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How To Treat Severe Acne On Face

Diagnosis And Treatment Of Acne

Acne Treatments : How to Treat Severe Acne & Marks on the Face

STEPHEN TITUS, MD, and JOSHUA HODGE, MD, Fort Belvoir Community Hospital Family Medicine Residency, Fort Belvoir, Virginia

Am Fam Physician. 2012 Oct 15 86:734-740.

Patient information: See related handout on acne treatments, written by the authors of this article.

Acne is the most common skin disorder in the United States, affecting 40 to 50 million persons of all ages and races.1 Potential outcomes include physical scars, persistent hyperpigmentation, and psychological sequelae.


Topical retinoids are effective in the treatment of noninflammatory and inflammatory acne.

Clinical recommendation

Oral antibiotics are effective for the treatment of moderate to severe acne.

Benzoyl peroxide should be used in conjunction with topical and oral antibiotics to reduce the risk of bacterial resistance.

After treatment goals are reached, oral antibiotics should be replaced with topical retinoids for maintenance therapy.

Topical antibiotics are more effective when used in conjunction with topical retinoids.

Combined oral contraceptives can be used to treat inflammatory and noninflammatory acne.

A = consistent, good-quality patient-oriented evidence B = inconsistent or limited-quality patient-oriented evidence C = consensus, disease-oriented evidence, usual practice, expert opinion, or case series. For information about the SORT evidence rating system, go to .

Is Increased Face Mask Wear Causing Other Skin Health Concerns

In addition to clogging pores, the friction from mask wear also breaks down the protective barriers of skin more quickly. The surface of the skin has a microscopic layer of protective oils and fats that maintain moisture levels promote general skin health and keep skin safe from external irritants, toxins, and bacteria or viruses. When this protective barrier is broken down, more serious or more frequent flareups in chronic skin conditions like rosacea, eczema, and psoriasis. This can make managing your skin health more challenging. Those who already have sensitive or dry skin may also see more serious issues related to mask wear and have more difficulty controlling their symptoms.

COVID-19 has changed many things about our daily lives. Wearing face masks is one of the most pervasive changes. For people who struggle with acne and other chronic skin conditions, the added heat, friction, and moisture under a face mask can be a recipe for bad breakouts and flareups. If you already struggle with a skin condition, wearing a mask can exacerbate your symptoms, so make sure youre working with a dermatologist to create an ongoing care plan.

The lips are one area that many patients neglect, but they are likely to be one of the areas most impacted by mask wear. Make sure to apply lip balm or protective petrolatum ointments to the lips to protect them from mask irritation and dryness.

Treatments From Your Health Care Provider

If pimples are still a problem after you’ve tried over-the-counter medicines, your health care provider may suggest:

  • Antibiotics in the form of pills or creams that you put on your skin
  • Prescription gels or creams containing a retinoid to help clear up the pimples
  • Hormone pills for women whose acne is made worse by hormonal changes
  • Isotretinoin pills for severe acne
  • A light based procedure called photodynamic therapy
  • Chemical skin peeling

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What Can I Do If I Have Acne

The self-help techniques below may be useful:

  • Don’t wash affected areas of skin more than twice a day. Frequent washing can irritate the skin and make symptoms worse
  • Wash the affected area with a mild soap or cleanser and lukewarm water. Very hot or cold water can make acne worse
  • Don’t try to “clean out” blackheads or squeeze spots. This can make them worse and cause permanent scarring
  • Avoid using too much make-up and cosmetics. Use water-based products that are described as non-comedogenic
  • Completely remove make-up before going to bed
  • If dry skin is a problem, use a fragrance-free, water-based emollient
  • Regular exercise can’t improve your acne, but it can boost your mood and improve your self-esteem. Shower as soon as possible once you finish exercising, as sweat can irritate your acne
  • Wash your hair regularly and try to avoid letting your hair fall across your face

Although acne can’t be cured, it can be controlled with treatment. Several creams, lotions and gels for treating spots are available at pharmacies. If you develop acne, it’s a good idea to speak to your pharmacist for advice.

Treatments can take up to 3 months to work, so don’t expect results overnight. Once they do start to work, the results are usually good.

Home Remedies For Cystic Acne

How to Get Rid of Hormonal Acne?
  • Try topical creams like Retinoid A . A dermatologist can also prescribe higher strength retinoids.
  • Use warm compresses to soothe inflammation. Make sure to use a clean washcloth and dont use water thats too hot. This can help encourage pus to come to the surfacebut dont pop the pimple once it has.
  • Remove makeup every single night before going to bed. It may also help to choose products that are labeled non-comedogenic or oil-free to combat build-up under the skin.
  • Use a gentle facial cleanser. Harsh scrubs can further irritate and dry out your skin, which can lead to excess oil production as your skin works to make up what was lost. You should wash your face at least once per day in the evening before bed with a gentle cleanser.
  • Avoid picking at your skin to lessen irritation and prevent infection from spreading. If you find yourself unconsciously touching irritated areas, try covering cysts with an adhesive bandage and keeping your nails short.
  • Consider your diet.There is evidence that a low-glycemic diet can help alleviate acne. It may help to cut back on sugar and other high-glycemic foods like white bread, potatoes, and pasta.

Dont use homemade remedies like toothpaste, baking soda, honey, or sugar on your skin. These substances can irritate and clog your pores, and do not work at combating cystic acne.

Recommended Reading: What Is The Best Way To Clear Acne Scars

Treatment For Acne Professional

If your acne is not improving with over-the-counter treatments or if you have more severe forms of acne, you will need to see your doctor. Your family doctor can assess your acne, determine if you are developing any scarring and prescribe treatments specific for your type of acne.They may also refer you to a dermatologist for assessment and possible prescription of isotretinoin. After a course of isotretinoin, most people are cured of their acne. Isotretinoin can have side-effects that need to be carefully explained to you before commencing treatment.Medication can lead to significant improvements in how the skin looks and can reduce the number of new pimples.Medical treatments are topical or oral and can include:

  • retinoids, which unblock pores of existing acne and prevent new blockages from developing
  • antibiotics to kill bacteria and reduce inflammation
  • hormonal agents, such as the contraceptive pill, to reduce the amount of androgen in the body and therefore oil secretion.

Can Acne Cause Scars

Acne does sometimes result in scarring. It happens when the acne penetrates the skin and damages the deeper layers. Inflammation makes the acne pores swell and breakdown occurs in the wall of the pore. Scarring can, of course, be a source of anxiety, which is normal. But before it can be treated, your healthcare provider will determine what type of acne caused the scars.

There are several available treatment options. Chemical peels, dermabrasion, laser resurfacing, microneedling and surgery can all be used to treat acne scars.

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Effective Acne Treatments Are Available

There are many acne treatment products that can clear your skin. Yet, despite advertising claims, even the most effective products won’t work magic overnight. They won’t cure acne, either.

It will likely take at least six to eight weeks before you start to notice a change in your skin. And a full response may take 12 weeks.

If you’re patient, you will almost certainly see improvement. It just won’t be as quick as some acne treatment products claim.

How Can I Prevent Acne

HOW TO TREAT ACNE SCARRING! Remove Mild, Moderate & Severe Acne Scars
  • Gently wash your face twice a day and after sweating.
  • Shampoo your hair regularly.
  • Do not pick or squeeze your acne this increases the risk of scars.
  • Keep your hands off your face. Wash your hands before applying make-up.
  • Be careful what you put on your face, and avoid ingredients that promote acne.
  • Stay out of the sun and off tanning beds excess tanning can damage your skin.
  • See a dermatologist if you feel shy or products don’t work.

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What About Alternative Therapies

Herbal therapies such as tea tree oil, and topical and oral ayurvedic compounds seem to be well tolerated however, there are limited data about their efficacy and safety in treating acne. One clinical trial showed that topical tea tree oil was effective but had a slower onset of action than traditional topical agents. The Cochrane Collaboration is undertaking a systematic review of the effects of treatments in the management of acne that are currently considered complementary or alternative.

Neutrogena Rapid Clear Stubborn Acne Daily Leave

For the peskiest of big pimples, like cystic acne on the chin, combine a hydrocortisone cocktail as a leave-on spot treatment. Zeichner recommends a hydrocortisone cream to reduce inflammation, a two percent salicylic acid product to dry out excess oil , and then benzoyl peroxide to kill acne-causing bacteria. “Put a drop of all three in the palm of your hand, mix them together, then apply.”

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How To Treat Bad Acne Scarring

There are quite a few options when you want to treat your acne scarring, no matter how severe it is. The more severe cases will take longer to treat and be more difficult to treat, but there is something you can do for every type of scarring.

The American Association of Dermatology explains there are many different treatments for the different scar types:

Key Skin Care Tips To Protect Your Face From Irritation

10 Remedies to Get Rid of Severe Acne
  • Wash your face first: Dirt and oil on your skin will get trapped under the mask and can cause breakouts. Always put your mask on over a clean face. Choose a gentle cleanser that is fragrance free and oil free. Rinse with lukewarm water, not hot. Avoid scrubbing or rubbing the skin.

  • Apply a good moisturizer: Moisturizer keeps your skin hydrated and acts like a barrier to friction from your mask. Choose one that is fragrance free and oil free. Look for protective ingredients like ceramide and hyaluronic acid. Avoid heavy products that can clog your skin and make you break out.

  • Skip the makeup: Dont wear makeup underneath your mask. Masks act like occlusive barriers, which means trapped makeup can lead to clogged pores and breakouts. Also, residue from makeup can soil your mask fabric.

  • Wear only clean masks: Dirt and oil from your skin plus bacteria from your mouth and nose will end up on your cloth mask. Keep a rotation of masks on hand and wash them after every use.

  • Stick to fragrance free laundry detergent: When washing your mask, choose a fragrance free laundry detergent and lay flat to dry. Fragrance within fabric can be an irritant, so you definitely dont want it on your face.

  • Dont reuse surgical masks: Surgical masks are not meant to be reused because there is no good way to clean them. The CDC does not recommend surgical masks for the public. But if you choose to use one, dont use the same one twice.

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    How Is Acne Diagnosed

    Your healthcare provider can diagnose acne during a skin exam. They may also ask if youre undergoing significant stress or if you have a family history of acne, all of which are risk factors. Teenage girls and women may also be asked about their menstrual cycles, as breakouts are sometimes related. Sudden, severe acne outbreaks in older people can sometimes signal another underlying disease that requires medical attention.

    Start With A Cleanser That Contains Salicylic Acid

    “Think of your cleanser not as a true wash, but rather as a short-contact therapy,” Zeichner suggests. For this reason, he typically recommends that patients with cystic acne use cleansers that contain high concentrations of salicylic acid, a beta hydroxy acid that helps shrink cystic pimples by removing excess oil, sloughing off dead skin cells, and drying them out.

    Typically, salicylic acid concentrations range between 0.5 to two percent, and if you’re prone to cystic acne, Zeichner recommends looking for a cleanser that leans toward a higher concentration. A couple of great 1.5- to 2-percent salicylic acid-based cleansers include La Roche-Posay Effaclar Medicated Acne Face Wash and Murad Clarifying Cleanser.

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    Top 12 Home Remedies For Acne

    By Kathleen McCoy, BS

    Our skin is a reflection of our overall health, which is why glowing, beautiful skin often results from proper care, hydration and eating a nutrient-dense diet. On the other hand, skin ridden with whiteheads, blackheads and other types of pimples can indicate oxidative damage, poor nutrition and hormonal imbalances making it all the more important to find home remedies for acne.

    According to the American Academy of Dermatology, acne is the most common skin condition in the United States. Occasional breakouts and chronic acne plague tens of millions of Americans of all ages every year. About 85 percent of teens experience some type of acne, but even many adults deal with at least occasional breakouts too. About half of teens and young adults suffering from acne will have severe enough symptoms to seek out professional help from a dermatologist.

    From mild to severe, acne can cause painful and unsightly outbreaks on the face, back, chest and even arms. Left untreated, acne can also lead to diminished self-esteem and long-term hyperpigmentation or scarring. Genetics, changing hormone levels, lack of sleep and stress are all contributing factors to acne.

    Related: Adult Acne: How to Get Rid of Hormonal Acne Naturally

    How Well Do Topical Treatments Work

    How to treat severe acne pimples with D.I.Y face mask for clear skin | Trying skincare hack

    Topical therapy is the standard of care for mild to moderate acne. Retinoids and antimicrobials such as benzoyl peroxide and antibiotics are the mainstay of topical acne therapy. Such treatments are active at application sites, and they can prevent new lesions. The main side effect is local irritation. Gels, pledgets , washes and solutions tend to be drying and are helpful for oily skin. Lotions, creams and ointments are beneficial for dry, easily irritated skin. Most topical preparations require at least six to eight weeks before an improvement is seen they may be used for years as needed.

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    Whats The Best Material For A Face Mask

    The material your mask is made out of affects how well it protects you. It also affects how well you can breathe through it and how your skin responds to it.

    The best choice for a homemade mask is tightly woven, 100% cotton. It is effective, yet gentle on the skin. An air filter company called Smart Air did a study comparing mask fabrics. They found that cotton provides a good balance of protection and breathability. You can watch a video on how to make your own mask here.

    Smartairs study showed natural fibers like cotton filter better than synthetic fibers like polyester. Scarves and bandanas were the least effective. Denim and canvas worked well and were breathable, but would be too rough on the skin.

    For more information on how to get the best use out of your mask, read this post.

    Start With Otc Acne Treatments

    If your acne is mild, or if you’ve just started to break out, you may be able to clear your skin with over-the-counter acne medications.

    But not all acne products are created equal. The most effective will contain the following active ingredients on the label.

    Don’t worry too much about the brand name, or what form of treatment you’re usingfor example, whether the product is a cleanser, medicated pad, or lotion. Instead, choose a product that fits your budget and is easy for you to use.

    Once you find a product that works for you, keep using it. If you stop, your acne will come back.

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    Bad Acne Scar Treatment Results

    Is it possible to see results for the treatment of bad acne scarring? The answer is yes, over time, you can see results for all types of scarring, no matter how mild or how deep.

    The skin heals in layers, which is why it takes much longer to treat deeper scarring, but you will see results when treating even severe scarring over time.

    Personally I had incredibly severe indented acne scarring all over my face, and have used collagen-induction therapy, AKA at-home micro-needling combined with Copper Peptide cream at night and Vitamin C serum + an exfoliation cream each morning.

    Over a years time period my skin has shown dramatic improvements and I am finally happy with how my face looks again as well as able to confidently look people in the face again .

    If there is one thing I could go back in time and tell myself, it would be to never ever pick my face or acne scarring, which I did do and it made it 10X worse, and I would tell myself to not be stressed or depressed so I wouldnt get as much cystic acne. Then, after, if I did still have scarring, I would tell myself right away about at-home microneedling, Vitamin C and Copper Peptides, as well as the importance of keeping skin not-inflamed and moisturized during the healing process.

    Well, we cant go back in time, can we? So the next best thing is to just do the best we can to work with what we have and help our skin heal.

    Here are my very severe acne scars at their worst, and here they are during the healing process:

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