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The ABCs of Acne

Everything you need to know about the causes of and treatments for acne, your most mystifying skin issue
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O Is for Oxidative Stress
You've heard of antioxidants and you know they're good for your skin -- you just don't know why. Turns out they're especially good for acne-ridden folk.

Antioxidants fight oxidation, which happens when free radicals form in your body. Free radicals are molecules that have lost one of their electrons. So they borrow electrons from other molecules to become stable, causing those molecules to borrow electrons from other molecules, and so on. This molecule-mooching leads to oxidative stress, which leads to inflammation, a major cause of blemishes.

If you have a high level of antioxidants in your body, this counteracts the inflammation caused by oxidative stress. However, acne-prone people are clinically shown to have more inflammatory markers in their blood as well as lower levels of antioxidants in their systems. Essentially, if you're pimple-prone, you're probably deficient in antioxidants.

Your Rx: Use antioxidant-infused skin care products; investing in high-quality products is key, since antioxidants quickly degrade when they're not properly stabilized. Common antioxidants include vitamins A, C and E, beta carotene and resveratrol. (We love SkinCeuticals Resveratrol B E). Also make sure to eat antioxidant-rich fruits and vegetables as well as "superfoods" like chia seeds and green tea.

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P Is for Pills
Like birth control pills, antibiotics can be taken for several months to treat acne. Your derm will probably prescribe a "-mycin" or a "-cycline" -- that is, erythromycin, clindamycin, tetracycline, minocycline or doxycycline. They're usually prescribed in combination with topical antibiotics to clear bacteria and reduce inflammation.

Another interesting med option: spironolactone, a blood-pressure medication that's used off-label for relieving acne. Spiro is an anti-androgen, and because oil production is an androgen function, it decreases the amount of sebum in the skin, thwarting pimples.

Your Rx: Talk to your derm about whether your acne is hormonal, which can help lead you to the right prescription. "Oral antibiotics work well for people with inflammatory acne and cysts," says Tanzi. "Spironolactone works better for women with adult-onset acne that has a strong hormone component."

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Q Is for Quick Fix
You've probably heard that there are no quick fixes when it comes to acne. Except there are. If you end up with a honker of a pimple, ask your derm for a quick prick.

"Cortisone appears naturally in the body in response to inflammation," says Peredo. "Injecting it directly into a cystic acne lesion works to quickly reduce swelling and speed up the healing process." While this doesn't remove the bacteria that causes the nodule in the first place, cortisone helps reduce the pimple's size within 24 hours.

Your Rx: Cortisone injections aren't practical for regular use, but they're a good option in emergency social situations. "Cortisone shots are great for if you have an upcoming big event like a wedding," says Peredo.

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R Is for Retinoids
Women who suffer from adult acne find themselves at that uncomfortable intersection of pimples and wrinkles: Which do you treat? Both, as it turns out, with a retinoid prescription.

"Retinoids work by irritating the skin, which in turn is good because this [causes] exfoliation," says Goldfaden. "They can help clear mild acne by normalizing how skin cells grow and then shed."

Tanzi recommends prescription retinoids over the OTC variety, which don't contain a high enough concentration of retinoic acid to be effective against acne.

Your Rx: Talk to your doctor about trying a retinol prescription; brand-name meds include Retin-A, Tazorac and Differin.

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S Is for Scars
If there's anything worse than a pimple, it's the scar that it leaves behind. Scars -- more precisely, post-inflammatory hyperpigmentation -- occur when the pimple's inflammation stimulates your skin's melanocytes to produce melanin, which is the pigment in your skin.

"There are three imperative steps" to treat hyperpigmentation, says Goldfaden. "Exfoliate, treat with a lightening agent and protect with [sunscreen]."

Your Rx: Tanzi treats hyperpigmentation with "short bursts" of hydroquinone and mushroom-derived kojic acid, which lighten skin by curbing melanin production. (GloTherapeutics Lightening Serum contains both ingredients.) Goldfaden recommends his Goldfaden MD Light Treatment Dark Spot Corrector, which uses arbutin, "a natural ingredient derived from berries that inhibit[s] melanin production and breaks down whatever darkness is already on the surface."

What causes acne, how to prevent acne from forming, and how to treat existing acne are three of the most mystifying issues in dermatology today. That's because acne can be influenced by such a weird amalgamation of factors -- from major influences like lifestyle, heredity and stress down to seemingly insignificant details like what you pour over your cereal in the morning. Here's everything we know about acne and how to cure it, from the foods that cause acne to pimple home remedies to antibiotics for acne.
BY KATIE MCCARTHY | JUN 1, 2015 | SHARES
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