated with prescription oral and topical acne medications, as almost all patients improve with a consistent treatment regimen.” Furthermore, it’s important to address the right symptoms in the right order. “I tell all of my patients that, before treating any scarring or discoloration from acne, it is generally best to treat the acne first,” he adds.
- In-Office Treatments: Dr. Jaber’s favorite professional acne treatment is actually aimed at the discoloration and hyperpigmentation that comes after. “The Cosmelan® chemical peel can be a true game-changer for patients with the post-inflammatory hyperpigmentation of acne, as it can really brighten the skin with just one treatment,” he shares.
- At-Home Remedies: “I see so many patients that spend so much money on OTC products from Sephora or try at-home treatments from influencers that don't work,” Dr. Jaber cautions. “See a dermatologist, as there are many safe and effective prescription treatments that are more effective and usually cheaper than OTC products.” While he says he doesn’t see “consistent benefits” from most at-home remedies, light therapy tools can be a worthwhile investment. “For patients that use red and blue light devices daily, some report it can help,” he shares.
7. The Expert: Angela Lamb, MD
- Philosophy: “We hear this often, but try not to pick,” says Angela Lamb, MD, a board certified dermatologist in NYC. While we know this is easier said than done, she offers this rationale for keeping your fingers away from your face: “I have seen infections and permanent indented scars from picking,” she cautions.
- In-Office Treatments: “I love a chemical peel,” Dr. Lamb says. “Depending on the depth, you can get excellent results with minimal downtime. “
- At-Home Remedies: She is a fan of pimple patches because “they can help dry up stubborn blemishes,” and she says liquid spot treatments can have a similar effect. “There are also some drying solutions you can apply to lesions that contain salicylic acid, zinc oxide, or clay that can decrease the appearance and hasten resolution,” she adds.
8. The Expert: Michele Green, MD
- Philosophy: As Michele Green, MD, a NYC-based board certified dermatologist, explains, it’s important to know the kind of acne you are dealing with before deciding on a treatment. “Although acne is a very common skin condition, it does not have to be treated only using at-home or over-the-counter treatments,” she explains. “If you have cystic acne or if your acne breakouts hinder your social, professional, and personal life, it is best to seek out a board certified dermatologist to discuss the best treatment options for the type of acne you have as well as your skin type.”
“There are a variety of treatment options for acne depending on the type of acne presented,” Dr. Green says. As such, she has a variety of professional favorites, including:
- Extractions: Also known as acne surgery, extractions performed by a dermatologist involving “opening the acne lesions and removing excess sebum, debris, and dead skin cells, followed by intralesional corticosteroid injections to shrink the acne,” she shares. “Intralesional cortisone injections are used to reduce inflammation in pustules and cysts, so the skin is then able to naturally heal itself without the damage from inflammation.” She notes that this mechanical extraction is also a safe option for pregnant women struggling with acne, as a lot of acne treatment options (think: oral and topical medications) are contraindicated.
- Accutane (Isotretinoin): Dr. Green says the prescription oral medication is “effective in permanently curing acne.” As she explains, Accutane is a retinoid that “shrinks oil glands in the skin and directs the growth of new skin cells to prevent buildup in the pores.” In turn, this “combats the development of acne scars by reducing inflammation and severity of acne breakouts,” she adds. The net-net: “By preventing new acne from forming, it allows the skin to properly heal.”
- HydraFacial®: As she describes it, the “medical-grade hydradermabrasion treatment is great for deeply cleansing, gently exfoliating, and intensely nourishing the skin.” The vortex fusion technology in the HydraFacial® handpiece is “perfect for extracting sebum, dead skin cells, and debris trapped in pores that causes acne breakouts,” she adds. After cleansing and exfoliating, the skin is infused with antioxidants, vitamins, and peptides to enhance the natural protective barrier.
- VBeam® Laser: The pulsed dye laser is “a gold standard for treating acne redness, facial flushing, rosacea, broken capillaries, acne scars, and more,” Dr. Green shares. The energy emitted by the VBeam® laser is absorbed by the chromophores in the skin – specifically hemoglobin in blood or blood vessels.
- Photodynamic Therapy: Used to target everything from cancer cells to age-related macular degeneration, Dr. Green says photodynamic therapy is also a treatment for acne vulgaris. First, a photosensitizing drug that is sensitive to a certain wavelength of light is administered topically to the skin. Next, a light is used to activate the photosensitizer drug that remains in the harmful cells while leaving normal cells unaffected. “Photodynamic therapy is a great option for those who are non-responsive or reluctant to oral or topical antibiotics and Accutane,” she says.
- Chemical Peels: The skin resurfacing treatment can treat a variety of skin concerns including acne, acne scars, rosacea, fine lines and wrinkles, sun damage, and discoloration. “By using a chemical solution, chemical peels exfoliate the skin, unclog pores, and help treat acne breakouts,” Dr. Green explains. Popular ingredients used for acne include glycolic acid, salicylic acid, and light trichloroacetic acid (TCA).
“The best acne products aim to speed up skin cell turnover, decrease oil production, reduce inflammation, and inhibit bacterial growth,” Dr. Green shares. It all comes down to choosing the right ingredients:
- Alpha & Beta Hydroxy Acids: “Important active ingredients to look out for in chemical exfoliant products include beta hydroxy acids (BHAs) and alpha hydroxy acids (AHAs),” she says. The most common BHA is salicylic acid, while popular AHAs for acne include glycolic and lactic. “AHAs disrupt the bond between the dead skin cells and the outer layer of the skin,” she says. “BHAs are oil-soluble ingredients that penetrate deeper into the pores for a deep cleanse.” Her MGSKINLABS, Inc. Retexturizing Pads with glycolic and salicylic acids are a great option – just be sure to up your sun care to an SPF 50 or higher during use.
- Benzoyl Peroxide: This active treats acne “by killing bacteria underneath the skin while clearing out dead skin cells and excess sebum from the pores,” she explains, adding that benzoyl peroxide works well for inflammatory acne like pustules, papules, cysts, and nodules.
“There are habits that you can incorporate into your daily life to help prevent acne breakouts,” Dr. Green says. Her top tips:
- Keep Your Hands Clean: “Be sure to wash your hands frequently and avoid touching the skin to prevent bacterial transfer and growth on the skin.”
- Shower Often: “You should shower and wash your face after exercise, as sweat and oil can build up in the pores and cause acne.”
- Don’t Touch: “Avoid picking or squeezing the blemishes when they appear because it causes further trauma on the skin and can lead to infection or scarring.”
There is no one way to treat acne, and there are both professional and at-home solutions that can help heal active breakouts and prevent future ones. Before you start self-diagnosing your acne and self-prescribing treatments, book an appointment with a board certified dermatologist. They will be able to assess your condition and put you on a comprehensive treatment plan (that will likely include some of the remedies outlined here) designed with a clearer complexion in mind.
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