Acne : What is Acne : What causes acne? : Acne Face Map : Acne Treatments : Acne Treatment List
|
Over-the-Counter |
Prescription Only (Rx) |
At-Home Remedies |
|
Check here for facial procedures (such as peels, laser, etc) |
Retinoids: Other: |
Topical Diet Alternative Medicine |
Benzoyl peroxide (BP) is one of the most common active ingredients in over-the-counter acne treatments. It works by putting oxygen into your pores and increasing skin turnover. Therefore, P. acnes (the bacteria that causes acne) is killed (because it only survives in an oxygen-deprived environment) and pores are cleared.
Benzoyl peroxide is actually oxidizing in the long run though, which ages your skin faster....so be aware of that. Also, although most places sell 10% BP, studies have shown that 2.5% and 5% work just as well without being as irritating.
Most people will experience slight redness and irritation when they first start using BP, but a small percentage of people are actually allergic, so it's best to start with a low percentage and minimal application to gauge skin tolerance. You'll know if you're allergic if BP causes your skin to turn really red and itchy and all sorts of uncomfortable-ness.
To keep skin clear of acne, BP has to be used long-term. Once you stop using it, the bacteria colonies come back and breakouts resume. However, unlike antibiotics, the p.acnes bacteria does not develop resistance towards BP.
BP is also a bleaching agent....so try to keep it away from your eyebrows, hair, and clothes. I remember back in high school, I always had these mysterious bleached parts on my pillow cases and T-shirt sleeves and now I know they were from BP!
For more information about including benzoyl peroxide in your skin care routine, see Daniel Kern's regimen at acne.org. For benzoyl peroxide product recommendations, check here.
(FYI, ProActiv's main ingredient is also BP.)
BHAs (beta hydroxy acids), also known as salicylic acid, help clear your skin by increasing skin turnover and exfoliating your pores from the inside. They are great for getting rid of clogged pores and blackheads, but only if formulated at the right pH, a pH around 3. BHAs seem to be less irritating than BP, but take longer to work.
Since they clear your pores from the inside, BHAs can also cause acne flares. Some people break out or "purge" for about two weeks when they start using them. Also, most people see results after 2-3 weeks of consistent use. Unlike AHAs, which make your skin more sensitive to the sun, BHAs can be used during the day. However, it's always a good idea to wear sunscreen anyway!
BHAs are found in many drugstore acne treatments, usually as the 2% salicylic acid active ingredient, but higher percentage BHA products can be found online. There are also high percentage BHA chemical peels to help your skin clear faster.
Many people often think that aspirin (as in the aspirin mask) is also a BHA, but aspirin and BHAs are not the same thing.
For BHA product recommendations, check here.
AHAs (alpha hydroxy acids), such as glycolic and lactic acid, exfoliate the outer part of your skin. Many people get AHAs and BHAs confused, but AHAs exfoliate the surface of your skin while BHAs exfoliate the inside of your skin.
With consistent use, AHAs are excellent for reducing hyperpigmentation, acne marks, and light wrinkles. Because they're a chemical exfoliant, AHAs help smooth out skin, improve acne (for some people), and give skin that "glow".
Glycolic acid seems to be the more readily available AHA on the market. Most products have 10% glycolic acid in them, but there are some with 8% and 14% glycolic acid. I don't really see a lot of lactic acid facial products (I think that's because lactic acid is more expensive) but there are some lactic acid body lotions, such as AmLactin and LacHydrin, which are marketed towards those with keratosis pilaris. High concentration AHAs (both glycolic and lactic acid) are also the base for many chemical peels. You can learn more about their differences here.
Some people have adverse reactions to AHAs, so be sure to spot test before slathering it all over your face. Similar to BHAs, some people also "purge" when they first start using AHAs. They make your skin more sensitive to the sun, so they are best used at night, in conjunction with a good sunscreen during the day. If you're new to AHAs, I'd start off slow, using it once every other night to slowly build up tolerance. They could also make your skin red and flakey.
On a side note, I've read recommendations that say to use glycolic acid for three days and then take a day off to let your skin regenerate for better results. But, I have no idea if this works any better than using glycolic acid every single day.
Sulfur is mainly used to dry up pimples. Lots of products with sulfur as the active ingredient also don't smell that great (think rotten eggs).
Sulfur is a hit or miss for most people. Some people love it while others (like me) see no results from it whatsoever. However, sulfur has been used in the past as a beauty secret ingredient.
When I was in Japan, we went to a lot of natural thermal spas in the mountains and I remember almost every single place had a thermal pool labeled "For Beautiful Skin". And guess what was in it? Besides lots of minerals from the nearby springs, there was definitely a lot of sulfur!
Anyway, since sulfur is used to dry up pimples, using sulfur can be quite drying for your surrounding skin. Unlike benzoyl peroxide, BHAs, and AHAs, sulfur is mosly sold as a spot treatment. The others can be used as spot treatments too but a lot of the times people use them all over their face as a preventative measure.
However, not all sulfur treatments are marketed as spot treatments. Sulfur is actually known to help reduce redness and acne lesions from rosacea. There are also lots of sulfur soaps and sulfur masks. For more information about sulfur-based products, check here.
Tea tree oil is supposed to be a great spot treatment and all-over antibacterial product. It is antiseptic and antifungal so it can not only be used for killing off pimples, but it can also be used for bug bites and tiny wounds.
Studies have found that 5% tea tree oil can be just as effective as 5% benzoyl peroxide without all the irritation that comes from using BP. So those who are allergic to BP can give tea tree oil a try.
Now be prepared because tea tree oil really reeks. You can buy products with tea tree oil in them or you can simply purchase 100% tea tree oil from Whole Foods or even Wal-Mart. However, if you do buy the 100% tea tree oil, make sure you dilute it so it won't burn your skin upon application.
Lots of people who make their own moisturizers, essential oils, or oil cleansers like to add a couple of drops of tea tree oil to make their product more antibacterial. On a side note, if you do use tea tree oil, you have to make sure to use at least 4% tea tree oil or else the bacteria colonies will get used to the tea tree oil and develop antibiotic resistance.[1]
Oh, and if you have cats, keep tea tree oil away from them because it's supposed to be a deadly toxin for cats!
1. University of Ulser. Tea Tree Oil Can Lead to Antibiotic Resistance. 15 Feb 2007RETINOL
NOTE: Please consult this section on retinoids before moving on.
Even though retinol is the weakest type of retinoid, it still provides anti-aging and anti-acne benefits. Because it's weaker, products with retinol may not be as effective as stronger retinoids and may take longer to work. However, most people tend to experience less irritation when they use products with retinol, compared to using products with tretinoin (or Retin-A).
Retinol is available in many over-the-counter products, mainly targeting the anti-aging market. However, just because a product has retinol in it doesn't mean it will automatically give you anti-aging and skin clearing benefits. It will depend on the percentage of retinol in the product as well as overall product formulation.
The strongest retinol available over-the-counter is Green Cream. Green Cream comes in three different versions: level 3, 6, and 9. Level 3 is the weakest while level 9 is the strongest. When starting out with Green Cream you want to use the lowest level and follow the guidelines for how to correctly use retinoids. You can then move onto level 6 and/or 9 if you feel you need a stronger product.
Using Green Cream and other products with retinol can result in peeling, redness, and irritation. Many people also find Green Cream's alcoholic base too drying. However, the alcohol is there to enhance the retinol's penetration and make the product more effective. If Green Cream is too irritating for your skin, you could try buffering it or using another retinoid product.
Retinaldehyde is stronger than retinol but weaker than retinoic acid (or Retin A). For a chart comparing the different strengths of the different types of retinoids, check here.
Like retinol, retinaldehyde is available over-the-counter and also provides anti-aging and anti-acne benefits. Before using retinaldehydes, you should familiarize yourself with retinoids in order to get the maximum benefit from the product and minimize irritation.
Avene has many products with retinaldehyde as the active ingredient. A few of these include: Eluage, Ystheal (the gel form has since been discontinued), Diacneal, and Retrinal. Most of these products are only available in Europe and Asia, however some CVS stores are starting to carry them in the US as well.
Diacneal is one of Avene's more popular products. It has 0.1% retinaldehyde and 6.4% glycolic acid. This is probably one of the most powerful over-the-counter retinoid products. The additional glycolic acid ingredient helps retinaldehyde penetrate the skin better, making the product more effective. However, people with skin sensitive to glycolic acid may want to avoid this product.
This is a LED pen that supposedly zaps pimples. It works by using different frequencies of light waves to penetrate the skin and kill bacteria. There are red, blue, and red/blue light settings. Red reduces the inflammation, redness, and swelling from a pimple. Blue helps to kill bacteria and red/blue lets the two of them work simultaneously.
Basically, to use it, you just hold it close to a pimple for about 10 minutes (or however long you want to use it) and the pimple should get better/reduce in size. Lumiport is kind of like a mini-portable light therapy pen.
It also comes in a case along with alcohol pads for you to clean the tip of the pen. It didn't work for me though (turned pimples into two-headed pimples) and I'm glad they had a full-refund policy (within 30 days)! If you don't mind wasting shipping and handling, you could give this a try. Lumiport had pretty fast shipping and pretty good service.
Differin is the mildest prescription retinoid that most dermatologists initially prescribe. It's available in gel and cream form. The gel form is a bit stronger than the cream form in terms of penetration, although both are .1% adapalene (.3% is also available now). Differin gel seems to be the more popular base because the cream version can be problematic for acne prone skin. However, if the gel is too drying, the cream could be less irritating.
Because Differin is the mildest prescription retinoid, its side effects (such as dryness, peeling, redness) aren't as pronounced as those for Tazorac or Retin-A. However, Differin also tends to not work as fast.
It takes a while to see results from Differin and you have to start out slow, like with all retinoids, to minimize irritation. You can try buffering Differin or even using short contact therapy, but check here for more information.
Retin-A is stronger than Differin but not as strong as Tazorac. Its active ingredient is tretinoin or retinoic acid. Retin-A can be used for anti-aging, but it is mostly marketed as an acne treatment.
Retin-A is available in a variety of formulations, so people of all skin types should be able to find one that works for them. Retin-A cream has 0.025, 0.05, and 0.1% strengths. The gel version has 0.01 and 0.025% strengths. Finally, the liquid version is only available in 0.05% strength.
Most people I know use the gel formulation. Many of them also start using the Retin-A with the lowest percentage of tretinoin and work their way up. Do you have to move up to a stronger strength? No, you don't. You can if you think you need extra oomph in your routine or if the strength you're currently using isn't giving you enough anti-aging and anti-acne benefits. However, if your skin is doing just fine with, say 0.025% Retin-A, then you can keep using that strength as long as you want. If you try a stronger percentage and don't like it, you can always move back down.
Retin-A Micro or RAM is an updated version of Retin-A. They both have tretinoin as the active ingredient, however RAM has an oil-free base that can be less pore clogging. RAM also works on a time-release mechanism, called the microsponge delivery system.
When you apply RAM to your skin, microspheres in the product reserve and hold parts of the medication. The microspheres then slowly release tretinoin into your skin so that your skin absorbs small amounts of the retinoid over time instead of getting hit with a lot of it all at once. The microspheres themselves aren't absorbed by your skin but are merely washed off each time you cleanse your face.
This time-release delivery system helps to reduce irritation and increase tretinoin's effectiveness. Some people prefer RAM for this reason, while others dislike it because they won't be able to buffer the product. Buffering RAM may be problematic and cause it to be ineffective because buffering interferes with how the microspheres work.
RAM is available as a gel in 0.04 and 0.1% strengths. The gel actually looks like a white cream when you are applying it to your skin, but the whiteness of it comes from the composition of the microspheres.
Renova is another tretinoin prescription product. Unlike Retin-A and Retin-A Micro, which are marketed as acne treatments, Renova is more commonly prescribed for anti-aging. It has a creamier base compared to the other two and is available in 0.025 and 0.05% strengths.
Tazorac, also called Avage and Zorac, is the strongest prescription retinoid available. Its active ingredient is tazarotene. Tazorac is available in a cream form with 0.05 and 0.1% strengths, as well as gel form with 0.05 and 0.1% strengths.
Although Tazorac is used to treat acne and psoriasis, it is usually prescribed only after patients have zero success with Differin and/or Retin-A.
Since Tazorac is pretty strong, it is often much more irritating than the other retinoids. The side effects from Tazorac (such as initial breakout, redness, peeling, dryness, etc) also take longer to go away. The good thing about Tazorac is that since it is a synthetic retinoid, you can use short contact therapy with it to receive its benefits without all the added irritation.
I think this is the first thing I learned from magazines about spot treating acne. You basically dab the pimple with some toothpaste (paste, not gel) to help it go away faster. However, this generally doesn't work.
You can also tell most people don't have much success with it because if toothpaste really did work, people would be smearing tubes of Crest over their skin instead of investing their money in other acne creams.
I actually tried using toothpaste as a spot treatment, but it stung so badly that I had to wash it off rather promptly. And after I washed it off, the pimple and its surrounding skin turned bright red. They also stung from the menthol in the toothpaste.
The reason toothpaste is recommended is to use it as a drying agent for the pimple. However, if you're going to use toothpaste, you might as well go out and buy some real acne cream.
It has long been known that garlic possesses antibacterial, antimicrobial, and antiseptic properties. Because of this, rubbing raw garlic on your pimples is supposed to help kill the bacteria and help the pimple go away faster.
However, I would advise against doing this. I actually tried it and it did nothing but burn, stink, and turn my skin red!
Wait a minute? Isn't that for chicken pox?
Yup, well except for the fact that most kids nowadays are vaccinated for this unsightly pink polka-dotted plague...(lucky bastards!)
Anyway, regular calamine lotion (the pink kind) has 8% calamine and 1% Pramoxine HCl as its active ingredients. The calamine itself is actually made up of zinc oxide (like diaper rash cream) and a little bit of iron oxide. Clear calamine lotion, like Caladryl Clear, has 1% Pramoxine HCl and 0.1% zinc acetate as its active ingredients, a little bit different from the original lotion.
The calamine and zinc acetate ingredients prevent infection by forming a protective seal. They also relieve itching and have somewhat of a drying effect on your skin. The Pramoxine HCl ingredient, on the other hand, is an analgesic, or pain killer. I think it's calamine lotion's drying effect that makes it an effective acne topical.
So basically, calamine lotion can help dry up your pimples and prevent the bacteria from spreading. You can either use this as a spot treatment or an all-over-the-face mask. Some people even sleep with it as a mask at night. I definitely would not recommend using this under makeup or during the day because the seal it forms on your skin looks somewhat glossy and would probably roll/rub off under makeup or sunscreen.
As for how effective it is, I can't say that it's helped "clear" my skin, but it does have somewhat of a soothing effect. At any rate, calamine lotion seems to get glowing reviews at acne.org. And, if it doesn't work out for pimples, at least it's cheap and....it's always good to have some anti-itch cream on hand for those pesky bug bites!
I've heard a lot about using diaper rash ointments as acne treatments. People claim that they help reduce redness and dry up any existing lesions.
The idea behind using this for acne is that diaper rash creams contain zinc oxide (usually around 10%). Zinc oxide, which is also in calamine lotion, relieves itching and reduces the possibility of infection.
However, be aware that diaper rash cream is very white and pasty (from the zinc oxide ingredient), so it's best used as a night treatment. Some ointments can also be somewhat greasy and if you don't use them often, the oils in them can separate.
I tried Burt's Bees Baby Diaper Ointment for awhile, but was sorely disappointed. I pretty much went to bed with a ghastly face and woke up with no improvements in my skin. The ointment did feel soothing though....
So diaper rash cream didn't work for my acne, but it could be something that works for you.
There is a Chinese belief that eating lots of pearl barley (or Job's Tears) will give you beautiful, porcelain-like skin.
(Actually, if you've ever been to a Traditional Chinese Medicine practitioner, herb mixtures prescribed for acne usually include some form of job's tears and/or mung bean powder. Both cool the "heat" in your system, which is responsible for breakouts.)
To test this out, I substituted pearl barley for rice for all three of my meals for about 2-3 months, but unfortunately, didn't notice a difference in my skin. I still had acne and still had red acne marks. I don't think it made my skin better at all, but at least it tastes good!
I believe this is another Asian thing. When all of my relatives saw how craptastic my skin had become (breakouts galore!) they all told me to eat large amounts of chicken butts. This is considered a delicacy in many Asian countries, but it's probably something too weird for Western cultures to embrace.
Anyway, hormones in the chicken butt, along with the fat and gelatinousness of it, is supposed to give your skin all the nutrients it needs to be beautiful and plump. I tried to eat this stuff but I couldn't really stomach it so I don't know if it actually works or not. However, I do know this 50 year old woman who eats a bag of chicken butts everyday and she has amazingly beautiful, young looking skin. Her skin isn't the only thing clear and plump though...all those chicken butts have taken a toll on her weight!
On another note, one of my cousins loves to eat chicken butts (Is there a more graceful term for this?? Chicken glutes maybe? Chicken maximus?) as well but she still has acne. Maybe the 50 year old lady is just gifted with wonderful genes!
When I was really desperate, I started searching online for at-home remedies to clear acne. Eating lots of raisins was one of the things I read and tried. I'm actually getting quite embarrassed by posting all of the weird things I have done to get my skin to clear up, but oh well!
Anyway, the idea behind eating lots of raisins is that there is a lot of fiber and vitamin C in them. The fiber will keep your digestive system more active and the vitamin C will give your skin helpful nutrients. Many people think that a sluggish digestive system does not remove toxins from your body quickly enough and as a result, these toxins erupt as pimples and acne lesions on your face. So, if you improve your digestive system, you will prevent these toxins from causing pimples.
However, I don't think I ate enough raisins because I got tired of them pretty quickly. I don't think this would really work anyway because while you are what you eat, I don't think eating more or less raisins could really clear up your skin.
Although many researchers and dermatologists believe there is no connection between food and diet, Asian dermatologists are more willing to make this link. My dermatologist in Taiwan tells all of his acne patients to avoid sugar, peanuts, and high-caffeine foods.
You can actually try to see if diet affects your skin by keeping a food journal. Write down everything you eat and make notices for whenever you get new pimples. By keeping track of everything, you can see whether certain foods trigger certain breakouts. However, eating something that might aggravate acne won't make you break out the very next day, so diet related acne sleuthing can get pretty confusing.
On the other hand, you could simply eliminate isolated food groups from your diet. For example, you could stop drinking milk to see if milk is an acne culprit. If you clear up, that proves you may have a dairy sensitivity.
I think trying to fix your acne through diet is very difficult though because it's very hard to keep food restrictions. For example, whenever you hang out with your friends, it sucks to be a party pooper and not share dessert with everyone because you're trying to cut out diary or sugar. However, having a healthy diet benefits your entire body, not just your skin!
This is a very popular e-book floating around on the internet. Lots of people have actually purchased it and tried it, but I'm not sure how successful they've been. The e-book basically claims that you can clear your acne by eating nothing by apples for three days. I think it's kind of like an internal cleanse type of regimen where you cleanse out your system and flush out toxins.
There's also something about taking a spoonful of olive oil or something like that on the last day of this regimen and after three days of eating nothing but apples, you're supposed to have wonderfully clear skin. Yea right! As a student, I didn't have enough energy to stay awake and walk to all of my classes on just apples, so I have actually never tried this regimen before. I doubt that it would work though.
There is another version that is similar to this, but instead of eating apples, it's eating cucumbers because cucumbers are supposed to be cleansing and cooling to the body. I tried eating cucumbers for one day but really couldn't stand it so, I can't say that I've tried this method.
Reflexology is a branch of traditional Chinese medicine, where you basically massage, squeeze, or press onto different parts of the feet, hands, or ears to improve other parts of your body. The thinking behind reflexology is that each section of your foot is connected to a bodily organ or function. So by massaging and pressing on certain pressure points, you can stimulate these organs and improve their function.
Does this actually work? No, not for me. If you get reflexology done by a real reflexologist, the process can actually be quite painful and cathartic. However, since I was doing this by myself based on a reflexology how-to book (and probably doing it incorrectly) I didn't see any results. Getting it done by a professional might be different though. Who knows.
When topical products do not work, many people turn to holistic methods for acne treatments. Acupuncture is a traditional Chinese medicine technique used to balance your qi.
In laymen's terms, acupuncture basically balances all the things that need balancing to help your body heal. Once everything inside of you is balanced, there would be no reason for you to get any skin eruptions.
During acupuncture, the specialist will stick very fine needles into certain points and meridians in your body. The needles don't hurt too badly or cause you to bleed or anything, but you do have to stay still during the entire treatment process. More than one treatment is necessary for your desired results. But if you get acupuncture, make sure you get this treatment from a qualified professional!
How well acupuncture works for acne is still a mystery. Some people get good results from it and others don't. For example, one of my cousins had very persistent, moderate acne. She was very into traditional Chinese medicine and refused to use any prescription topicals on her skin. So, she always turned to taking Chinese medicinal herbs and getting acupuncture as treatments. She kept this up for about a year, but her skin still stayed the same. It didn't really clear up anything or prevent pimples from forming.
Though I do believe that traditional Chinese medicine and other holistic methods have their benefits, I would rather slap on some cream and call it a day.
Lots of online places recommend sitting in the sauna or steam room to help with acne. The heat/steam is supposed to help you sweat out all those bad toxins stored in your body and kill or deter the growth of p.acnes. It also "opens" your pores so that the gunk inside is softened and can be pushed out by your skin more easily.
However, I honestly don't think you can clear your acne by sitting in a sauna everyday. Such extreme temperatures inside the sauna could also cause broken capillaries on your skin. In a non-steam room type of sauna, the dry heat might even aggravate acne.