Dermatologist-Reviewed Articles

How to Treat Inflammatory Acne

woman washing her face

Nothing ruins a good night’s sleep more than the surprise arrival of a giant pimple to greet you in the morning. Lurking under the surface of your skin, inflamed acne is the most frustrating kind, as its life cycle lasts longer than your average blemish. But by using these inflammation-targeting and skin-calming solutions, you can feel free to show the world your face again—no sick day necessary.

Skin Cycle Shutdown

A pimple is not always a pimple by any other name. Non-inflammatory acne includes blackheads and whiteheads, while inflammatory acne includes pimples, red pustules and larger lesions that are formed when sebaceous glands flare up. An overproduction of sebum leads to a rupture, which then begins to store bacteria, causing an inflammatory reaction. This inflammation is responsible for redness, swelling and pain associated with acne cysts. The more severe the acne, the more the immune system responds.

All About Acids

Hydroxy acids—alpha-hydroxy acid (AHA) and beta-hydroxy acid (BHA)—are often the first line of defense against acne inflammation. These compounds come in over-the-counter topical creams, gels and washes. The antibacterial and anti-inflammatory properties of benzoyl peroxide, a BHA, make it an effective agent, but since it also induces peeling, it can make skin dry and irritated or cause a burning sensation. Salicylic acid, often included under the BHA umbrella, is also anti-inflammatory, as well as mildly antibacterial and exfoliating, and is generally gentler on skin than benzoyl peroxide. Meanwhile, AHAs like glycolic and lactic acid are exfoliants and keep the surface of the skin clear of debris—reducing the amount of pore-clogging activity.

Viva Vitamin A

Vitamin A derivatives such as retinoids can also indirectly put a stop to acne inflammation. They help unclog pores, let sebum and bacteria flow out freely, discourage bacteria from growing and inhibit the immune system’s inflammatory responses. Tretinoin is a common type, often used together in combination therapy with benzoyl peroxide or antimicrobial formulas. Watch out for scaling and burning, which sometimes crop up. Topical antibiotics can also help inhibit bacterial growth and reduce inflammation, although they may also cause peeling, itching, burning and dryness.

Break Out the Big Guns

A regular treatment routine to manage and prevent inflammatory acne’s development is all well and good—but maybe you’ve got an inflamed acne breakout today. Ditch the agony of flare-ups with the same products that help prevent them. Apply a small amount of a benzoyl peroxide–based topical product to the breakout area daily to reduce the inflammation. You can even spot-treat individual zits. Follow up with a second topical product that contains salicylic acid or a retinoid for an anti-inflammatory double-punch. If BHA and retinoid products irritate or dry your skin, moisturize with gentler anti-inflammatory products containing zinc, aloe vera, green tea or witch hazel to further reduce the inflammation. Avoid picking or scratching at your acne spots, even if they itch—it’ll just make the inflammation worse.

Seek a Professional

If your acne inflammation is severe and painful, or doesn’t respond to topical treatment, give your dermatologist a call. Inflammation from immune response is not the only cause of swollen acne. You might also be having a hormone overload in your skin, either from stress or a hormone imbalance. Oral antibiotics or contraceptive pills may give your skin the boost needed to kick its acne habit for good—or at least tone it down. If you’re experiencing cystic acne that needs to be tamed, cortisone shots are the quickest way to make it disappear.


This article has been reviewed by board-certified dermatologist Dr. Emmy Graber.

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