Best treatments for pimples

What Causes Pimples and Acne?

Pimples pop up when pores become clogged with a combination of sebum (the natural oil our skin produces), dead skin cells, and acne-causing bacteria known as Propionibacterium acnes or P. acnes.10,11

Normally, sebum travels up the hair follicle and out through the pore opening, but when there's too much sebum, it can stick to dead skin cells and get trapped in the pore. This plugged follicle is the perfect breeding ground for P. acnes bacteria. As the bacteria multiply, the pore becomes inflamed, red, swollen, and painful, causing a pimple.10,11

But what causes this pore-clogging process to happen in the first place? Acne is a complex condition affected by a variety of factors:

• Hormones: Androgen hormones, which are higher during puberty, make the sebaceous glands produce more pore-clogging sebum. This is why acne is so common in teens. But hormonal changes can cause breakouts at any age, particularly in women because of menstrual cycles, pregnancy, and menopause.11,12
• Genetics: If you have a parent or sibling who had severe acne, your chance of developing it is higher. There are several genes involved in acne that affect sebum production, inflammation, and more.21,21
• Diet: Studies suggest certain foods can make acne worse, particularly cow's milk and high-glycemic foods that quickly spike blood sugar like white bread, chips, and sweets. These foods increase inflammation and sebum production. On the flip side, low-glycemic diets rich in whole grains, legumes, and colorful fruits and veggies may help acne.13,14
• Stress: When you're under pressure, your body makes stress hormones that stimulate oil glands and increase inflammation. Stress can't cause acne, but it can make it worse.15
• Medications: Certain drugs including corticosteroids, anabolic steroids, and lithium are known to trigger breakouts.16,16
• Environmental factors: Hot, humid climates, pollution, and workplace chemicals like industrial oils can all cause acne.9,10

Contrary to popular belief, greasy foods and dirty skin aren't primary causes of acne. While it's important to wash your face, acne isn't caused by a lack of cleanliness. Scrubbing too hard or using harsh products can even further irritate skin and make breakouts worse.10,11

Top Treatments for Different Types of Acne

Just as the causes of acne are diverse, so are the types and severity of acne people experience. Acne can range from a few occasional blemishes to frequent, widespread, and painful breakouts.

To help you understand where your acne falls on the spectrum and the best treatments to try, here's a quick overview:

• Mild acne involves mostly clogged pores (AKA comedones) with a few papules and pustules scattered about.1,2 Papules are small, raised, red bumps, while pustules contain a yellowish fluid. Mild acne can often be managed with over-the-counter (OTC) products containing:
• Benzoyl peroxide to kill acne bacteria and unclog pores
• Salicylic acid to dissolve dead skin cells and oil
• Adapalene 0.1% gel (now available OTC) to prevent clogged pores
• Moderate acne looks like more frequent and widespread papules and pustules, along with some nodules, which are firmer, more painful bumps under the skin.2,5 Moderate acne is often treated with a combination of topical treatments and oral medications like:
• Prescription-strength benzoyl peroxide, retinoids, and topical antibiotics to fight bacteria and unclog pores
• Oral antibiotics to reduce inflammation and bacteria for up to 6 months
• Birth control pills or spironolactone to regulate acne-triggering hormones in women
• Severe acne causes deep, inflamed cysts and nodules that are painful to the touch and can last for weeks or even months.8 Severe acne treatment is more intense, and may include:
• Oral isotretinoin (formerly Accutane), a powerful vitamin A derivative that targets all the major causes of acne by reducing oil production, killing bacteria, fighting inflammation, and normalizing skin cell turnover. It's highly effective but needs close monitoring for rare but serious side effects.8
• Hormonal therapies like birth control pills and spironolactone for women
• Oral corticosteroids to quickly reduce inflammation
• Procedures like laser treatments, chemical peels, and drainage and extraction to treat current breakouts and prevent future ones3,4

Two other common types of acne that may need a specialized treatment approach are hormonal acne and cystic acne:

• Hormonal acne tends to appear in the lower third of the face, along the jawline and neck, and is often triggered by hormonal fluctuations during menstruation, pregnancy, or menopause.5,7 Combination birth control pills and spironolactone (which blocks the effects of acne-triggering hormones) are often prescribed alongside topical treatments.5,6
• Cystic acne is the most serious form of acne, causing large, painful, pus-filled lumps deep under the skin. This type of acne is most likely to lead to scarring, so aggressive treatment is often used, typically with oral isotretinoin.8

While there are many effective treatments for every type and severity of acne, finding the right regimen can take some trial and error. A dermatologist can examine your skin, assess your acne, and create a treatment plan that works for you.

Home Remedies and Lifestyle Changes for Acne

In addition to medical treatments, there are many natural remedies and lifestyle practices that can help clear up acne and prevent it. Here are some of the most effective strategies to try:

• Adopt a skin-friendly diet: Studies suggest certain dietary changes may help reduce acne:
• Follow a low-glycemic diet. High-glycemic foods like white bread, sugary snacks, and pasta cause quick spikes in blood sugar that can increase inflammation and oil production. Low-glycemic foods like vegetables, whole grains, and most fruits may help improve acne.13,14
• Drink less cow's milk. Some studies have found a link between drinking cow's milk and acne severity, particularly skim milk.35,36
• Eat more colorful fruits and vegetables. Leafy greens and brightly colored fruits are rich in antioxidants and vitamins that help fight inflammation. Try to eat at least five servings per day.37
• Upgrade your skincare routine: Using the right products can go a long way towards preventing new breakouts.
• Cleanse gently. Wash your face twice a day and after sweating with a mild, non-abrasive cleanser. Steer clear of harsh scrubs, alcohol-based toners, and hot water, which can all irritate skin.25,26
• Don't overwash. Washing too frequently can strip skin of its natural oils, causing your skin to overproduce oil and break out.10,11
• Moisturize daily. While it may seem counterintuitive to moisturize acne-prone skin, it's important for keeping skin balanced. Choose a lightweight, oil-free, unscented, non-comedogenic formula.25,26
• Wear sunscreen. Sun exposure can cause inflammation and redness that makes acne look worse. Apply a non-comedogenic SPF 30+ sunscreen every day.24,24
• Resist the urge to pick or pop: Picking and popping can drive bacteria deeper into the skin, causing more inflammation and increasing the risk of scarring.38,41
• Manage stress: Stress can exacerbate acne.33,34 While you may not be able to eliminate stress from your life, you can change how you handle it.
• Practice deep breathing exercises.
• Try yoga or meditation.30,29
• Exercise regularly to release feel-good endorphins.
• Get enough sleep (7-9 hours per night for adults).
• Talk to a therapist if you're feeling overwhelmed. Cognitive behavioral therapy (CBT) can help change negative thought patterns and help you learn coping strategies.28,29
• Try natural spot treatments: For the occasional pimple, try a DIY spot treatment using ingredients from your kitchen:
• Dab on diluted tea tree oil. This essential oil has natural antibacterial and anti-inflammatory properties. It is important to dilute it first as it can cause irritation if applied directly.27
• Make a honey mask. Honey has antibacterial and wound-healing properties. Apply a thin layer to your face, leave on for 10-15 minutes, then rinse off.22,23
• Make a green tea compress. Green tea is packed with antioxidants that help reduce inflammation. Steep green tea bags in boiling water for 3-5 minutes, let cool, then apply to breakouts.

While these natural remedies can be helpful for mild acne, they're usually not enough to treat more severe cases on their own. If you've been using OTC products and home remedies consistently for several weeks without improvement, make an appointment with a dermatologist for a more targeted treatment plan.

Preventing and Treating Acne Scarring

Acne scarring can be prevented and treated with the right approach. The most important thing is to treat acne breakouts as soon as they appear to minimize inflammation and prevent the damage that leads to scarring.39,40

If you do develop scars, there are many effective professional treatments available. Chemical peels use a solution to remove the top layer of skin, improving the appearance of scars and promoting collagen production.44,45 Laser resurfacing works similarly, using focused light to remove damaged skin and stimulate healing.44,45 Dermal fillers can be injected into depressed or pitted scars to even out the skin's surface. Microneedling creates tiny punctures in the skin to trigger the body's natural healing response and collagen production.44,45

For raised scars, steroid injections can help flatten and soften the tissue.44,45 Cryotherapy, which involves freezing the scar tissue, can also be effective for raised scars.44,45 In some cases, surgery can be used to remove particularly stubborn or deep scars.44,45

Treating acne scars often requires multiple approaches tailored to your individual skin concerns and scar type. A dermatologist can evaluate your scars and recommend the most effective treatment plan for you. They can also help you prevent future scarring by managing active breakouts and caring for your skin.

When To See a Dermatologist for Acne

If you're struggling with persistent breakouts, it may be time to get help from a dermatologist. Here are some reasons to see a dermatologist:

• Over-the-counter treatments aren't working. If you've been diligently using products containing benzoyl peroxide, salicylic acid, or adapalene for several weeks without improvement, you may need something stronger that a dermatologist can prescribe.24,24
• Your acne is severe, painful, or scarring. Nodular and cystic acne, causing deep, inflamed lesions, often needs a more aggressive treatment approach that a dermatologist can prescribe.8 Getting treatment quickly will help prevent permanent scars.
• Your acne is affecting your self-esteem or quality of life. Many people feel embarrassed or self-conscious about their skin, which can lead to anxiety, depression, and social isolation.
• Getting the right diagnosis. A dermatologist can help identify skin conditions that may be mistaken for acne, such as rosacea, eczema, or folliculitis. These conditions may need a different treatment.
• Developing healthy habits. A dermatologist can recommend lifestyle changes and skincare practices to help manage your acne. This may include working on your diet, stress management techniques, and how to properly care for your skin type.
• Creating a skincare routine. Dermatologists can help you figure out a gentle, consistent skincare routine that won't irritate your skin or cause breakouts.
• Scarring. They can assess your scars and recommend the most effective treatment options. The type of treatment will depend on the type and severity of your scars, as well as your skin type and overall health.

It's important to have realistic expectations when seeking treatment for acne. While there are many effective treatments, it can take time to see results. Most treatments take several weeks to start working, and it's not uncommon for acne to get worse before it gets better as your skin adjusts. Consistency is important for managing acne. Stick with your treatment plan even if you don't see immediate results.

Find a dermatologist that you feel comfortable with and trust. Look for a board-certified dermatologist who has experience treating acne and takes the time to listen to your concerns and goals. Ask questions about their treatment approach and what you can expect in terms of results and side effects.

Conclusion

Acne is a complex skin condition that can be frustrating and challenging to manage on your own. While there are many over-the-counter treatments and home treatments, sometimes a professional may be helpful for achieving clear skin.

If you're dealing with persistent, severe, or scarring acne, it may be time to see a board-certified dermatologist. A dermatologist can provide personalized treatment options, including topical and oral medications, in-office procedures, and lifestyle guidance to help you achieve your skincare goals.

Acne is a treatable condition and you don't have to suffer in silence. With the right combination of professional treatments, skincare practices, and lifestyle habits, you can have clear and healthy skin.

Citations:

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