Acne is a common skin condition that is usually not permanent and can be treated. However, the severity and duration of acne varies from person to person and can depend on several factors such as genetics, hormone levels, diet, and skincare regimen. In some cases, acne may leave permanent scars, but proper treatment can help minimize scarring. If you have persistent or severe acne, it’s recommended to see a dermatologist for proper evaluation and treatment options.

How does acne cause?

Acne typically appears on your face, forehead, chest, upper back and shoulders because these areas of skin have the most oil (sebaceous) glands. Hair follicles are connected to oil glands. The follicle wall may bulge and produce a whitehead. Or the plug may be open to the surface and darken, causing a blackhead. A blackhead may look like dirt stuck in pores. But actually the pore is congested with bacteria and oil, which turns brown when it’s exposed to the air. Pimples are raised red spots with a white center that develop when blocked hair follicles become inflamed or infected with bacteria. Blockages and inflammation deep inside hair follicles produce cystlike lumps beneath the surface of your skin. Other pores in your skin, which are the openings of the sweat glands, aren’t usually involved in acne. Certain things may trigger or worsen acne:

  • Hormonal changes. Androgens are hormones that increase in boys and girls during puberty and cause the sebaceous glands to enlarge and make more sebum. Hormone changes during midlife, particularly in women, can lead to breakouts too.
  • Certain medications. Examples include drugs containing corticosteroids, testosterone or lithium.
  • Diet. Studies indicate that consuming certain foods — including carbohydrate-rich foods, such as bread, bagels and chips — may worsen acne. Further study is needed to examine whether people with acne would benefit from following specific dietary restrictions.
  • Stress. Stress doesn’t cause acne, but if you have acne already, stress may make it worse.

If you have acne.

These self-help techniques may be useful:

  • Chocolate and greasy foods. Eating chocolate or greasy food has little to no effect on acne.
  • Hygiene. Acne isn’t caused by dirty skin. In fact, scrubbing the skin too hard or cleansing with harsh soaps or chemicals irritates the skin and can make acne worse.
  • Cosmetics. Cosmetics don’t necessarily worsen acne, especially if you use oil-free makeup that doesn’t clog pores (noncomedogenic) and remove makeup regularly. Nonoily cosmetics don’t interfere with the effectiveness of acne drugs.
  • Do not wash affected areas of skin more than twice a day. Frequent washing can irritate the skin and make symptoms worse.
  • Wash the affected area with a mild soap or cleanser and lukewarm water. Very hot or cold water can make acne worse.
  • Do not try to “clean out” blackheads or squeeze spots. This can make them worse and cause permanent scarring.
  • Avoid make-up, skincare and suncare products that are oil-based (sometimes labeled “comedogenic”). Use water-based non-comedogenic products, as they’re less likely to block the pores in your skin.
  • Completely remove make-up before going to bed.
  • If dry skin is a problem, use a fragrance-free water-based emollient.
  • Regular exercise cannot improve your acne, but it can boost your mood and improve your self-esteem. Shower as soon as possible once you finish exercising as sweat can irritate your acne.
  • Wash your hair regularly and try to avoid letting your hair fall across your face.
  • Although acne cannot be cured, it can be controlled with treatment.
  • If you develop mild acne, it’s a good idea to speak to a pharmacist for advice.
  • Several creams, lotions and gels for treating spots are available to buy from pharmacies.
  • Products containing a low concentration of benzoyl peroxide may be recommended, but be careful as this can bleach clothing.
  • If your acne is severe or appears on your chest and back, it may need to be treated with antibiotics or stronger creams that are only available on prescription.

Acne scars vs. Acne marks.

Most pimples leave behind evidence. Our hope is that their marks are superficial. If your skin remains smooth in dark or red areas, you simply have an acne mark. Those marks are not scars — they are just temporarily discolored. It usually takes 3-6 months for the marks to disappear. However, if you have a scar, you’re dealing with permanent skin damage that needs treatment in order to disappear. An acne scar changes the texture of the skin. If acne has left indentations, or raised spots, the damage has occurred at a deeper level in the skin. This “cobblestoning” effect indicates scarring that needs more than a surface-level treatment. The best intervention for smooth skin is prevention. If you’re experiencing acne, you need to take steps to keep these scars from occurring. Treat new acne immediately, working with your dermatologist to find the best treatment option for you. And don’t pop pimples! You’ll just create more long-term damage. If you notice that your skin remains bumpy after a pimple has cleared, visit your dermatologist for an early treatment plan. The ultimate goal is to stop the scars from forming.

What Causes Acne Scars?

Scars form when the skin is damaged. With acne inflammation, different types of blood cells and collagen rush to the point where injury may repair the skin. But they can’t always return the skin back to normal, especially when severe acne doesn’t give the skin time to heal before it breaks out again.

Types of Acne Scars

When you’re ready to treat your acne scars, your first step is identifying what type you have. You may have one specific scar that bothers you or a combination of multiple types of scarring. So grab a mirror and see what best describes the scars you’re facing. First, see what general type of scar you have. Is it:

  • Depressed – Goes down into the skin
  • Raised – Rises from the skin
  • Discolored – Lighter, darker, or redder than your skin tone

Once you know the category of the scar, identify the specific type.

Depressed Scars

Also called “pitted” or indented acne scars, they go down into the skin. Some are rather shallow; others extend to the lower layers of the skin. These scars usually appear on the cheeks and forehead and most likely came from inflammatory acne. Here are the three specific kinds:

Rolling Scars

Rolling scars are broad depressions with sloping edges. They can be shallow or deep but most likely came from long-term inflammatory acne. As the skin ages, it loses elasticity and fullness, making rolling scars more pronounced. Because the edges are rolling, these scars respond great to treatment.

Boxcar scars

These scars also left broad depressions in the skin, but the edges of the scar are sharply defined. Since the edges are steeper and more distinct from the surrounding skin, they’re more difficult to treat.

Ice Pick Scars

These deep, narrow scars often look like an open, enlarged pore, or an ice-pick wound. As the deepest depressed scar, it’s also the most difficult to treat. Depressed scars respond best to more aggressive treatments. Fractional laser treatments, Intense Pulse Light phototherapy, and RejavaPen improve the skin’s texture after acne. However, the depth of the scar and steepness of the edges often determine how effective the treatment will be.

Raised Scars

If you have a raised scar, you likely had a cyst there before. As the cystic acne healed, too much scar tissue formed in its place. Now it’s a bulge of thick, rubbery scar tissue (called a keloid or hypertrophic scar) that protrudes from the skin. These scars aren’t as common as other types, but if you have them, they’re likely on your chest, back, or jawline — where you had cystic acne. Raised scars respond well to treatment. Laser resurfacing is especially effective in smoothing raised acne scars.

Discoloration

If you’ve had acne, you likely have skin discoloration. Discoloration isn’t technically a scar but is the most common side effect of acne. Whether brown, red, or white, the pigment in these areas isn’t the same as the rest of your skin tone. Often, the discoloration fades with time. But sometimes, the change in color becomes permanent. There are three categories of discoloration — and treatment options for each! If you have a brown discoloration, you’re dealing with hyper-pigmentation. The acne damaged the skin cells, and the cells that produce melanin (melanocytes) either multiplied or overproduced melanin in an effort to recover. Consequently, you ended up with a freckle-like spot that won’t go away. There are several options for treating dark spots. We use laser and light treatments, hydroquinolone, or topical retinoids to reduce melanin production (so the pigment decreases) and increase cell turnover (so you can slough off the discolored skin).

Hypo-pigmentation is characterized by the light spots that result from a lack of melanin. With this type of skin damage, melanocytes are depleted from the injured area or lose their ability to produce melanin. This occurs when healthy skin has been replaced with scar tissue. Because scar tissue has a light pink color, it’s more noticeable on people with darker skin tones. Few treatments completely erase hypo-pigmentation, but chemical peels and laser resurfacing can be helpful in creating a more balanced skin tone.

Erythema is a permanent redness that comes from damaged skin cells. Small capillaries near the surface of the skin become permanently dilated, resulting in a red spot. It’s common in acne patients and most visible in lighter skin. For treatment, we can prescribe a topical medication to decrease vasodilation temporarily, or work toward more long-term solutions with Intense Pulse Light phototherapy.

Home remedies for acne

Some of the most popular home remedies for acne involve natural herbal extracts, many of which traditional medicine practitioners may use. Below, we discuss the best home remedies for acne, what the research says, and lifestyle changes that can help. If an individual is interested in trying certain topical remedies, it is a good idea to talk with a dermatologist before applying the topical remedy directly to the skin, or do a patch test first, which consists of putting a small amount of the topical treatment on the wrist or hand to test for skin reactions.

1. Tea tree oil

Tea tree oil is a natural antibacterial and anti-inflammatory, which means that it might kill P. acnes, the bacteria that causes acne. Tea tree oil’s anti-inflammatory properties mean that it can also help reduce the swelling and redness of pimples. A 2019 review study looked at the existing evidence for tea tree oil and acne. The researchers found that tea tree oil products can reduce the number of acne sores in people because of tea trees’ antimicrobial capabilities. This same review also noted research showing the total number of acne lesions of study participants was reduced from 23.7 to 10.7 after 8 weeks of using tea tree oil facial products.

How to use tea tree oil

People can apply tea tree extract to their acne in creams, gels, or essential oils. However, a 2016 review article points out that tea tree oil can cause allergic reactions in some individuals, and suggests people use tea tree oil products under 5%Trusted Source concentration to avoid skin irritation. Although research suggests that essential oils may have some health benefits, it is important to remember that the Food and Drug Administration (FDA) does not monitor or regulate the purity or quality of these. A person should talk with a healthcare professional before using essential oils, and they should be sure to research the quality of a brand’s products. A person should always do a patch test before trying a new essential oil.

2. Jojoba oil

Jojoba oil is a natural, waxy substance extracted from the seeds of the jojoba shrub. The waxy substances in jojoba oil may help repair damaged skin, which may also help speed up wound healing, including acne lesions. Some of the compounds in jojoba oil might help reduce skin inflammation, which may reduce redness and swell around pimples, whiteheads, and other inflamed lesions. In a 2012 study, researchers gave 133 people clay face masks that contained jojoba oil. After 6 weeks of using the masks two to three times per week, people reported a 54% improvement in acne.

How to use jojoba oil

Try mixing jojoba essential oil with a gel, cream, or clay face mask and apply it to acne. Otherwise, place a few drops of jojoba oil on a cotton pad and rub this gently over acne sores.

3. Aloe vera

Aloe vera is a natural antibacterial and anti-inflammatory, meaning it may reduce the appearance of acne and prevent acne breakouts. Aloe vera contains sugar molecules, amino acids, and zinc, making it an excellent skin moisturizer and protectant. It is especially suitable for people who get dry skin from other anti-acne products. In a 2021 studyTrusted Source, researchers determined that the number of bumps, lesions, and dry skin lowered when using aloe vera combined with ultrasound and soft mask applications.

How to use aloe vera gel

An individual should clean acne sores and then apply a thin layer of cream or gel twice daily after cleansing with soap.

4. Honey

For thousands of years, honey has treated skin conditions because it contains many antioxidants that can help to clear clogged pores. However, while there is evidence that honey has specific antimicrobial effects, a 2016 review trusted Source did not find strong evidence for honey’s effect on acne specifically.

How to use honey

Using a clean finger or cotton pad, rub a little honey into the pimples. Otherwise, add honey to a face or body mask.

5. Zinc

With its anti-inflammatory properties, zinc is often touted as a method to reduce acne lesions and redness. According to a 2021 articleTrusted Source, research is conflicting on zinc’s effectiveness. However, a person can expect better results when applying the supplement directly to the skin. The reason is that when taken orally, some of the supplement gets broken down in the digestion process and may lose efficacy along the way.

How to use zinc

People can apply zinc topically onto the skin or take it via supplement form.

6. Green tea

Green tea contains high concentrations of a group of polyphenol antioxidants called catechins. Some people with acne have too much sebum, or natural body oils, in their pores and not enough antioxidants. Antioxidants help the body break down chemicals and waste products that can damage healthy cells. Green tea also contains compounds that may help to:

  • reduce the skin’s sebum production
  • reduce P. acnes
  • reduce inflammation

How to use green tea

An individual can either drink green tea or put green tea extract on their skin, though researchers say current evidence is limited. However, one 2017 studyTrusted Source found a 79–89%Trusted Source reduction in whiteheads and blackheads after using a polyphenol green tea extract for 8 weeks. People can find green tea in most food stores. Green tea extract is more challenging to find but available from some health stores or online.

7. Echinacea

Echinacea, also known as purple coneflower, may contain compounds that help destroy viruses and bacteria, including P. acnes. Many people believe that echinacea can boost the immune system and reduce inflammation to fight off or prevent infections, including colds and flu. While there is some evidence that echinacea can help stop the spread of P. acnes and reverse inflammation caused by bacteria, current research is minimal.

How to use echinacea

People can apply echinacea creams to areas with acne lesions or take echinacea supplements. Echinacea products are available from health stores or online as creams or supplements.

8. Rosemary

Rosemary extract, or Rosmarinus officinalis, contains chemicals and compounds with antioxidant, antibacterial, and anti-inflammatory properties. Further research is needed to measure its effectiveness.However, a 2016 research article suggested that rosemary extract can reduce inflammation from the acne-causing bacteria P. acnes.

9. Purified bee venom

Although it’s not wildly available, purified bee venom contains antibacterial properties. In a 2016 studyTrusted Source, people who applied a gel containing purified bee venom to their face for 6 weeks saw a reduction of mild to moderate acne lesions. Though more research is needed, purified bee venom may be a beneficial future ingredient in acne medication.

10. Coconut oil

Like some other natural remedies listed, coconut oil contains anti-inflammatory and antibacterial compounds. These properties mean that coconut oil may help eradicate acne-causing bacteria and reduce the redness and swelling of pimples. Due to its soothing and moisturizing effectsTrusted Source, coconut oil may help speed up the healing of open acne sores. However, focused research on coconut oil as an acne deterrent is lacking.

How to use coconut oil

Try rubbing pure, virgin coconut oil directly into the area with acne. Look for coconut oil in the natural foods section of grocery stores or online.

11. Avoid touching pimples

It can be very tempting, but touching acne sores will irritate the skin, may make the pimple worse, and can spread pimples to other areas. Touching, rubbing, squeezing, or popping acne sores can also introduce more bacteria into the lesion, causing further infection. Squishing a pimple can push bacteria and debris further into the skin, so the spot may come back worse than it was before. Talk with a doctor about large sores or those deep under the skin to find out how to treat them safely.

12. Choosing the right cleanser

Many regular soaps have an acidity, or pH, that is too high and can irritate the skin, making acne worse. Choose mild cleansers, rinses, and washes to reduce the risk of acne flare-ups and let sores heal.

13. Using oil-free skin care

Oil-based or greasy products can block pores, increasing the risk of clogged and growing acne sores. Look for skin care products and cosmetics labeled as “oil-free” or “noncomedogenic,” which contain ingredients that allow pores to breathe.

14. Staying hydrated

When the skin is dry, it can become irritated or damaged, which can make acne worse. Staying hydrated also ensures new skin cells develop correctly as sores heal. There is no standard daily recommended water intake because each person’s water needs vary depending on age, how active they are, temperature, and any medical conditions. Making a concentrated effort to drink more water during the day is a good starting point.

15. Reducing stress

The American Academy of Dermatology lists stress as a possible cause of acne flare-ups. Stress causes levels of the hormone androgen to increase. Androgen stimulates hair follicles and oil glands in pores, increasing the risk of acne. Tips for managing stress include:

  • talking with family, friends, a doctor, or other supportive people
  • getting enough sleep
  • eating a healthful, balanced diet
  • exercising regularly
  • limiting alcohol and caffeine consumption
  • practicing deep breathing, yoga, mindfulness, or meditation.

When to see a doctor

People may want to talk with their doctor if their acne sores are:

  • very painful
  • often infected
  • deep under the skin
  • not responding to home treatment
  • covering a large area of skin
  • causing emotional distress

There are times when a person should see a doctor if they have acne because of the underlying causes. For example, home remedies may not be effective when acne occurs due to a hormone imbalance or an allergic response, leading to more severe conditions.

Hormonal acne

Hormonal acne occurs from a hormone imbalance and can occur from:

  • Foods containing hormones. For example, dairy products can consist of hormones.
  • Premenstrual flare-ups. Hormones fluctuate before a menstrual cycle and may lead to acne flares.
  • Stress hormones. Feelings of intense anger and anxiety may aggravate acne due to stress hormones rising with the emotions.
  • Polycystic ovarian syndrome (PCOS). PCOS is a common endocrine system disorder that can affect individuals during their reproductive years.

A doctor may offer potential treatment options or ways to avoid acne flare-ups with each type of hormonal acne.

Allergic acne

Acne is rarely itchy, so if a person experiences itchiness, it could signify another condition resembling acne. For example, allergic dermatitis and hives mimic the symptoms of acne caused by an allergy such as medications, foods, or certain skin care products. As a result, allergic reactions can lead to severe symptoms, and medical attention is needed. Gluten sensitivity can lead to dermatitis herpetiformis, which may appear as acne since a pruritic rash and blisters are symptoms. When one experiences gluten sensitivity, diet changes and medications may be necessary to control symptoms.

Fortunately, for most people, acne tends to go away by the time they reach their 30s. If your skin remains smooth in dark or red areas, you simply have an acne mark.Those marks are not scars — they are just temporarily discolored. It usually takes 3-6 months for the marks to disappear. However, if you have a scar, you’re dealing with permanent skin damage that needs. People of all races and ages get acne. About 4 of every 5 people between the ages of 11 and 30 have outbreaks at some point. It’s most common in adolescents and young adults. Although acne is usually not a serious health threat, it can be upsetting, and severe acne can lead to permanent scarring. People can choose from a wide range of home remedies to treat their acne. Not all treatments will work for everyone or in every case, however. The Food and Drug Administration (FDA) does not monitor herbal products or essential oils. Additionally, many natural remedies for acne are not scientifically proven to work, but some people may find them helpful. Always talk with a doctor before using natural remedies for severe, chronic, deep, or painful acne sores. Likewise, speak with a doctor about minor acne sores that do not respond to primary care or continue to get worse.