No one, I mean no one, welcomes a zit with open arms. But everyone gets them. Fact of life. And once you have them, it's not the preventative solutions that matter. It's the get-it-off-my-face-right-now-because-I-don't-want-to-relive-my-angsty-teen-years-again remedies that are most important.
But there's no one-treatment-fits-all when it comes to acne. Mainly because there are two categories of breakouts: non-inflammatory (think whiteheads and blackheads) and inflammatory (pustules/zits, nodules, and cysts). And then there are the lumps and bumps associated with other skin issues (like rosacea, hormonal acne, and acne mechanica, which is caused by heat or friction on the skin) that resemble acne but aren't really categorized as such.
No matter the type of breakout you're currently battling, know that these things take time to heal. So that old-wives' tale of popping an ibuprofen the minute you feel a pimple coming on? It's simply not going to give you the immediate solution your hoping for. "Ibuprofen works systemically to reduce inflammation, but will not reach concentrations in the pores that will have any meaningful result," says dermatologist Neil Sadick, M.D., Clinical Professor of Dermatology at Weill Cornell Medical College and founder of Sadick Dermatology in New York City. Instead, "your best option once you feel a pimple forming is to start a diligent skin-care routine with acne-friendly products to minimize inflammation and kill any acne-causing bacteria."
Here are some solutions for erasing your acne — no matter the type — and clearing the path to bump-free skin. Because nobody needs to relive her teen years.
What you need to know: Typically, these small bumps — called comedones — are painless. Whiteheads are white in color because, "the pore is filled with oil and dead skin cells but it's sealed with skin around the hair shaft which prevents the plug from becoming oxidized so it retains its milky white color just under the skin layer," say Sadick. Blackheads are the same but they get their color from an open and oxidized clogged hair follicle at the surface of the skin.
Clear skin choices: Mild acne has seen great success with over-the-counter topical product solutions. Two star ingredients to look for:
1. Benzoyl peroxide, which kills the bacteria that cause acne and "helps remove excess oil from the skin and remove dead skin cells, which can clog pores," says Sadick. Look for it in strengths of 2.5 to 10 percent. Try Clean & Clear Continuous Control Acne Cleanser ($4.79; target.com) and La Roche Posay Effaclar Duo Dual Action Acne Treatment ($25.99; target.com).
2. Salicylic acid, which prevents pores from clogging. OTC options range from .5 to 5 percent. Try Aveeno Clear Complexion Cream Cleanser ($7.99; ulta.com) or Clinique Acne Solutions Clinical Clearing Gel ($26; sephora.com). Use either cleanser twice a day and apply the treatment products at night on clean skin.
Natural alternatives can also bring some relief. Tea tree oil has long been known for soothing skin irritations, some associated with acne, and has anti-bacterial properties. Sadick suggests diluting it with a bit of water and then trying it on a small area first to make sure you don't have an allergic reaction. "Witch hazel, green tea, and aloe also all help reduce inflammation and fight acne-causing bacteria," says Sadick. Try Tata Harper Resurfacing Mask with witch hazel ($58; credobeauty.com) or Burt's Bees Natural Acne Solutions Targeted Spot Treatment with tea tree oil ($9.99; ulta.com).
Another option to try? Cleansing brushes. Best for those with normal to dry skin, cleansing brushes help to give skin a deeper clean and exfoliation so those with congested pores have a better chance of clearing them out and removing blockages. Try Clarisonic Mia FIT ($219; clarisonic.com)."They're also especially good for women with excess facial hair, as hair follicles tend to get blocked, causing congestion that can lead to acne. Just be sure to choose a soft bristled brush—firm brushes can lead to redness and sensitivity," says Sadick. And use them no more than twice a week.
Wait time: Patience is a virtue, no matter what acne-fighting regimen you choose. For more random, localized acne breakouts, you can use a concentrated spot treatment and see results within a few days. Try Neutrogena On-the-Spot Acne Treatment ($7.99; ulta.com). For more wide-spread bumps on your face, expect to be in it for the long haul. "The onset of the comedonal plugs flattening and exfoliating will occur within one to two weeks, but treatment needs to be continued for several weeks or months after depending on the severity of the acne," explains Sadick.
What you need to know: Anyone with this type of acne knows that these are no-joke when it comes to looks and how they feel. Papules are small red or pink bumps that are sensitive to the touch. They form when the pore itself has become compromised (or damaged) and the pore wall has collapsed. "White blood cells then attack the infection," says Sadick. Pustules (pimples with pus) are also sensitive, have a white head from fluid and bacteria, and a red ring around the base. They sit up a bit higher from the skin's surface. Nodules are large, firm and inflamed — but these do not contain pus. They form in the deeper layers of the skin and are most often painful. And, finally, cysts. They're the largest, and are pus-filled lesions which can be quite inflamed and painful. Insert sad/frustrated/tired/unamused emoji face.
Clear skin choices: The good news? For those with mainly papules and pustules, there are over-the-counter treatment solutions that work. The bad news? If you're maligned with nodules or cysts, most OTC options are totally ineffective and your best bet is to be treated by a dermatologist. In those cases, the doctor may prescribe oral antibiotics like sulfa-based Bactrim, oral medication like Isotretinoin (formerly known as Accutane), hormone therapy (like oral contraceptives), or Photodynamic Therapy (using controlled red or blue LED light exposure paired with a photosensitizing cream).
Just like non-inflammatory acne, salicylic acid can help those suffering with papules and postules, as well as exfoliants like alpha hydroxy acids (glycolic and lactic acids among others). AHAs treat acne "by helping to remove dead skin cells and reducing inflammation. They also stimulate the growth of new, smoother skin," explains Sadick. "This helps improve the appearance of acne scars and gives the impression of smaller pores." If a doctor prescribes it, look for them in the 50-70% range, if OTC lotions then the range is much smaller, between 10-15%, "which is effective with daily use for mild acne," says Sadick. Try Renee Rouleau Anti-Cyst Treatment ($42.50; reneerouleau.com) with lactic acid or Cane + Austin Acne Retexture Pads ($60; Sephora.com).
Wait time: There are no overnight miracles with inflammatory acne. Expect to continue your treatment routine for at least 2-3 weeks to see results and then continue it for several more after that. If during the time you have active breakouts, steer clear of heavy, greasy products that contain "pimple-producing ingredients like cocoa butter, mineral oil, or cold creams," advises Sadick. "Also avoid products that contain any kind of harsh ingredients like alcohol, menthol, peppermint, eucalyptus, camphor, and lemon or lime, as well as synthetic fragrances. These make skin dry, flaky, tight, and red, and encourage more oil production inside the pore."
What Else Can You Do?
Products aside, there are also lifestyle changes you can immediately put into place to help shorten the life-span of a breakout and help further decrease the inflammation, like eating well. "Diets containing a lot of high glycemic foods — like sugar, white breads, white rice, low-fat dairy products, and pastas — have been strongly linked to acne," explains Sadick. "They cause blood sugar levels to rise and prompt the release of various hormones which exacerbate acne. So avoid them during an outbreak." Additionally, it goes without saying that you should try to relax, avoid environments with tobacco or other irritants, take a multivitamin, drink plenty of water and by all means, get some serious beauty sleep.
January 06, 2017 | Redbook by Molly Nover-Baker