Acne Treatments That Really Work: Insights from Dermatology Experts

Acne is more than just a cosmetic concern; it’s a common skin condition that can significantly affect one’s self-esteem and quality of life. Characterized by pimples, blackheads, whiteheads, and sometimes cysts, acne results from clogged hair follicles due to oil and dead skin cells. While often associated with adolescence, acne can persist into adulthood, necessitating effective treatment strategies to manage and alleviate its symptoms.

At Metropolis Dermatology, we offer a comprehensive range of acne treatments tailored to individual needs, aiming to restore skin health and confidence.

What Is Acne? A Dermatology-Based Perspective

Acne, medically known as acne vulgaris, isn’t just a surface-level issue—a chronic inflammatory skin condition rooted in dermatological science. At its core, acne involves the inflammation of the pilosebaceous units, often triggered by excess oil, clogged pores, bacteria, or hormonal changes.

It manifests as various lesions, including:

• Comedones: Blackheads (open) and whiteheads (closed).
  
• Papules and Pustules: Inflamed red bumps and pus-filled lesions.
  
• Nodules and Cysts: Painful, deep-seated lumps under the skin.

Acne primarily affects areas with a high density of sebaceous glands, such as the face, chest, and back. Its severity can range from mild to severe, potentially leading to permanent scarring if not appropriately managed.

As a dermatology-led clinic, Metropolis Dermatology brings medical expertise to diagnosing and treating all forms of acne, ensuring that each treatment plan is as clinically sound as it is customized.

Factors That Contribute to Acne Breakouts

Understanding what fuels acne is essential to treating it effectively and preventing it from reappearing. Acne isn’t just a teenage rite of passage—it’s a multifaceted skin condition that can persist well into adulthood.

While the visible blemishes may appear similar, the root causes are often complex and deeply personal. Let’s take a deeper look at the most common contributors behind the breakouts.

• Hormonal Imbalances

Fluctuations in hormones, particularly androgens, can overstimulate the sebaceous (oil) glands, leading to clogged pores and inflammation. This is especially common during puberty, menstruation, pregnancy, or perimenopause.

Adult women often find themselves battling persistent breakouts along the jawline and chin due to hormonal shifts, a pattern dermatologists at Metropolis understand well. Hormonal acne often requires a more targeted approach, combining both topical and systemic treatments.

• Excess Sebum Production

Sebum, or oil, is necessary to maintain a healthy skin barrier. But when the skin produces too much of it, it mixes with dead skin cells and becomes the perfect environment for bacterial overgrowth.

This oily environment can lead to whiteheads, blackheads, and inflamed cystic acne. Many acne treatment plans start with regulating oil production, without overly drying the skin.

• Clogged Pores from Dead Skin Cells

Skin naturally renews itself, but when dead cells aren’t properly shed, they can block pores. This block creates a plug where acne-causing bacteria thrive.

Exfoliation—whether chemical or physical—is a vital step in most acne treatment regimens to keep the skin’s turnover process running smoothly.

• Bacterial Overgrowth (Cutibacterium acnes)

Cutibacterium acnes (formerly known as Propionibacterium acnes) is a bacterium that lives on everyone’s skin. But when it becomes trapped inside clogged pores, it triggers an immune response that results in inflammation, redness, and the formation of painful pimples.

Targeting bacterial overgrowth is a key reason why dermatologists use ingredients like benzoyl peroxide, topical antibiotics, and blue light therapy.

4. Genetics and Family History

If your parents dealt with acne, you’re more likely to experience it yourself. Genetic predisposition affects how your skin behaves—its oiliness, its sensitivity, its healing process.

While you can’t change your genes, knowing your family history allows a dermatologist to predict how your acne might respond to different treatments.

• Skincare and Cosmetic Products

Ironically, some products meant to improve skin can make acne worse. Comedogenic ingredients, heavy makeup, or using too many products can overwhelm the skin’s barrier and trigger breakouts.

This is where medical-grade skincare guidance from dermatologists becomes crucial. Knowing what’s truly non-comedogenic and safe for acne-prone skin can make or break your results.

• Diet and Nutrition

The role of diet in acne is still being researched, but emerging evidence suggests that high-glycemic foods, dairy, and excess sugar may exacerbate inflammation and hormonal fluctuations.

Acne patients often see improvement when they reduce inflammatory foods and hydrate more intentionally. Dermatologists may recommend working with a nutritionist to support skin healing from the inside out.

• Stress and Mental Health

Stress doesn’t just live in your mind—it can manifest on your skin. Elevated cortisol levels can stimulate oil glands, increase inflammation, and interfere with your skin’s natural healing process. Chronic stress may also lead to habits like picking or touching the face, worsening acne, and creating post-inflammatory marks.

• Environmental Irritants

Pollution, humidity, and sweat (especially from workouts or wearing face masks) can trap dirt and oil against your skin, leading to congestion. Patients living in urban environments or working in physically demanding jobs may need tailored skincare routines that account for daily environmental exposure.

• Medications and Health Conditions

Some medications—like corticosteroids, certain birth control pills, and antidepressants—may list acne as a side effect. Polycystic ovary syndrome (PCOS) and other endocrine disorders can also lead to stubborn breakouts that don’t respond to over-the-counter treatments.

Effective Acne Treatments for Active Breakouts and Ongoing Management 

When it comes to managing acne and the marks it leaves behind, Metropolis Dermatology offers a dual approach: one that targets active breakouts and another that smooths and refines the scars, texture, and enlarged pores left in their wake. These treatments don’t just mask the symptoms—they address the root causes while restoring balance, clarity, and confidence to your skin.

Our dermatologists begin by focusing on calming inflammation, clearing clogged pores, and restoring healthy oil production. These treatments are especially effective for those currently experiencing breakouts or managing chronic acne.

• Advanced Medical-Grade Facials

These aren’t your typical spa facials. Our acne-focused treatments include deep pore cleansing, extractions, and medical-grade ingredients like salicylic acid or sulfur to calm inflammation and remove congestion. Each facial is tailored to your skin’s unique needs and designed to support other in-office treatments.

• Prescription Topicals and Oral Medications

From retinoids and benzoyl peroxide to oral antibiotics and hormonal regulators, prescription treatments form the cornerstone of many acne protocols. They work to unclog pores, reduce bacteria, and prevent new breakouts, while being customized to your skin type, sensitivity, and goals.

• Metropolis Skincare Line

We offer our own line of dermatologist-approved, non-comedogenic skincare formulated specifically for acne-prone skin. These products reinforce your in-office results with at-home care that’s simple, effective, and free of pore-clogging ingredients.

• Cortisone Injections

For painful cystic lesions that flare up before important events, a cortisone shot offers fast relief. This quick in-office treatment involves injecting a small amount of steroid directly into the pimple, dramatically reducing inflammation and flattening the blemish, often within 24 hours.

• Accutane (Isotretinoin)

Reserved for severe or treatment-resistant acne, Accutane is a powerful oral medication that reduces oil production at the source. It’s administered under careful medical supervision with regular lab work, and for the right candidate, it can offer long-term remission.

• Professional Extractions

Safely removing blackheads and whiteheads reduces the risk of inflammation and scarring. Our dermatology providers use sterile, gentle techniques to clear congestion without damaging the skin.

Best Treatments For Acne Scarring, Texture Issues, and Enlarged Pores

Once breakouts are under control, the focus shifts to smoothing skin texture, fading discoloration, and refining pores. These advanced treatments promote collagen remodeling and cellular renewal for a more even, polished appearance.

• RF Microneedling

This combination treatment uses fine needles and radiofrequency energy to stimulate collagen production deep within the skin. Ideal for rolling scars, large pores, and rough texture, it delivers firmer, smoother skin over time. At Metropolis, we customize the intensity and depth for your specific concerns.

• Laser Skin Resurfacing

For deeper or more stubborn scars, laser treatments like Hollylwood Spectra MDF, fractional CO2, LaseMD Ultra Thulium Laser, Ultraclear Laser, or Picosure Focus Laser offer powerful resurfacing capabilities. These technologies gently remove damaged skin layers and encourage fresh skin to form, improving tone, texture, and clarity. Depending on your needs, we may recommend ablative or non-ablative options.

• Microneedling with PRP (Vampire Facial)

Microneedling becomes even more effective when paired with Platelet-Rich Plasma (PRP). Your body’s natural growth factors are infused into the skin after needling, boosting collagen production and accelerating healing. This combination is ideal for softening scars and enhancing radiance.

• TCA Cross Treatment

Targeting deep ice pick scars, this precision-based treatment uses trichloroacetic acid to stimulate collagen remodeling from within the scar itself. It’s a highly effective option for isolated, deep-set marks that don’t respond well to traditional resurfacing.

• Chemical Peels

Superficial to medium-depth chemical peels using glycolic, salicylic, TCA acids, and VI Peels exfoliate the skin, reduce post-acne pigmentation, and smooth mild textural concerns. For many patients, peels are used in conjunction with other scar-reducing treatments to amplify results.

• Subcision with PRP 

Subcision is an advanced treatment for deep, rolling acne scars that works by releasing the fibrous bands beneath the skin’s surface. This allows the skin to lift and remodel naturally. When combined with PRP, it enhances collagen production and accelerates healing—resulting in a smoother, more even texture over time with minimal downtime.

Take the Next Step Towards Clearer Skin

If you’re struggling with acne or its aftermath, professional dermatological care can make a significant difference. At Metropolis Dermatology in Los Angeles, Pasadena, LA’s Westside (Brentwood), Costa Mesa, and San Jose, CA, our experienced team is dedicated to providing personalized, effective treatments to help you achieve healthier, clearer skin.

Contact us today to schedule a consultation and embark on your journey to improved skin health!