Ask a group of people to describe their acne breakouts and you’ll usually get two main types of response.
Some people will quickly mention getting a pimple every now and then, or occasionally spotting a blackhead or other mild acne lesion every other week.
Others will be able to describe persistent, stubborn acne breakouts that never seem to go away and have a tendency to pop up at the worst possible moments.
If you’re one of the millions of people who fit into the second category, you’ll know that treating acne isn’t always as easy as it’s made out to be. You’ll also know that the typical treatments for acne can fall short when your breakouts are particularly severe or resistant to treatment.
Although stubborn acne can be seriously annoying, it is treatable with the right combination of science-based medications and skin-friendly habits.
Below, we’ve explained how stubborn acne can develop, as well as the treatments that you can use to get it under control for good. We’ve also shared some simple habits and lifestyle changes that you can implement to prevent acne breakouts and keep your skin looking its best.
Acne develops when a combination of sebum and dead skin cells create a blockage in your hair follicles, or pores.
To understand the process behind acne breakouts, it’s important to cover the basics of how your skin maintains and cares for itself.
Your skin is constantly exposed to damage from the outside world. As part of your body’s line of defense against toxins, bacteria and other germs, your skin needs to maintain and repair itself in order to stay healthy.
Your sebaceous glands, small glands that open into your hair follicles, play a part in this process by producing an oily substance called sebum.
Sebum plays an integral role in protecting and repairing your skin. It’s essential for keeping your skin moisturized, lubricated and healthy, as well as providing a physical barrier that keeps toxins and other harmful microbes out of your body.
When your sebaceous glands produce too much sebum, the excess sebum can get stuck inside your follicles, causing a blockage to develop.
Your skin also repairs and rejuvenates itself by constantly creating new skin cells to replace old, dead ones. This process is referred to as epidermal turnover and occurs roughly every 40 to 56 days.
As part of the epidermal turnover process, dead, leftover skin cells can gradually build up on the surface layers of your skin. When these mix with sebum, they can contribute to the blocked hair follicles that cause acne breakouts.
Acne that’s caused by sebum and dead skin cells alone tends to be mild and is often referred to as comedonal acne. These are the classic whiteheads and blackheads that can develop if your skin is overly oily.
Although comedonal acne is usually mild, acne can become more severe when bacteria enters into the equation.
Certain types of bacteria, including the P. acnes bacteria that resides on your skin, can become trapped inside blocked hair follicles. When these bacteria multiple, they can cause your acne to become red, inflamed and painful.
Inflamed acne is often stubborn and difficult to treat. This type of acne includes larger pustules, papules and nodules, as well as more severe cysts that can form deep in your skin and lead to acne scarring.
No matter how severe or stubborn your acne seems to be, it’s almost always possible to treat it with the right combination of products, medications and habits.
We’ve listed the treatment options for stubborn acne below, along with more information on how each treatment works to control breakouts and prevent acne.
Although products available over the counter often aren’t strong enough to get rid of very severe or persistent acne, some can offer real benefits for your skin.
One of the most important products to have in your toolkit for treating stubborn acne is a gentle, non-abrasive facial cleanser.
A good quality quality cleanser, such as our Deep Sea Cleanser, will help to lift dirt and oil from your skin, reducing your risk of developing blocked pores. Make sure to look for a mild cleanser that’s labeled non-comedogenic -- this means that it’s less likely to contribute to blockages.
It’s important to use your cleanser properly. Instead of scrubbing your skin clean, be gentle and apply cleanser lightly using your fingertips in a circular motion. Once you’re finished, wash away the cleanser using warm water and carefully pat your skin until it’s dry.
If you have inflamed or infected acne, you may want to look for a cleanser that contains benzoyl peroxide. This ingredient is a topical medication that prevents the bacteria that cause acne from multiplying on your skin.
You can find benzoyl peroxide in many over-the-counter acne cleansers, facial scrubs and other products.
Other active ingredients to look for include alpha and beta-hydroxy acids, such as glycolic acid, salicylic acid and others. Although these ingredients don’t target bacteria, they can help to peel away the dead skin cells that can accumulate on your skin and contribute to breakouts.
We’ve talked more about these ingredients and their effects in our guide to chemical peeling for treating acne.
While over-the-counter products can certainly make a difference, treating stubborn acne usually requires the use of prescription medications.
Several prescription medications are available for acne, including topical medications you apply to your skin and oral medications you take in tablet form. Common prescription medications for treating stubborn acne breakouts include:
If you have stubborn acne and would like to use prescription medication to treat it, you can talk to a healthcare provider online to learn more about your options.
Because no two cases of acne are precisely the same, there’s no one-size-fits-all medication for treating stubborn acne. Depending on your needs and the severity of your acne, your healthcare provider may prescribe one or several medications to get your breakouts under control.
The right combination of over-the-counter products and prescription medications can usually get rid of even the most stubborn, persistent acne.
However, even if you’re prescribed medication to treat acne, it’s important to maintain good skin care habits. Taking good care of your skin will help to prevent your acne breakouts from coming back. Use the following tips to prevent stubborn acne from returning:
When acne is extremely persistent and doesn’t seem to respond to any medication, it may not be acne at all.
Several skin conditions can cause acne-like breakouts that won’t respond to the products and skin care medications typically used to treat acne. These include perioral dermatitis, keratosis pilaris and hidradenitis suppurativa (HS).
Many of these conditions are treatable, but require different medications than the ones used to treat and prevent acne breakouts.
If you think you may have a non-acne skin condition that resembles acne, it’s best to schedule an appointment with a dermatologist. They’ll be able to check your skin and let you know what you’re dealing with and your best options for treating it.
Dealing with stubborn, persistent acne can be a frustrating process, especially when products designed specifically to treat acne do little to reduce the severity of your breakouts.
If you have persistent acne, your best move is to talk to a licensed healthcare provider to learn more about your options and, if appropriate, receive science-based medication to prevent acne breakouts and keep your skin clear.
You can also find out more about treating acne in our detailed guide to acne treatment options backed by science.