Woman on static background with red zits

Cheat Sheet

How to Treat Every Type of Acne, According to a Dermatologist

by @abigailrena
Jun 16, 2022


I don't have proof of this, but I'm pretty sure cavemen had acne. How could they not? They were sleeping on dirt, sweating without AC, and barely eating their vegetables. They didn't have cleansers or spot treatments for their pimples. They didn't even have mirrors to see their zits! Although, I don't think they cared much for their vanity, what with having to fight to stay alive everyday...anyway, my point is humans have been plagued with breakouts since the dawn of time and we still don't have the cure to completely eradicate zits from our foreheads.

It's frustrating, we know, so we reached out to Dr. Joshua Zeichner, a dermatologist at Mount Sinai Hospital in New York City, to help (professionally) pop all your acne-related questions. Consider this your ultimate guide.

Instagram @joshzeichnermd

Instagram @joshzeichnermd

What is acne?

Dr. Zeichner: "Acne is a condition caused by over activity and inflammation within your oil glands. It is thought that excess oil production, combined with overgrowth of acne-causing bacteria, sticky skin cells that block the follicles, and the resulting inflammation all contribute to the development of breakouts."

What causes acne?

Dr. Z: "Acne is caused by genetics. We do not completely understand why some people break out and others don’t. Other contributing factors include stress and diet. We know that stress is associated with the activation of oil glands, promoting oil production and inflammation. Dairy, particularly skim milk, as well as sugary foods also promote inflammation and oil production in the skin leading to breakouts."

What are the different types of acne?

Dr. Z: "Generally speaking, acne is categorized into inflammatory and non-inflammatory types. Non-inflammatory acne includes blackheads and whiteheads. Blackheads look like dilated pores with a black center, and whiteheads look like skin-colored or white bumps in the skin. They are both caused by excessive oil being trapped and dilating the pores. Blackheads have a large opening to the surface of the skin, allowing the oil to become oxidized, giving the black appearance. Inflammatory acne includes papules, pustules, nodules, and cysts. These are red, angry pimples, some filled with pus and some being large and tender."

What are the best acne-fighting ingredients?

Dr. Z: "We have three main over-the-counter approved ingredients for the treatment of acne.

Salicylic acid is a beta hydroxy acid that helps remove excess oil and dead cells from the surface of the skin to keep the pores clear.

Benzoyl peroxide is an ingredient that lowers levels of acne-causing bacteria and reduces inflammation.

Adapalene is a topical retinoid that prevents cells from sticking together and blocking the pores. You can think of them as pipe cleaners. They also have anti-inflammatory benefits.

The best way to treat your acne is to apply your medication in the entire area that is breaking out. While we want to clear pimples that we already have, it is much better to prevent new ones from popping up as well. Otherwise, you will constantly be playing catch-up."

Is picking your zits bad?

Dr. Z: "Some pimples, such as blackheads, can be extracted if the procedure is performed properly. However, I caution patients against picking their face, because trauma to the skin can lead to more inflammation, potential infections, and even scars. Plus, the marks and scabs left behind from picking frequently last even longer than the pimple would have if it were left alone."

5 tips for not picking your zits:

Dr. Z:

  1. "Do not look in the mirror right before bed, especially when you are tired. This is the absolute worst time to pick your face because it's often not done the way it should be done.

  2. If you have a magnifying mirror, throw it away.

  3. Put a big glob of your acne medication on top of the pimple.

  4. Consider an acne patch. These patches are essentially hydrocolloid dressings that enhance wound healing and form a physical barrier to keep your fingers off of your face.

  5. Face picking may be an underlying sign of anxiety. If you would like to stop picking but you feel like you can’t, make sure to speak to your doctor about it."

What's the best way to treat acne scars?

Dr. Z: "The good news is that the red blotches and brown spots that are often left behind after the pimples resolve are temporary. They are stains in the skin rather than true scars. Continue using your acne medications to help them heal fully. The fire may be out because the pimple has cleared but think of the marks as still having glowing embers underneath them.

Unfortunately, true scars, which are indentations in the skin, are permanent. The good news is that you can speak to your dermatologist about lasers to improve their appearance. They are not covered by insurance, but they work."

When should you seek a dermatologist for acne treatment?

Dr. Z: "If your over-the-counter acne medication is not helping after about a month of continuous use, speak to your dermatologist about professional help. If you have large surface areas affected, including the chest in the back, and topicals are not enough, professional help maybe needed. Finally, if you have severe acne with painful nodules and underground pimples (a.k.a. cysts) or if you have acne leaving scars behind, you should visit a board-certified dermatologist."

Now that we've picked (holds for applause) Dr. Zeichner's brain, we want to know which products you use to safely deal with your acne. Add your review below!

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