It starts when the pore gets clogged with dead skin cells and sebum. "That mixture of dead skin cells and sebum becomes trapped inside the pore, creating an oxygen-free environment where a naturally occurring bacteria, called P. Acnes, which resides in the hair follicle, multiples very quickly, resulting in inflammation," she says.
To treat it then, Dr. Levin says you need to address all the causes, including clogged pores, inflammation, oil production, and bacteria. "Retinoids are the absolute backbone of an acne treatment since they treat and prevent acne by declogging pores by normalizing skin cell turnover and as an anti-inflammatory. Furthermore, retinoids have been proven to improve skin discoloration and texture and therefore, restores the skin from prior outbreaks," she says.
But that doesn't mean you should pick up any retinoid and use it for your zit. Differin Gel is the first retinoid approved for over the counter use to treat mild, moderate, and severe acne. Previously, you could only get your hands on with a Rx.
"I recommend Differin Gel or any retinoid as a full field treatment, meaning you should treat the entire face or entire back," she says of the clear gel. "The point of a retinoid is not only to treat the acne but actually prevent it from occurring it in the first place, so maintenance is absolutely key." AKA, it's not a spot treatment.
It's super lightweight, isn't sticky at all, and absorbs quickly, so it's easy to add to your routine. While I've seen a pimple vanish without return while using it, it doesn't happen overnight. You need to apply it regularly, and you need to give it time to kick into high gear.
"Since Differin works by normalizing skin turnover, I advise my patients that results can take up to 6-12 weeks, but some patients start to notice an improvement as early as 2 weeks, but this is rare," explains Dr. Levin. "After an acne outbreak is controlled, you should continue Differin Gel. It's about prevention and maintenance!"