Skin break out is here and there considered an issue for tweens and teenagers.
While it frequently occurs in pre-adulthood, it doesn’t be guaranteed to stop whenever you’ve blown the candles out on your twentieth birthday celebration.
Reid Maclellan, MD, an individual from the assistant workforce at Harvard Clinical School, says that breakouts clear up with age is one of numerous legends about skin inflammation.
Different misinterpretations, similar to the legend that having skin break out implies your skin is messy, can likewise impede legitimate treatment.
Confounding issues, there are a few kinds of skin inflammation that require various methodologies, and people answer distinctively to medicines.
“Skin break out is definitely not a one-size-fits-all treatment,” says Maclellan, who is likewise the overseer of Proactive Dermatology Gathering and pioneer and Chief of Cortina. “Every distinctive individual is novel and unique, so what might work for one person with a specific kind of skin break out may not work for another.”
Whether you’re a high schooler attempting to oversee disappointing breakouts or a grown-up encountering hormonal or cystic skin inflammation, you have choices accessible to you.
This is the very thing Maclellan and two different dermatologists need to say regarding how to treat skin break out in view of your particular circumstance.
Acne types quick guide
| Appearance | Treatment | What not to do | |
| Whiteheads | shut comedones causing white knocks | typically over-the-counter (OTC), sometimes prescription-grade products with sulfur, benzoyl peroxide, or salicylic acid | Don’t pop! |
| Blackheads | open comedones causing dull knocks | typically OTC, sometimes prescription-grade products with sulfur, benzoyl peroxide, or salicylic acid | Don’t pop, vacuum, or pore strip. |
| Papules | small red bump less than 1 cm, no pus | typically prescription-grade, sometimes OTC products containing benzoyl peroxide, topical retinoid, topical or oral antibiotics, birth control | Don’t pop or skip seeing a dermatologist for recommendations on OTC vs. prescription treatment. |
| Pustules | small bumps with white center, inflamed head, and yellow pus inside | typically prescription-grade, sometimes OTC products containing benzoyl peroxide, topical retinoid, topical or oral antibiotics; dermatologists can drain pus | Don’t pop or skip seeing a dermatologist for recommendations on OTC vs. prescription treatment. |
| Nodules | flesh-colored or red bumps that are deeper than the skin’s surface; may or may not have pus. | prescription-grade products with benzoyl peroxide, sulfur, or salicylic acid; topical and/or oral antibiotics; birth control; spironolactone (in females) | Don’t pop or attempt to treat with OTC remedies, which don’t go deep enough. |
| Cystic | most severe (large, red, painful, and pus-filled bumps | oral retinoids such as Accutane (isotretinoin), oral antibiotics such as doxycycline; birth control; spironolactone (in females) | Don’t pop, skip seeing a dermatologist, or take Accutane while pregnant or trying to become pregnant. |
| Fungal (technically not acne) | small red or white bumps about 1–2 cm | antifungal medications | Don’t attempt to treat with typical acne medications. |
| Adult hormonal | hormonally-driven with deeper cysts and nodules on the lower face/jawline | retinoids, topical treatments with benzoyl peroxide, azelaic acid, oral antibiotics, hormonal treatments | Don’t pop. |
| Acne excoriée | scars or scabs from constant picking of acne lesions | therapy, like CBT, medications like SSRIs in addition to dermatologist-recommended treatments | Don’t scratch at, pick, or pop; or skip assessing the mental health component. |
| Acne mechanica | can be small bumps or inflamed (more noticeable papules), pustules, or nodules | remove the root cause of the friction if possible; use a gentle cleanser, OTC products with benzoyl peroxide, retinoids, and topical antibiotics | Don’t pop, or wear tight-fitting clothing. |
| Acne as a medication side effect | small or inflamed bumps | speak with a medical professional to consider switching medications; otherwise, treat based on acne type | Don’t stop taking medications without guidance from a medical professional, and don’t pop! |
| Severe nodulocystic acne | numerous inflamed nodules or cysts (scarring is common) | prompt care from a dermatologist; corticosteroids injections, oral isotretinoin, oral dapsone | Don’t pop, pick, or wait to see a dermatologist. |
| Acne conglobata | deep burrowing, often interconnected abscesses, odorous discharge | retinoids, dermal fillers, surgery, oral medication, cryotherapy, photodynamic therapy | Don’t pop, or wait to see a dermatologist. |
The most common types of acne are:
Aaron Secrest, an academic/research dermatologist at the University of Utah, says these types are broken into two groups:
- Comedonal acne, including whiteheads and blackheads
- Inflammatory acne, including papules, pustules, nodules, and cystic acne
Both types of acne are caused by:
- clogged pores
- bacteria
- overproduction of oil
- hormonal changes
Acne subtypes
There are also several subtypes of acne, including:
- adult hormonal acne (occurs due to hormonal fluctuations)
- acne excoriée (occurs when someone with acne compulsively picks their skin, leading to scarring)
- acne mechanical (occurs due to friction or pressure against the skin)
- acne conglobata (occurs when nodules, abscesses, and cysts link below the skin, causing redness and swelling)
- acne as a side effect of medications
Adult hormonal acne
Adult hormonal acne occurs when sex hormones rise and fall. This can cause excess sebum production, changes to circulation and pH balance, and inflammation.
Acne excoriée
Acne excoriée, also known as excoriation or skin picking disorder, occurs when acne is picked at. It’s most commonly found among adolescents with anxiety disorders or obsessive-compulsive disorder (OCD).
Acne mechanica
This type of acne occurs when the skin is squeezed, rubbed, or exposed to pressure. It often occurs in professionals who wear masks or helmets, like football players or medical staff.
It typically shows up on the:
- face
- arms
- legs
- torso
- buttocks
Acne conglobata
Acne conglobata is rare but severe and most often seen in teenage males, according to 2018 research. It happens due to sebum and bacterial buildup and can lead to large, red, painful bumps on the skin.
Acne as a medication side effect
Acne may be a side effect of several types of medication, according to older 2013 researchTrusted Source. These include:
- corticosteroids
- lithium
- vitamin B12
- thyroid hormones
- halogen compounds, like iodine, bromine, fluorine, and chlorine
- antibiotics, like tetracycline and streptomycin
- antituberculosis drugs
- antiepileptic drugs, like phenobarbital and hydantoin derivatives
- cyclosporin A
-
Fungal acne
Fungal acne technically isn’t acne. It’s actually caused by yeast.
“Fungal acne is a very rare condition that I have seen less than five times in the past decade, despite its popularity on social media,” Secrest says. “It is caused by a yeast, Malassezia furfur, and can occur after chronic use of oral and topical antibiotics to treat inflammatory acne.”
Erin Schoor, MD, a dermatologist with NYU Langone, says fungal acne is most common in people with oily skin.
Though pharmacies are full of products that promise to unclog pores, over-the-counter (OTC) remedies are not always the best route.
“When the acne becomes inflamed or OTC medications are not working, prescription medications are recommended,” Schoor says. “Antibiotics can be more helpful for deeper inflammation, which can lead to scarring.”
Prescription products and medications are most often needed for inflammatory acne.
Topical treatments
Mild to moderate inflammatory acne typically requires a prescription-strength topical treatment, Schoor says.
According to 2016 researchTrusted Source, these products typically contain ingredients like:
- retinoids, like adapalene, isotretinoin, motretinide, retinoyl-β-glucuronide, tazarotene, and tretinoin
- antibiotics, like clindamycin and erythromycin
- azelaic acid
- benzoyl peroxide
- chemical peels
- corticosteroids
- dapsone
- hydrogen peroxide
- niacinamide
- salicylic acid
- sodium sulfacetamide
- sulfur
- triclosan
Retinoids are a derivative of vitamin A that typically — but not always — requires a prescription. A 2017 reportTrusted Source supported their use in acne therapy.
Maclellan says benzoyl peroxide is also typically more effective than salicylic acid. Still, he noted some people find it causes dryness, flaking, and irritation. In this case, he might prescribe a product with salicylic acid instead.
A 2020 studyTrusted Source suggested azelaic acid was less effective than benzoyl peroxide.
A 2021 reviewTrusted Source indicated niacinamide could aid in treating several skin conditions, including acne.
A 2016 studyTrusted Source on acne treatment mentioned that sulfur has become less popular because of its smell. The same study indicated that topical corticosteroids could be used for very inflammatory acne but noted they should only be used for a short duration.
A 2018 case studyTrusted Source suggested that oral dapsone may help treat nodulocystic acne if isotretinoin (Accutane) doesn’t work.
Oral medication
Oral antibiotics may be prescribed to treat inflammatory acne. The most common include:
- macrolides, like erythromycin, clindamycin, azithromycin, and roxithromycin
- fluoroquinolones, like levofloxacin
- tetracyclines, like doxycycline, minocycline, and lymecycline
- co-trimoxazole
Schoor says spironolactone, a water pill normally used for blood pressure, may also help with hormonal acne treatment but should be avoided during pregnancy.
Schoor notes that oral antibiotics are not a long-term solution and are usually combined with other, often topical treatments for the most effectiveness.
“Oral antibiotics are limited to a 3-month treatment for fear of antibiotic resistance and side effects,” she says.
Isotretinoin can also come in pill form and may help with moderate to severe acne, but it’s also not a long-term treatment.
“This pill is usually given for 4 to 6 months and is weight-based,” Schoor says. “It can cause birth defects if a pregnant person takes isotretinoin and is associated with other potential side effects, so it is monitored closely.”
Maclellan says hormonal birth control may aid in treating hormonal acne.
Injections
Schoor says cortisone can be injected into a deeper nodule or cyst for a more rapid resolution.
Research from 2016Trusted Source suggested that these injections, particularly using the corticosteroid triamcinolone acetonide, may reduce the appearance of keloid scars and their post-surgical reappearance.
Still, researchers indicated that this treatment isn’t without risk, including side effects like pain and skin atrophy, characterized by a loss of skin elasticity.
A 2020 studyTrusted Source indicated that using glucocorticoids could also induce skin atrophy.
Laser and light-based therapies
According to Schoor, individuals hoping to avoid medication sometimes opt for laser therapy. She says it’s most effective for scar treatment. Research from 2016Trusted Source suggested laser and light-based therapies were effective.
There are several sources to choose from, including:
- fluorescent lamps
- full-spectrum lights
- green light
- violet light
- blue metal halide lamps
- xenon flash lamps
- laser
The American Academy of Dermatology (AAD) says people often see results, but they vary and can take time, typically about 12 weeks.
However, lasers and light treatment can rarely clear acne completely and are typically not recommended as a lone treatment.
Photodynamic therapy (or PDT) is a similar option that uses lower-powered light sources to nix P. acnes.
It’s most effective when combined with topical treatments, like aminolevulinic acid (ALA).
A 2013 studyTrusted Source of 75 patients suggested it can help treat acne conglobata.
Other physical treatments
The AAD indicates acne scar removal surgery and fillers can aid in treating a few depressed acne scars.
Per 2016 researchTrusted Source, other treatments may include:
- comedone extraction to remove scarring, usually combined with isotretinoin
- cryoslush therapy, or brushing a combination of solid carbon dioxide and acetone on the infected skin area
- cryotherapy, usually with liquid nitrogen, to destroy diseased skin tissue, improve cosmetic appearance, and aid in the treatment of acne conglobata