So, what is acne anyway? Here we identify this self-esteem-crushing problem and the different ways it can show up. Knowing what causes acne is your first step in learning how to take control so you can get rid of breakouts and get back to having clear skin!
What Is Acne?
Most of us are familiar with acne, even if we don’t know the specifics of what makes it acne and not some other skin problem. Acne’s textbook definition is that it’s a skin disorder that occurs when hair follicles (every pore on your face is actually part of a follicle) become plugged with dead skin cells and oil. That mixture of oil and cells allows the bacteria responsible for acne, Propionibacterium acnes (P. acnes), to flourish inside the follicle instead of remaining on skin’s surface, where it normally resides without causing much trouble.The bacteria feasts on the follicle’s contents, which starts a domino effect by producing inflammatory chemicals and enzymes. This process attracts white blood cells to combat the bacteria, which leads to inflammation. Acne is first and foremost an inflammatory disorder, and it’s important to remember that when treating it! Anything you can do to reduce inflammation will help acne heal faster—the reverse is true as well, making the inflammation worse will make the acne worse!
The last of the “precursor” stages in the development of acne is when the wall of the plugged follicle breaks down, spilling everything inside to nearby skin-leading to lesions or pimples.
Forms of Acne
Acne can show up on many areas of the body, including the face, neck, chest, back, shoulders, and arms. While the classic pustule form (if such a thing can be called classic!) is what many people typically think of when acne comes to mind, it can actually take several forms, as described below.- Comedones: This form of acne presents itself in two ways: whiteheads or blackheads. According to the Mayo Clinic, comedones are the non-inflammatory version of acne. When these lesions are closed at the skin’s surface, they are flesh-colored, slightly raised bumps called whiteheads. When they’re open, the exposure to air allows the plugs in the hair follicle to oxidize, resulting in a dark or black spot on skin called a blackhead. That dark spot is not dirt showing beneath the surface of skin!
- Papules: These are small, raised bumps that indicate inflammation is occurring in hair follicles.
- Pustules: Larger than papules, these red, tender bumps have white pus at their tips and are a sign of a more advanced, deeper inflammation.
- Nodules: One of the most painful forms of acne, these bumps remain below the surface of the skin and are large and solid. They develop when buildup occurs deep within hair follicles that are severely clogged.
- Cysts: Painful, pus-filled lumps that form beneath the skin, and that present an increased risk of scarring due to their depth and collagen-destroying potential. You can learn more about how cysts form - and how to treat them - in our article Cystic Acne Agony.
Main point:
So, we now know what acne is, and what it can look like, what can you do to treat it? The good news is that there is a wealth of information about the different ways to treat acne and bring it under control. We invite you to check out our articles that tackle every aspect of acne, including the factors that cause it, how to prevent it, myths that could be making your skin worse, prescription treatments, over-the-counter treatments, and even alternative treatments that could help when other options fail. This is a battle that can be won—and the feeling of happiness when you finally have clear skin again is among the best ever!The Plan to Fight Acne & Wrinkles
Acne breakouts or wrinkles can be challenging enough when you're dealing only with one or the other. But, when you're struggling with both at the same time, it can be frustrating and confusing. If you follow our list of the type of products needed to help you fight wrinkles and breakouts at the same time, you will find your skin looking radiant, clearer, and smoother in just a few days—really!
We've outlined the 5 essential products you need for treating acne and wrinkles at the same time.
Step 1: Gentle Cleanser
Acne doesn't need drying cleansers or bar soaps; these actually make matters worse. "Medicated" cleansers aren't helpful either, because the active ingredient, even if it's effective, is just rinsed down the drain. On the other hand, just because your skin is showing signs of aging doesn't mean you need a rich cleansing cream; the emollient ingredients in these types of cleansers can clog pores and make breakouts worse. Instead, wash your face twice daily with a silky, but effective, water-soluble cleanser formulated with gentle, soothing ingredients, and at night use a soft washcloth to be sure you get all your makeup off. If you haven't used this method before, you'll be amazed at how much better your skin will look and act, just from this small change!
Step 2: BHA Exfoliant
Exfoliating with a beta-hydroxy acid (BHA or salicylic acid) product is the most effective way to improve breakouts and fight signs of aging at the same time. Salicylic acid exfoliates the skin's surface as well as inside the pores, where clogs (such as white bumps or blackheads) occur. It also reduces redness and stimulates collagen production for firmer, more youthful skin. This single ingredient is the #1 secret weapon for anyone struggling with breakouts and wrinkles! In fact, many people see results overnight. For best results, apply at least once daily, after cleansing (and toning, if your routine includes a well-formulated toner).
For more stubborn acne: After applying a BHA exfoliant, you can treat acne breakouts with a leave-on product medicated with benzoyl peroxide. This topical disinfectant kills the bacteria responsible for creating red, inflamed breakouts. Used in combination with a BHA exfoliant, you can achieve even better results for breakouts. Be sure to look for products that contain 2.5% benzoyl peroxide, as this strength is a great balance of gentle yet effective.
Step 3: Treatment Serum
Most treatment serums are lightweight (which is great for use on breakout-prone areas), and the best ones are loaded with the kinds of ingredients all skin types need to look and act younger and healthier and to help heal red marks blemishes often leave behind. Such ingredients include antioxidants, skin-repairing substances, and cell-communicating ingredients. These not only help repair signs of aging and stimulate collagen production, but also reduce redness from breakouts while helping skin heal and fight inflammation (a major component of acne). Talk about win-win! For best results, apply twice daily, including around the eyes, after cleansing, toning, and exfoliating.
Step 4: Lightweight Moisturizer
The challenge in finding the best antiaging/anti-wrinkle moisturizer for blemish-prone skin is that it must hydrate and nourish skin without feeling thick, creamy, or greasy (all of which can increase breakouts). Generally, this means you want to use a moisturizer with either a very light thin lotion feel or a gel texture loaded with antioxidants and skin identical ingredients! Your skin needs to get beneficial ingredients such as antioxidants to stimulate collagen production, anti-irritants to reduce red marks and help reduce patches of dry, flaky skin, and softening ingredients to diminish the appearance of wrinkles. Apply at night after exfoliating and after applying your treatment serum.
Dry skin around the eyes? Then the type of moisturizer described above won't provide enough moisture. For your eye area, consider a more emollient moisturizer (it need not be labeled "eye cream").
Step 5: Sun Protection
No skin-care routine is complete without daily sun protection. It is essential to use a product rated SPF 25 or greater. But, did you know that protecting your skin from further sun damage helps combat breakouts, too? It's true! By preventing the inflammation sun damage causes, you're strengthening your skin, allowing its immune response to help heal breakouts (and the red marks they can leave) faster! Those with breakouts and wrinkles need matte-finish sun protection from a product that smooths and hydrates without making breakouts worse. You can also consider a foundation and a pressed powder with sunscreen as your daily facial sun protection, too. Just make sure it's rated SPF 25 or greater. Layering like that can feel more comfortable if you also have combination or oily skin. Make sure sunscreen application is the last step in your morning skin-care routine!
Acne Myths
Acne breakouts are terrible enough on their own, but they can be made even worse by the sheer amount of misinformation about how to treat breakouts, and what causes them. A quick search of the web turns up all kinds of theories about why people get acne, and what to do if you have it. It’s enough to make your head spin! The big question is how to figure out what’s true and worth trying and what isn’t.
Following are the most common acne myths out there. Find out what’s true so you don’t have to waste any more time, and save yourself disappointment!
Five Major Acne Myths
With acne, it seems there is no shortage of advice and all sorts of theories as to what works and why. Among them are the following five commonly-held myths that turn up all the time, no matter how many times they’ve been debunked:
- You can dry up blemishes. Water is the only thing you can "dry up," and a blemish has nothing to do with skin being wet. Drying up the water and other moisture-binding substances in skin actually hurts its ability to heal and fight inflammation, and encourages bacterial growth. Absorbing oil that's on the skin's surface or in the pore is radically different from "drying up" skin with harsh ingredients.
- Acne is caused by dirty skin. This mistaken belief often leads to over-cleaning of the face with soaps and strong detergent cleansers, which only increases the risk of irritation and dryness, while doing nothing to prevent pimples. It's also the perfect recipe for skin that feels dry and tight underneath, but is oily on top. If you have blackheads, that dark color you see at the tip of the blackhead isn’t dirt beneath the surface of your skin; it’s dead skin cells and oil that have oxidized, giving the pore opening a dark appearance.
- You can spot-treat acne. Although you can reduce the redness and swelling of a breakout with a salicylic acid (BHA)–based product or with a benzoyl peroxide disinfectant (both explained below), that doesn't go far enough. Dealing with only the pimples and pustules you see means you are ignoring those that are in the process of forming. As you may have guessed, this leads to a never-ending cycle of chasing acne around your face. Spot-treating tends to work best for those whose breakouts are infrequent and localized (for example, on the chin) rather than for those who experience them more frequently and all over the face.
- If it tingles, it must be working. Ingredients that make your skin tingle, such as menthol, peppermint, eucalyptus, and lemon, show up in countless anti-acne products, yet there is no research showing they have any benefit for acne or oily skin. In fact, these ingredients irritate skin, and only make matters worse! Irritating the skin triggers stress-sensing nerve endings at the base of the pore, which in turn stimulate oil production. That cooling sensation, however nice, has no ability to reduce acne.
- Eating chocolate or greasy food causes acne. While it’s absolutely true that eating healthy food is good for you and your overall well-being, eating chocolate or greasy food isn't going to give you acne. If that were true, then everyone who ate either of these things would have acne, and that’s simply not the case!
Now You Know
With these myths busted, you now have the facts about what causes breakouts and how to treat them, and are in a much better position to take control. We invite you to read our other articles about every aspect of acne, including factors that cause it, how to prevent it, prescription treatments, over-the-counter treatments, and even alternative treatments that might help when other options fail. Armed with this information, you can succeed in making breakouts a thing of the past!
Cystic Acne Agony
Cystic acne is one of the most difficult types of acne to treat. Though it is most likely caused by the same bacteria (p. acnes) as regular acne, cystic acne lesions are far more painful and have more risk of scarring compared to mild or moderate acne.
Cystic acne lesions actually rupture beneath the surface of the skin, pushing the blockage and swollen contents beyond the reach of traditional, topically-applied anti-acne products. Many dermatologists regard cystic as the most severe type of acne, and, many admit that traditional acne treatments are largely ineffective. Due to the slow healing time of cystic acne lesions, the potential for scarring and the extent of damage is something to take seriously. It's especially important to be informed about potential triggers and treatment options—otherwise, you're likely to make matters worse and even more painful.
Read More Below
What Causes Cystic Acne?
Like almost every type of acne, the cystic variety is triggered by hormones. With cystic acne, for reasons unknown, the skin's oil glands become hypersensitive to excess male hormones (women have male hormones that trigger acne), and react by overproducing sebum (an oily substance produced by the body to lubricate and waterproof skin). So much sebum is produced that the oil gland itself becomes engorged, swollen, and hardened with the excess. Unable to push almost any of the extra oil to the surface, the gland bursts underneath the skin, creating the large swollen mass (called a nodule or cyst) below the skin's surface. Once that occurs you are in the throes of this terribly painful and unsightly type of acne.
Although not a lot is known about what causes some people to get cystic acne, there is likely a genetic component involved. Given the strong hormonal component, it is most likely to occur during these times or if certain disorders are present:
- The onset of puberty (when hormones go bonkers)
- Pregnancy
- Menstrual cycle
- Perimenopause and menopause
- Polycystic ovary syndrome (a condition caused by a hormonal imbalance in a woman's ovaries)
What Does Cystic Acne Look Like?
- Cystic acne nodules appear as raised, red bumps that extend deep beneath the skin.
- Generally they do not have a "whitehead" showing, but this is not always the case.
- They are almost always painful to the touch, or even when not touched.
- Cystic acne lesions can often be felt beneath the skin before they are seen.
How Can I Treat Cystic Acne?
There is no way to completely avoid cystic acne (you're either prone to it or you're not), but there are ways you can minimize its occurrence while doing what's best for your skin.
As with all types of acne, the first place to start is with over-the-counter products and common sense skin-care tips:
- Keep your skin-care routine as simple as possible and follow it religiously.
- Use a gentle, but effective water soluble cleanser twice a day (drying, harsh cleansers only make matters worse).
- Avoid bar cleansers (the ingredients that keep bar soap in bar form can clog pores).
- Exfoliate once or twice a day with a salicylic acid-based exfoliant (to reduce redness and swelling, help reduce bacteria in the pore, and exfoliate on the surface and inside the pore to improve oil flow). Paula's Choice offers a variety of effective BHA exfoliants.
- Apply benzoyl peroxide for killing the bacteria in the pore (be sure there are no irritants such as menthol or alcohol which will increase redness and inflammation). Paula's Choice Clear offers two benzoyl peroxide-based lotions.
- Never use thick moisturizers (especially creams) in the areas where any type of acne occurs (these can clog pores). Stick with lightweight options with gel or lotion textures.
- Photodynamic Therapy (PDT): Recent research points to the promising results that cystic acne sufferers have found through a series of PDT treatments, which is a procedure that involves topical application of a photosensitizing cream and repeated, controlled blue or red LED light exposure. Though treatment takes several visits to a dermatologist over the span of a few months (and carries a high price tag), there's enough evidence to suggest that these treatments shrink the oil glands, reduce the amount of oil in the pores and kills the bacteria, all of which can minimize cystic acne breakouts.
- Oral Antibiotics: There are several types of oral antibiotics available for those with acne. All of them are worth discussing with your dermatologist and are options for short-term use under a doctor's care. Side effects include, but are not limited to, dizziness, headache, nausea, rash, and gastrointestinal issues such as diarrhea and abdominal pain. The rise of sulfa-based antibiotics (such as Bactrim) to manage acne is due to the development of bacterial resistance to more commonly prescribed antibiotics (such as tetracycline). Oral antibiotics should also be used in conjunction with topical products designed to treat acne.
- Hormone Therapy: For some women constant over production of androgens (hormones that produce male traits) is the chief culprit for causing cystic acne. There is a good deal of research showing that drugs which block the production of androgens can be incredibly helpful. The downside is that these prescription drugs are not without side effects (which need to be discussed with your physician). To reduce side effects, anti-androgen medications (an example would be spironolactone) are generally prescribed in low dosages.
- Isotretinoin: Isotretinoin (formerly prescribed as Accutane) is an oral medication that directly affects the oil gland changing its shape and stopping the flow of oil. Results can be immediate and lasting. Unfortunately, isotretinoin is associated with serious side-effects that must be taken into consideration. Risk to a fetus if you become pregnant, overly dry skin, hair loss, nose bleeds, liver function problems, and headaches are some of the more notable you should be aware of. Despite the risks, isotretinoin remains the only potentially permanent cure for cystic acne.
If you suffer from acne breakouts, you’ve probably felt like throwing up your hands in frustration at least once, since it seems like acne just won’t go away no matter what you do (and you’ve tried everything). We’re here to tell you that you’re not powerless in this matter! There’s a lot of bad information and bad products out there that can keep you from having the clear, bump-free skin you want. Keep reading for the basic, tried-and-true clear skin tips!
Steps to Prevent Acne
The most important thing to remember about acne is that it’s an inflammatory condition, which means that anything you can do to avoid inflammation is going to help keep breakouts and their redness at bay. Following are some key steps you can take to make sure acne doesn’t stick around for long:
- Keep skin clean, but don’t overdo it. Clean skin is a good thing, of course, because washing removes the excess oil and dead skin cells that contribute to acne. But washing too much will lead to irritation, especially if you use harsh cleansers or scrubs. The best way to go is to wash your skin twice a day (once in the morning, once at night) with a gentle, water-soluble cleanser. Stay away from bar cleansers – they can leave a film or residue on your skin, which in turn can clog pores and reduce the effectiveness reduce the effectiveness of any anti-acne products you apply after cleansing.
- Avoid skin-care and makeup products that can cause irritation. Irritation = inflammation - and that’s bad news! Unfortunately, many skin-care and makeup products, including many claiming to treat acne, contain irritating ingredients. Don’t use products that contain SD or denatured alcohol because it dries out skin and actually can lead to increased oil production. Also on the “do not use” list: mint and citrus ingredients, especially in oil form. You can find a full list of ingredients to avoid here.
- Choose makeup products for your skin type. If you have oily or combination skin, stick to makeup that’s labeled as being for that skin type. Avoid creamy, heavy formulas and choose powder formulas when possible.
- Remove makeup before going to bed. Sleeping with makeup on can lead to clogged pores, not to mention cause red, puffy, irritated-looking eyes. If you wear heavy makeup, consider following your cleanser step with a makeup remover that’s made especially for removing long-wearing makeup to ensure every last trace is gone before your head hits the pillow.
- Use lighter hair-care products. If you have hair that touches your forehead or the sides of your face, keep in mind that traces of the products you use to style your hair will also end up on your skin. That means if you have acne-prone skin, you should avoid thick, waxy styling products, as they can clog pores and lead to breakouts along the hairline.
- Protect yourself from the sun. You might have heard that a good dose of sunlight can “clear up” acne breakouts - there’s no research anywhere that indicates sun exposure clears up acne. Sun damage is yet another form of inflammation, and inflammation is a must to avoid. If you’re concerned that the emollience of sun protection products can potentially cause a breakout, there are several lightweight options available; you’ll find a list of some of the best ones in that category.
The Bottom Line
While this might seem like a lot of information to digest all at once, preventing (or at least reducing) acne can be very simple, and certainly worthwhile. It’s a matter of treating your skin gently, and learning what products and ingredients to avoid and what ones to use. If your skin is happy (in other words, not inflamed), you stand a much better chance of winning the battle against breakouts AND the red marks they leave behind! If you want to learn more about acne, we have a wealth of information available, including myths that could be making your skin worse, prescription treatments, over-the-counter treatments, and even alternative treatments that could help when other options fail.
Makeup for Acne-Prone Skin
Choosing makeup when you have acne can be confusing, even worrisome—is there a way to know what’s “safe” for breakout-prone skin and, if so, how can you find makeup that won’t draw attention to an uneven skin tone and cover marks from past breakouts?
Does Makeup Cause Acne?
Acne is primarily an inflammatory disorder that occurs deep in the skin and is influenced strongly by hormones—surprisingly, acne can’t be “caused” by your makeup. What is possible is that certain types of makeup can exacerbate breakouts in those already prone to developing them.
The types of ingredients and formulas you want to avoid aren’t always what you expect—we’re about to bust one of the biggest myths in the cosmetics industry and help you make sense of it all!
Why the Term “Non-Comedogenic” is Meaningless
You’ve no doubt seen the phrase “non-comedogenic” dozens of times—you may even look for it when shopping for makeup, believing such products won’t clog pores or contribute to acne. Unfortunately, it’s a totally unhelpful claim—primarily because it was coined under conditions that don’t represent how ingredients work in makeup and perhaps more importantly, aren’t remotely applicable to how you use your beauty products.
So, how did the “non-comedogenic” myth get started? It stems from a 1979 study published in the British Journal of Dermatology. This study examined the potential of various ingredients (like cocoa butter, for example) to clog pores and form what’s known as a comedone. This was determined by applying a pure amount of an ingredient to skin on rabbit ear.
Here’s the kicker: each ingredient was layered five times per application over for a period of two weeks without cleansing skin at any time. Can you imagine? This methodology easily dispels the whole notion of these tests relating to how cosmetics are formulated (few products contain 100% of any ingredient) and how people use them.
What really affects whether makeup (or skincare) products are likely to trigger a breakout is how much of an ingredient is used in its formula. A tiny amount of an ingredient like mineral oil in your moisturizer, blush, foundation or concealer is incapable of exacerbating a breakout. By the way, the researcher largely credited for developing the concept of comedogenic, Albert Kligman, said as much in his 1972 study, ”Acne Cosmetica”:
It is not necessary to exclude constituents which might be comedogenic in a pure state. The concentration of such substances is exceedingly important. To exile such materials as lanolin, petroleum hydrocarbons, fatty alcohols, and Like most of the beauty advice from the seventies (hello, baby oil + sunbathing), it’s time to retire the whole concept of “non-comedogenic”. It’s just not a helpful claim, and how many of us have bought products claiming they won’t cause breakouts—and we broke out anyway? Instead, let’s look at what you should avoid when shopping for makeup for acne-prone skin.
Products to Avoid When Shopping for Makeup
OK, so we know that no one can say with certainty whether a product will or won’t exacerbate a breakout if you’re already prone to acne. What we can do is make your search easier by helping you identify the biggest culprits—namely irritating products and thick, waxy products.
Avoiding irritant-loaded formulas is critical for anyone, but it’s especially true for those that have oily, acne-prone skin because inflammation can worsen your breakouts and oiliness. The tricky part about irritation is research has demonstrated you don’t always need to see it for your skin to reap the damage.
However, inflammation in skin is cumulative and repeated exposure to irritants contributes to a weakened skin barrier, slower healing (including of red marks) and a dull, uneven complexion.
If that weren’t enough, inflammation in skin plays a supporting role in increased breakouts and making oily skin oilier. Suffice to say, it’s really, really important to avoid alcohol-based or fragrance loaded makeup (skincare, too, for matter).
If you’re acne prone, thick, or solid makeup products like stick, pancake, cream, or cream to-powder compact foundations and concealers should be on your “avoid” list. The same goes for bronzers or blushes in stick, cream, or cream-to-powder forms. The types of ingredients that help keep these products in a solid form (often waxes, or similar ingredients like polyethylene or ethylhexyl palmitate) are iffy for those with breakout-prone skin.
We can understand the temptation to use such products—if you’re seeking medium to full coverage formulas for concealing discolorations, red marks and breakouts, pan or stick concealers often offer the type of makeup power you want!
Fortunately, there are plenty of alternatives to consider—we share our favorites below.
Makeup for Acne-Prone Skin
When experimenting with makeup to help conceal present or past breakouts, try to resist the urge to cover your entire face in a blanket of full-coverage foundation. Most will find the combination of a medium coverage foundation and strategically applied full-coverage concealer adds the extra help where you need it most while giving you a much more natural-looking result.
As we mentioned above, stick or cream foundations and concealers are often trouble, so look to liquid formulas instead. Here are a few of our favorite foundations for acne-prone skin, each offering medium to full coverage that looks like healthy skin and (this is the important part) sheers out beautifully.
- Laura Mercier Smooth Finish Flawless Fluid Foundation
- Clinique Stay Matte Oil-Free Makeup
- M.A.C. Matchmaster SPF 15 Foundation
- Make Up For Ever HD Foundation
- Urban Decay Naked Skin Makeup
- Rimmel London Stay Matte Foundation
- Hourglass Immaculate Liquid Powder Foundation
- Revlon Age Defying with DNA Advantage Concealer
- Revlon ColorStay Concealer
- Lancome Maquicomplet Complete Coverage Concealer
- Make Up For Ever Full Cover
- Kevyn Aucoin Sensual Skin Enhancer
- Kat Von D Lock-it Tattoo Concealer
You can find more of top-rated makeup picks at Beautypedia.com—and for more info check out our YouTube Live Chats with The Paula’s Choice Research Team, like this episode where we discuss How to Shop for Makeup (When You’re Acne Prone)!
Red Marks & Acne Scars: What's the Difference?
Acne is enough of an issue on its own, so it's not fair that long after the breakout has healed you're left with red or brown marks where the breakout once was. There are skin care steps you can take to prevent these marks (to the extent possible) and, more important, help them go away faster than they would on their own. We'll also explain the difference between an actual scar and the type of post-breakout discoloration many refer to as a scar.
Red Marks & Acne Scars: Know the Difference
A common point of confusion for those with acne is knowing the difference between an actual acne scar and a post-breakout red mark or discoloration. Some people who ask us about solutions for acne scars are actually referring to the superficial pink, red, or brown marks from a breakout, which heal over time; others are referring to a genuine acne scar that is the result of deeper damage the breakout left behind. What's the difference?
A scar results when there is damage to the deeper layers of your skin (that is, the skin below what you see on the surface) that has broken down the skin's support structure.
Moderate to severe acne can damage the deeper layers of skin, causing the breakdown of collagen and elastin. This leaves you with an actual indented or "ice-pick" scar. Physical scarring of skin cannot be improved without the aid of medical treatments.
A mild to moderate breakout often leaves a red, pink, or brown discoloration, which eventually fades over time. Although people often refer to such marks as acne scars, they are really post-inflammatory hyper-pigmentation marks, which appear as your body heals. Luckily, such marks are not really scars at all, and it is rare for them to be associated with permanently damaged skin. That means there are steps you can take to speed up their healing and return to clear, even-toned skin!
A quick note: If you have the bad habit of picking at breakouts—don't!—because that can further damage your skin and turn a breakout into a permanent scar, when it could have been just a red mark that diminishes over time. For the details on how to pop a pimple the right way, see our article, How to Pop, Treat, & Conceal a Blemish and consider using a professional comedone extractor tool.
OK, now that we've defined the difference between a post-breakout discoloration and an acne scar, let's talk about the solutions for each!
Treating Red Marks & Acne Scars: What Works (and What Doesn't)
With very few exceptions, skin-care products claiming to eliminate post-breakout discolorations don't work as promised. There are indeed skin-lightening treatments that contain hydroquinone and slow down melanin (which is responsible for giving color to hair, skin, and eyes) production, which reduces the appearance of sun-damaged areas of skin (i.e., brownish discolorations).
However, the pink to red acne marks are not related to melanin, which means that using hydroquinone or other types of skin-lightening ingredients is largely unhelpful. The one exception is for those with darker skin tones where post-acne marks are brownish in color from the skin's pigment, melanin. In those cases, hydroquinone is an option to fade their appearance.
At-home treatments, such as rubbing lemon juice or other citrus fruits on your face, don't work—they can't exfoliate skin properly and their acidic juices are potent skin irritants that can prolong the healing process. Don't fall for that one! There are no solutions in the kitchen for this skin issue.
Following are five ways to fade post-acne discolorations (and treat the underlying causes that lead to breakouts) that work for any skin tone or ethnicity.
Tip No. 1: Use only well-formulated, gentle skin-care products. It's tempting to try abrasive scrubs and all manner of irritating treatments in a desperate effort to get rid of acne discolorations, but irritation only causes more harm, which impedes your skin's ability to heal itself. Scrubs tear into the skin, delaying healing, and products with irritating ingredients also impede healing. Stick to the products we've reviewed and recommended on Beautypedia (or look up ingredients in our research-based Ingredient Dictionary). Of course, all Paula's Choice products are formulated to be gentle and they are all free of irritants.
Tip No. 2: Use an AHA or BHA exfoliant daily. The benefits of a well-formulated AHA or BHA, especially BHA, can be truly impressive. A BHA (beta hydroxy acid, active ingredient salicylic acid) used daily not only exfoliates the surface of the skin but also penetrates oil so it can reach inside the pore, dissolving the clogs that lead to breakouts. BHA is also a potent anti-inflammatory that reduces redness. Thus, in one step, you reduce the likelihood of developing a breakout and you speed the fading of the post-acne marks you have now.
Alpha hydroxy acids (AHAs, like glycolic acid) work on the surface of the skin, which absolutely can help fade discolorations, just like a BHA. However, AHAs cannot penetrate oil and exfoliate inside the pore like BHA, so they are not as adept at treating breakouts or clogged pores.
Tip No. 3: Use a broad-spectrum SPF 25+ product every day, without exception. Unprotected exposure to UV light (which will get to your skin whether it's sunny or cloudy) hurts your skin's ability to heal, which means the red marks from acne will stick around longer. UV exposure damages skin cells (even if you aren't "tanning" or sunburned), making healing slower and less efficient. Protecting your skin from UV exposure every day is critical to fading discolorations, plus it keeps your skin healthier-looking longer!
Paula's Choice has several excellent SPF-rated daytime moisturizers for any skin type! For the face, Paula's Choice Skin Balancing Ultra-Sheer Daily Defense Broad Spectrum SPF 30 is a great choice, as is SkinCeuticals Physical Fusion UV Defense SPF 50.
Looking for an all-over formula for face and body? Try Paula's Choice Extra Care Non-Greasy Sunscreen SPF 50 or Peter Thomas Roth's Uber-Dry Sunscreen Cream SPF 30.
You also can consider combining a foundation or tinted moisturizer rated SPF 25+, and a pressed powder with SPF 25+ as your sunscreen! That can be a great option for facial protection.
Tip No. 4: Use products loaded with antioxidants, especially vitamin C and cell-communicating ingredients like retinol.
Those two categories of beneficial ingredients—antioxidants and cell-communicating ingredients—help defend your skin from further damage, while also "communicating" with your cells to help them speed up their ability to repair damage. The result is reduced inflammation and a shorter healing time for your discolorations. Using a toner, serum, and/or moisturizer formulated with a variety of these ingredients (and in stable packaging; that is, no jars or clear containers) is the best way to get their skin-repairing benefits.
Some types of cell-communicating ingredients, such as niacinamide and retinol, are particularly beneficial in the fight to fade your post-acne annoyances. Two targeted Paula's Choice products to consider are Resist Anti-Aging Clear Skin Hydrator and the super-charged Clinical 1% Retinol Treatment. Each is loaded with those cell-communicating powerhouse ingredients, in addition to other complexion improvers like vitamins C and E! Speaking of vitamin C, many will find the potent dose of 25% vitamin C in Paula's Choice Resist Vitamin C Spot Treatment significantly hastens the fading of post-acne marks, whether they're pink, brown, or red.
Tip No. 5: Consider professional help. Research shows that post-inflammatory pigmentation—red or brown discolorations where a breakout once was—responds well to a series of Intense Pulsed Light (IPL) treatments. So, if you're desperate, have an imminent social event, and need the discolorations gone sooner than a skin-care routine can accomplish, IPL treatments may be your solution (for those with deeper skin tones, speak with your dermatologist about alternatives laser options to the IPL.) Another option is prescription tretinoin, (Retin-A, Renova), as is a monthly BHA or AHA peel performed by a cosmetic dermatologist.
For true acne scars (the pitted, indented kind), treatment options aren't as easy. Due to the extensive damage to and loss of collagen, no skin-care product can reverse their appearance. Dermal fillers can plump up the indentations, and you can combine dermal fillers with AHA or BHA peels or a series of fractional laser treatments for best results.
Microdermabrasion also is an option, but has much greater risks of damage to skin than laser treatments or higher-strength AHA or BHA peels, and the results aren't as impressive.
Each of the options described above has its advantages and disadvantages, so it is important to discuss them with your dermatologist.
The Bottom Line
Patience, protecting your skin from sun damage, and treating the cause of your breakouts is the best approach to fading post-acne red marks (and reducing the risk of being left with a permanent scar). Following our research-supported tips will help you shorten your skin's healing time, and that means fewer weeks spent with that reminder of breakouts past!
Pimples: How to Pop, Treat & Conceal a Blemish
No matter how often you breakout, you know what a blemish looks like, so we aren’t going to show you one (it just isn’t pretty). When it happens to you, the white, red, swollen appearance of a blemish is maddening, and research shows is an emotionally devastating experience. Using great skin care is vital to reduce or even stop breakouts, but what do you do with that pimple you see in the mirror is important, because it can determine how long you have to live with its memory.
Here is your straightforward, honest three-step guide with everything you need to know for complete damage control the next time a blemish rears its ugly head.
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Lesson 1: To Pop or Not to Pop
You've heard people say never pop a pimple, offering only vague reasons why you shouldn't. They're wrong. In reality, popping a pimple reduces inflammation, scarring, healing time, and gets rid of the ugly white bump, but only if you do it right! Doing it right is key, because what you absolutely should not do is over squeeze, pick, puncture, or do anything else that can cause serious scabs.
Learning to when and how to remove a blemish properly is essential, since leaving a whitehead (or blackhead) sitting there on your face is just not realistic for most of us. You'll know the blemish is ready when you see a white head. As long as you can see an obvious head, and you're certain you're not dealing with cystic acne (deep, red swollen bumps far below the skin's surface), you can follow these steps to remove the contents. Here's what to do:
- Buy a comedone extractor. Here's what it looks like:
- Cleanse your face with a gentle water-soluble cleanser first but do NOT use cold or hot water (that makes the blemish redder—don't make a pimply angrier than it is!—and hurts the skin's ability to heal).
- With the cleanser lightly massage skin with a soft, wet washcloth to remove dead skin cells. This makes extracting the pimple easier but don't overscrub.
- Dry your skin gently. Do not use the comedone extractor or squeeze when your skin is wet because it's more vulnerable to tearing and creating a scab, which can cause scarring.
- Take the comedone extractor and center the opening over the pimple. Then gently (and we mean really gently) and with very little pressure (and we mean very little pressure) push the comedone extractor down on the whitehead and move it across the pimple. That should release the contents.
- You may have to repeat this one or two more times, but that's it.
- If you overdo it you will create a scab and risk scarring (a reminder of your acne you don't want with you for the rest of your life). Remember to be gentle; the goal is to remove the whitehead without creating a scab or damaging the surrounding skin (scabs are not better to look at than a pimple).
Lesson 2: Banish the Blemish
After your gentle extraction, you must follow up with a 2.5% or 5% benzoyl peroxide product (Paula's Choice CLEAR has excellent options but you can also check Beautypedia for other recommendations) and/or a 1% or 2% salicylic acid (BHA) product (again, Paula's Choice has several options, but Beautypedia can help you with other selections if you want). These will not only help immediately reduce inflammation, they will disinfect, and definitely help prevent further breakouts.
For more information about skin care for acne read our comprehensive article What Is Acne.
Lesson 3: Take Cover
Once you've removed the contents and treated your blemish with well-formulated anti-acne products, now it's time for the magic of makeup to make your blemish almost unnoticeable.
- Prep with a mattifying serum. If the skin is dry the concealer won't go on smoothly over the area.
- Select a matte concealer that matches your skin tone exactly, no peach, pink, green, or ashy colors. It should also have enough slip to make blending easy.
- After applying your foundation, use a concealer brush (synthetic hair with a flat, rounded point) or your finger and gently dab a small amount of concealer onto the center of the blemish, then begin blending softly outward, creating even coverage that sheers out to the unaffected skin around the blemish. If you need more coverage, let the first layer of concealer set for about a minute before adding more, starting at the center and using the same technique.
- It helps to set the concealer with a gentle dusting of powder. A small, soft eyeshadow brush is perfect for applying a layer of powder over a concealed blemish. Applying powder over a blemish with anything larger or scratchier and your makeup can look cakey or cause your makeup to breakdown.
- It helps to wear foundation so the concealer doesn't stick out on your face but if you're not wearing foundation you have to be extra careful how you apply the concealer. Check your application in daylight to make sure it doesn't look like there is a clump of makeup color over a blemish. You want it to look natural, not obvious.
Stay Smart; Stay Beautiful!
