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“If you know the enemy and know yourself, you need not fear the result of a hundred battles." Sun Tzu
Before you dive headlong into trying to treat your acne you should probably start by finding out what is causing it first. We break out the factors that usually cause acne into two main categories, environmental and biological. We have varying degrees of control over these factors so in some cases we can treat the underlying cause and see our acne vanish once and for all but in other cases, we just have to deal with treating the symptoms.
External factors can actually be easier to deal with since we can exercise a bit of control over them. A lot of us may think that we are just talking about pollution here but it goes a bit deeper into our diet and other lifestyle choices we make. Ideally, we would all live in a pristine countryside setting free of smog, grime, and grit. For many of us though, that just isn't the case, our skin is constantly bombarded with diesel exhaust, industrial fumes, and whatever that stuff is that comes out of manholes. This can lead to a higher incidence of clogged pores and increase the chances of a breakout. Luckily this is also an easy factor to deal with. Just remember to wash your face when you get back home. This may not bring your breakouts down to zero but it will help keep your pores clear of debris and reduce the chance of another zit popping up.
The next point to consider is your diet. Dairy and meat tend to be the culprits here. A lot of our meat and dairy farmers still utilize hormones in the production of our food. When we consume these products there is evidence that suggests that these hormones then affect our skin. Luckily this is also an easy (if pricey) fix. All you really need to do is ensure that you purchase and consume hormone free (organic) meats and dairy. These products do tend to cost a bit more but then, if it cleans up your skin you can think of it as an investment! While we are talking about our diets, you should also stay away from loads of sugar and carbs. These foods cause a spike in your insulin production as they are absorbed and this extra insulin, in turn, can cause your hormones to amp up your skins oil production.
Finally, we suggest you try to keep your stress levels in check. Stress results in the production of cortisol and androgens. For some of us, this can turn on our oil glands leading to clogged, pores, breakouts and the rest. We are all stressed to some degree, it could be about family, finances, friends, or something completely different but there are some easy ways to deal with it. In our view, the most efficient way to deal with stress is to meditate it away. Meditation combined with some light yoga can help to reduce your cortisol levels and reduce your breakouts (while perhaps brightening your outlook on life). We know time is important to you but then you don't have to take half an hour for this. Five to ten minutes either in the morning or at night should help to defray your nerves.
So you have tried the preventative measures but it seems your face is intent on having a Mt. Vesuvius moment. No worries, from small bumps to full-blown cystic acne, there are options to help clear up your skin.
First up are the small bumps and slightly reddened skin that can result from a slight oil buildup in the skin. These can be countered with many OTC salicylic acid washes or leave-ons. These can help to sooth the skin and the acid will help to clear pores of debris and oil. These do need to be used on a daily basis to prevent further breakouts as well.
Second, we look at whiteheads and zits. These tend to be a bit more prominent and can even hurt a little if left to their own devices. In these cases, you may want to use Adapalene since it is slightly less irritating to use and can be used daily on adult skin. AHAs and Retinol will also work here to prevent further outbreaks from happening by reducing the production of oil (when used regularly). In either case, it is necessary to moisturize since these products may dry out your skin. If your skin is too sensitive to the topical treatments, you can also look into blue light therapy which won't dry your skin out but it will help to kill bacteria.
Finally, we look at cystic acne which can be the most painful and hardest to deal with. When your oil glands overproduce, you can end up with painful nodules that grow under the skin. These may look a bit like large whiteheads but the redness surrounding the whitehead points to the larger size of the pimple. A targeted approach using benzoyl peroxide may be necessary to dry out these larger pimples but we would recommend that you see a doctor for cyctic acne as an oral medication may be needed.
If none of the at-home topical/light treatments work for you it is time to head to the doctor's office (especially true for cystic acne). When you get there you will find yourself with several options. Oral medications like The Pill may be used to regulate your hormones in an attempt to clear your skin. Topical treatments are generally either stronger forms of the previously mentioned solutions (retinoids, acids, etc.) or specifically formulated antibacterials like clindamycin can do the trick but are quite strong and you should watch for overdrying or skin sensitivity. Finally, shots may also be something to consider, but these too come with their own set of downsides including possible divets and hypopigmentation, all of which should be discussed with your dermatologist.
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