A: Scarring or "marks" on the face need to be separated into categories of discoloration vs. depressions. Usually discoloration represents deep inflammation that will resolve with time. Depressed areas will also improve with time and sometimes early intervention is premature. Usually scarring (depressions) are addressed after one year. The one year mark is an arbitrary time established for scar correction. Treatment options usually involve laser treatments being the Fractional or skin resurfacing lasers. Make sure you seek advice from a qualified professional as there are many facilities offering these services with very little experience.

A: Blackheads sometimes are "stuck" in the skin. I explain that many times this is analogous to a cork in a bottle. Acne medications will loosen up the blackheads and hopefully help them come out. Sometimes the blackheads need a little help. Outside of using the medicines divided with one in the morning and one in the evening, glycolic acid peels and a comedone (blackhead) extractor are very helpful. Controlling blackheads is very difficult and diligence is the key word here.

A: Acne is the nemesis for young people and adults. Acne can change from small pimples to large cysts without warning. The causes of acne are unclear. Most of the time acne is genetic in origin; however, acne may also be from medications or oil containing cosmetics. We do know that the pore is blocked, oil production is abundant and bacteria is present. Treatments are almost always individualized depending on skin type and degree of involvement. For many women,birth control pills are wonderful and control the acne (it takes three months to see improvement). There are also some great over-the–counter products to try. If conservative measures don’t work, it’s time to see a dermatologist. Read more about Acne with more detailed hints on YourSkinDoctor.com.

A: Basically, Alpha hydroxy acids are glycolic acids and beta hydroxy acids are salicylic acids. They both will work for acne (black heads). Salicylic acids tend to penetrate down the follicle: however, glycolic acids are very effective for exfoliation. It is important to use a comedone extractor with both acids after application. Also, remember that glycolic acids must be washed off. These acid peels should be used at most 1-2 times a week. Acne treatment requires daily maintenance so have patience.

A: Acne scars involve the deeper layers of skin. Improvement is seen with procedures that reach the deeper layers. Microdermabrasion and acid peels address the upper layers of the skin. Scarring on the chest is precarious in that it is not predictable and varies from person to person. Traditionally, theses areas have been treated with conventional methods such as cortisone injections and topical scar medications such as Mederma. Your goal should be scar improvement and not disappearance.I would like to add that you should work on controlling the acne and scarring shouldn't be a problem. Read about Acne and Scarring in YourSkinDoctor.com.

A: Acne is from skin irritation, blocked pores, bacteria and oil secretion in the skin. If your outbreak is sudden, go back and look at any predisposing factors such as oil containing skin products, a new exercise regimen with excesssive sweating, or even a new hair style with hair rubbing on your skin. The answer may be simple elimination of an irritation.Sometimes acne will present with no apparent reason. The treatment is then daily maintenance. Face washing 2-3 times a day is a must. Use of over-the-counter topical acid products and benzoyl peroxides are very helpful. (Read about Acne in YourSkinDoctor.com).

It takes six weeks for acne treatments to start working. As acne is improving, it will leave a temporary "dark area" in the skin. This"dark area" is not scar and will disappear with time - usually many months. If you continue to get new acne despite daily maintenance, you should consult your dermatologist.

A: "Clogged pores" are called comedones. This is a type of acne that can be controlled with daily maintenance. Hydroxy acids and retinols are a good place to start. Many people benefit from facials. The cosmotologist will extract all the debris. Have the cosmotologist teach you how to clean the pores at home. (YSD Recommended Products - Alpha Hydroxy Acids and Retinol)

A: Acne scarring consists of depressions in the skin. Discoloration in the skin from acne does not represent scarring. The medical term for the dark areas is called post-inflammatory hyperpigmentation. This discoloration takes many months to clear. If the acne outbreaks are controlled, there are fewer dark areas and the skin clears in time. Microdermabrasions exfoliate and stimulate the skin. This procedure helps improve fine wrinkles, sun damage and uneven pigmentation - essentially dull lifeless skin. Unfortunately, this procedure does little for acne scarring.

Sclerotherapy,is a procedure where a salt solution is injected into vessels. This is effective for spider and varicose veins on the lower extremities. Possible complications include scarring, post-inflammatory hyperpigmentation and possibly ulceration. It is not a common procedure used on the face.

Acne scarring is commonly treated with surgery or resurfacing with lasers or dermabrasions. For severe scarring usually more than one procedure is necessary. (See my write-ups on YourSkinDoctor.com for Acne and Hyperpigmentation)

A: In some people, acne will get worse before it gets better. As a rule of thumb, it takes six to eight weeks before significant improvement is seen. If after two months, the acne is as bad or worse, then it is time to switch treatment programs. Remember, most acne treatment is designed to suppress acne and not cure it. You must continue with your medications until your physician prescribes otherwise. Read my Acne write-up on YourSkinDoctor.com.

A: Dark areas from acne usually will go away in time. It may take many months but they usually all go away. You are correct. If you treat the dark areas early, you can hasten their disappearance. Hydroquinones really shouldn't be used during pregnancy.Options are topical vitamin C and topical glycolic acid peels(sunscreen/block is a must). Remember, try and control the acne before it leaves a mark.Finally,women can get dark areas in the skin from pregnancy. This is called melasma or pregnancy mask. This is treated the same as described above. Good luck with your little one. (YSD product recommendations - Topical Vitamin C, Glycolic Acid Peels)

A: Most raised white skin on the face is usually a type of Acne called comedones. Comedones can be opened or closed. Bumps on the face can also represent small moles or overgrowth of glands on the skin. Read more about how to address comedones on my write-up on Acne on YourSkinDoctor.com.

A: Dark areas in the skin after inflammation (pimples) is called post-inflammatory hyperpigmentation. The answer is to prevent the initial inflammation. Read YourSkinDoctor.com write-up on Acne. Fear not, the dark areas do not represent scarring. They will fade with time (months). Initially, a lightening gel will help. Have patience - small gains will pay off with clear skin. (YSD Product Recommendation - Skin Lightening Gel)

A: Retin A is one way to treat acne. Frequently, multiple treatments are used as each works by a different mechanism. It is also helpful to use something morning and night. Benzoyl peroxide products are wonderful if used correctly. Also, make sure all skin products are oil free. Read Acne in YourSkinDoctor.com for more suggestions.

A: Many times vitamins and homeopathic remedies are helpful; however, I am not familiar with this treatment. One acne treatment, Accutane, is a vitamin A derivative. This treatment must be monitored by a physician. It can cause birth defects and toxicity if used incorrectly. I would not recommend over the counter vitamin A for acne treatment. Zinc is now being used for the common cold - got a cold?

A: Conservative facial maintenance with retinoids and alpha hydroxy acids will help "tighten" up the skin and make the pores smaller and less visible. Enlarged pores are a problem as there is no permanent treatment. Try daily maintenance with the retinoids in the evening and acids in the morning. If you get too dry, use an oil free moisturizer and alternate day use of the products. YSD Product Recommendations - Retinol, Alpha Hydroxy Acids, Oil Free Light Moisturizer.

A: This is a straight forward procedure. Most important is the experience of the operator. Find out how many they do and do they have happy patients. Microdermabrasion has its limitations. Make sure you have realistic goals.

A: Acne scarring is usually deep seated in the skin. It requires more aggressive approaches and cannot be cured by creams and superficial treatments. Talk to your dermatologist about surgery, collagen, lasers and dermabrasion. Treatment usually involves a combination of the above. Make sure your physician discusses realistic outcomes. Acne scarring is difficult but not impossible to treat.

A: Blackheads, medically called comedones, are cellular debris trapped in dilated pores. This forms a plug. Treatment is conservative maintenance. The plugs are loosened by a warm washcloth and then a comedone extractor (ask your pharmacist). Don't use your fingers or it will look worse. Retinols and hydroxy acids are used daily to help prevent blackheads from forming. Periodic use of the comedone extractor will help keep the skin clear. YSD Product Recommendations - Retinol, Alpha Hydroxy Acids

A: I consider acne scarring to consist of depressions in the skin. Discoloration will resolve with time. The first step is to address the acne. Acne usually is controlled with daily use of medications and conservative skin care. (See YourSkinDoctor.com write-up on Acne).

A: For the most part, acne is controlled and not cured. For selected individuals, Accutane can "cure" acne. This must be prescribed and monitored by your physician. Most young people grow out of acne. Adult acne is more of chronic problem that requires daily maintenance. First, identify factors that may be exacerbating your acne - such as oil containing cosmetics. Then find a treatment regimen that you can tolerate and afford. A good facial wash and over-the-counter benzoyl peroxides (YSD Product Recommendation - Acne Cleanser 5% or 10%) are a good place to start. (See YourSkinDoctor.com write-up on Acne)

A: Most "small bumps" on the face are usually a type of acne called comedones. The common term is blackhead. Comedones can be open or closed. "Bumps" on the face can also represent small moles or overgrowth of glands in the skin. If you squeeze or push a "small bump" and a white to clear core comes out, then you have confirmed the condition . Be careful not to pick at your skin as this can worsen the problem. See the write-up of Acne in YourSkinDoctor .com on how to address comedones.