This is my attempt to make the most comprehensive guide to fighting acne specifically tailored for MEN. I fought acne for most of my life, finally getting it under control by going through all the tropes, appointments, figuring out what's bullshit and what's worth trying. It's important to make the distinction, men and women are VERY different. Therefore, the battles between acne are very different. The SCA subreddit has a ton of good info, but it's wading through a lot of things that may work for your little sister and not necessarily you. It's a much more talked about issue between females, despite acne being INSANELY easier to fight as a woman than a man.

A man's life breeds acne.

  • Testosterone, the literal essence of man, increases acne.

  • A man's diet, in a calorie surplus to gain/retain muscle, usually resorts to many foods being added to the diet. Higher dairy content, higher carb loading, and higher glycemic load all seem to aggravate and cause acne.

  • A man's workout, usually to increase muscle mass, can increase bacteria on the skin from sweating and increase hormones (testosterone.) This can cause and aggravate acne.

  • A man's life usually consists of more labor, stress (despite not being socially acceptable for a man to show this) and has less socially acceptable methods of treating skincare. Most skincare products are made for, advertised to, and bought by females.

  • To fight their own acne problems girls can; diet without losing muscle, tan to hide acne, wear makeup to hide marks, control their hormones with little to no side effects, have a billion products marketed to them, and change their life to fight acne while still maintaining feminine attraction. Put simply, if girls had to increase testosterone to fight acne, this would show them how a man approaches the fight. However, for some cruel reason our attraction is not only based in physical displays of testosterone, but in lack of it when it comes to our skin.

Now despite acne being much more aggressive and tougher to fight for a man, females still consider a clear face much more attractive. Society will consider you less attractive, happy, healthy, and even successful if you have acne scars on your face. I do not believe a man should ever resort to lowering his hormones or testosterone to fight acne, therefore none of the treatments listed will entertain this. A man must have testosterone more than he must not have acne.

I shouldn't have to list the benefits of having clear skin, but it can affect every aspect of your life. You wouldn't want to have a shitty haircut or wardrobe, so why carry a shitty complexion with you? It's not feminine to have great skin, and isn't just about getting laid either. Look at the studies, it will help your image at work, in the gym, and everywhere else you bring your face.

In order to recommend how to fight your acne I'm going to grade severity based on a scale of 1 to 5, with 5 being the most severe. A zero would be a man with no acne, despite anything he throws into and on his face and body. If this is you, congratulations because you have hit a genetic jackpot and a ton of stress is removed from your life because of this. Also, fuck you.

  1. Mild acne. No more than 2-3 small to medium lesions. Few blackheads, small natural pores. Little to no inflammation. Typically no body acne. Easily concealable, usually not a huge deal in attraction unless you are a celebrity, etc.

  2. Mild acne with moderate breakouts. Usually only an acne level 1, but suffers occasional breakouts consisting of 4-7 lesions. During a breakout, light to moderate inflammation, visible blackheads, and 1-2 painful zits (cysts.) Breakouts can usually create insecurities if timed with important events, but many people with this level go untreated as it's not "bad enough to treat."

  3. Moderate acne. Moderate amounts of lesions at a time on face. Usually no less than 5 except for "lucky" weeks. Can have large pores, very visible blackheads, moderate inflammation, usually several spots on back/shoulders. Tricky to conceal without good makeup experience. Can hamper attraction, usually starts taking toll on self confidence at this level. Most attempt at least a few therapies to treat acne here.

  4. Moderate to severe acne. Several active lesions. Stage where scarring takes large toll on skin. Several whiteheads, blackheads can take up large amounts of skin especially on forehead and nose. Painful cysts appear as red mountains on the skin. Affects face, neck, back, arms, shoulders, arms, chest, etc. Self confidence is a fraction of what it should be. Incredibly difficult to cover up. Occasionally gets decent days but takes time to repair skin.

  5. Severe acne. Crucifies attraction. Several painful cysts, impossible to cover up even for a fucking hollywood makeup artist. Controls life. Causes not only emotional depression, insecurities, and anxiety but physical pain as well. Girls usually won't even look at you.

Many people go through different stages of these, someone can be a 4 as a teenager and a 2 as an adult. I was around a 3 or 4 and now get the occasional small zit every week. I believe treatments should differ based on severity and how you rate on the scale. There are things every person with acne should be doing, however recommending isotretinoin to a 1 or 2 is a bit extreme. I'll now list treatments based on severity. Simply because a treatment is recommended for a 2 doesn't mean it won't be an effective treatment for a 4 either. Also, more difficult acne in the 2 scale might even require what is recommended for a 4. Acne is intricate and caused from several factors. The only "1 size fits all" approach is isotretinoin and even that isn't a guarantee.

There are also different types of acne. 3 main types are bacterial, fungal, and hormonal. Bacterial acne typically has large whiteheads, cysts, and the look of "traditional" acne. Fungal acne will have much smaller zits that seem to appear at once and cover a large area of skin. This almost looks more like a rash than large zits. Bacterial acne will mainly be fought from the outside killing the bacteria that causes acne known as Propionibacterium acnes, or P. Acnes. Fungal will mainly be fought from within with diet changes and using products containing yeast killers like zinc pyrithione. Hormonal acne is the toughest acne for men, due to no easy way to alter hormones without side effects. This will take the most experimenting from the list.

Dermatologists are usually recommended but I found they're are far too many shitty ones out there with a 1 size fits all approach and don't have the time to try several things on you. That being said, some of these options are prescriptions which you will need a dermatologist to write a prescription for. I tried using OTC options first. If you are a 4 on the scale, you should technically be doing everything on the 4 scale and above for maximum results. I tried including products widely available at most stores. As weird as it is, don't use products that say "For Men." They typically are inferior and marketed towards men who need a strong blue bottle, with the scent of sandalwood and cedar to regenerate masculinity that has been drained from caring for his face. Just use the girl's shit, it's better.

Treatments.

  • Improve water intake substantially.

  • Moderately cut foods from diet containing excess sugar, excess carbs, excess dairy (not including yogurt.)

  • Include exercise into weekly routine.

  • Add a quality facewash (lukewarm water, always) at night or twice a day (Cerave foaming cleanser, Cetaphil gentle cleanser, Neutrogena fresh foaming cleanser are all good. Stay away from beads/scents/exfoliating/baking soda or fruit based. If it sounds gimmicky, stay away.)

  • Practice not touching your face, you might not realize how often you do it. I did it at the gym all the time without thinking about it, transferring bacteria from the infested equipment to my pores.

  • Include moisturizing into your routine (big box stores typically have a ton, but get one specifically for your face. I use CeraVe PM but it's outrageously overpriced I'll admit.)

  • Do laundry regularly especially with shirts, sheets, and pillowcases. Do not sleep in your own oils every night.

  • Control stress as best you can by meditating, sleeping properly, and cutting out toxic people.

  • Add a BHA or AHA exfoliant in your routine to combat breakouts. (Stridex pads but only the red box, not the green, Paula's choice BHA liquid, or The Ordinary. Glycolic Acid 7%.) AHA's will make you more prone to sunburn, BHA's which are typically products containing salicylic acid will not however can dry the skin so make sure you moisturize. Use only on a dry face, after cleansing.

  • Significantly cut out dairy (not yogurt,) carbs, and especially sugar. Eat whole foods (eggs, meats, veggies, fruits, oats.) Do not eat processed food from a box, it's not that hard fatass.

  • Make sure your body has what it needs IE vitamins and minerals especially: zinc, vitamin d3, vitamin a, omega 3, and a probiotic if necessary for gut health. Gut health is incredibly relevant to acne and especially fungal acne.

  • If you sweat, wash your face after. I like to lift in the morning so I can shower immediately after. I also sit in a sauna for 20 minutes beforehand. This is good for your all around health especially skin.

  • Use a form of anti-fungal on your face if you believe you have fungal acne (head & shoulders, noble formula bar, or Nizoral shampoo.)

  • Use Benzoyl Peroxide if you believe you have bacterial acne. This will kill the bacteria that causes acne. (I did not have good effects with this, however everybody is diferent.) Use only on a completely dry face to fight burn marks. Use a thin layer of 2.5%, no more than 5%. This will bleach your clothes and sheets so pass on it if you have an expensive wardrobe.

  • Look into an oil cleansing method. If traditional cleansers and treatments don't seem to be working you can cleanse with oil. This is an effective way to leave your face's natural oils in tact which are necessary and to also strip the bad stuff. SCA has a great guide on this.

  • Look into OTC topical creams such as Differin, sulfur, niacinamide (I swear by this stuff,) or 10% azelaic acid. All can be effective without a prescription.

  • If OTC creams don't seem to be effective, a dermatologist will be able to look into some of the stronger creams (clindamycin is very effective, as well as dapsone and retin-a.) Again, identify which type of acne you believe to have and go into the derm appt. with a general idea to recommend to the Dr.

  • Prescription antibiotics are not my favorite solution, but can be effective. These include doxycycline, amoxicillin, and others. The idea is to kill the bacteria from within which can help if body acne is a great concern, however these also can effect gut health and create immunities to antibiotics. Try to stay away unless these are miracle cures. A derm made me go on amox for 2 years and getting off of it lead to the worst breakouts of my life. I prefer the method of using a probiotic and increasing gut health to fight acne as opposed to killing everything.

  • Do NOT take any androgen blockers. These are becoming increasingly popular due to the effectiveness with females. An example would be spironolactone. These can lead to gynocamastia (bitch tits) and really mess with your endocrine system.

  • Look into light therapy, and even try UV tanning. Most girls cringe at this on /r/skincareaddiction but UV light both kills bacteria and fungus that can cause acne. Don't go overboard, just a few minutes and never burn. See if you have positive results in a month and if not don't continue.

  • It is thought now that high estrogen in men can cause acne. Zinc and Vit B6 can help keep estrogen at bay, but more serious estrogen blockers might work as well. Use this as a last resort again, your endocrine system is very delicate.

  • Look into Curology. I used this and they tailor a cream for your face by you uploading pictures. It's $40 for a 2 months supply which isn't bad but it's not cheap either. Worked extremely well for me. If you want to, you can get a free trial and if it works, get a prescription for the same formula from your doctor and attempt to get insurance to cover it. Or buy the raw ingredients online (mine is a mixture of clindamycin, niacinamide, and azelaic acid.)

  • Look into isotretinoin, or accutane. It has some severe side effects in some people (depression, very dry skin, may be hard on heart and liver) but it is the most effective solution on this list. You typically need a prescription, but I know guys on steroid cycles that get it from the internet. It will 100% no doubt about it cause insane birth defects. Do not get your girl pregnant with this, if you have plates you are fucking on it tell them. Don't be a cunt. I'm talking serious birth defects. (side note, if you are not on it you can tell plates you are taking it to convince them to not "skip" a week of birth control. girls want your money for 18 years, but not if it means giving birth to a severely deformed baby. it's great insurance.)

  • Get tested for allergies. Common food allergies might be a contributing factor and if everything else fails this could tell you if a gluten or dairy allergy was affecting it all along.

  • Get blood work done, check to see if you're in good health. Sometimes inbalances in your blood levels can cause acne.

  • Clindamycin wipes on the body can help keep breakouts at bay, especially from sweating during workouts.

  • Professional chemical peels can help get your skin back to looking less scarred/red. They can be expensive, and painful but yield good results.

  • Professional extractions again can be expensive and painful, but can give you fast results if you really need a turnaround in a few days. Had this done once, seriously fucking hurts.

  • Professional facials. I prefer the ones that are more clinical than "spa like." Hydrafacials are more and more common and suck bacteria out of the skin while coating it with a moisturizing layer of hyaluronic acid. Again, these can be expensive.

  • At this point, get on isotretinoin. The valuable time from your life you are wasting letting acne control you isn't worth the few side affects you'll get from this. Your other option is to wait until it clears up and get tons of treatments for scarring which will be even more expensive.

This list is by no means every solution out there. Some guys will figure out that watching 5 minutes of The View caused their acne but I'm not going to include something that will most likely only help one fucking person. In other words, these are general treatments and not a conclusive list of every available treatment.

Feel free to add what worked for you below, I might have missed some stuff. Just remember, sometimes there is almost nothing you can do to completely get rid of acne (even isotretinoin) simply because you are a man that has testosterone coursing through his blood. It's not fair, but it's the price you pay for bigger muscles. Hopefully one day we will have an even more effective pill to cure it without side effects but until then, I hope this list helps you out.