Blemishes on your skin aren’t usually serious but can be frustrating and affect your self-confidence. Understanding these common skin concerns’ various types and causes is the first step toward effective treatment and clearer skin. 

Whether you’re experiencing acne, rosacea, hyperpigmentation, or other skin issues, it’s important to understand that each condition has unique causes and treatment methods. So, let’s dive into the world of skin blemishes, exploring their origins and unpacking the most effective treatments. 

Types of blemishes and their treatments

The first step in getting rid of blemishes is to understand what type of skin condition you’re dealing with. That way, you can receive the most appropriate treatment. Here are a few of the most commonly reported conditions that can cause facial blemishes.

Acne 

Acne is a common skin condition that often begins in adolescence and can persist into adulthood. It manifests as skin lesions, such as open and closed comedones (blackheads and whiteheads), papules, pustules, and cysts.¹

Treatment for acne includes both topical and oral medications. Topical treatments, applied directly to the skin, often contain ingredients like retinoids, antibiotics, benzoyl peroxide, azelaic acid, or salicylic acid. These treatments help reduce inflammation, clear dead skin cells, and prevent new lesions from forming.² 

Age spots (sun spots)

Age spots or sun spots, medically known as solar lentigines, are yellow to dark brown spots often found on skin exposed to the sun.³ They’re a common sign of skin aging. Treatment options include topical applications, like hydroquinone and retinoids, which help lighten the spots. Ablative therapies, such as chemical peels, cryotherapy, intense pulsed light, and lasers, also reduce their appearance.⁴ 

Prevention is key, particularly for people with fair skin and those prone to getting freckles. Tactics include limiting sun exposure, using sunscreen* regularly, and avoiding sunburns.⁵ 

Melasma

Melasma is a skin condition characterized by brown to gray-brown patches, typically appearing on the face, such as the cheeks, chin, nose bridge, forehead, and above the upper lip. It’s often linked to genetic factors, hormonal changes, or exposure to UV light.⁶

The primary treatment for melasma involves topical therapies, particularly a triple combination cream containing hydroquinone, tretinoin, and fluocinolone acetonide.⁷ These ingredients work together to help lighten the patches. Additionally, skin peels with glycolic or salicylic acid can help by increasing the turnover of hyperpigmented skin cells.⁸ 

A key part of treating and preventing melasma is strict sun avoidance. Using sunscreen and limiting sun exposure is important for managing the condition and preventing its recurrence.⁹

Rosacea

Rosacea is a chronic, inflammatory skin condition notable for causing redness on the nose, chin, cheeks, and forehead.¹⁰ While there’s no cure for rosacea, it can be effectively managed. The first step is to identify and avoid triggers like UV light, certain foods (e.g., spicy foods), weather changes, and alcohol.¹¹ 

Good skincare practices are also essential.¹² These include using pH-balanced skin cleansers instead of traditional soaps, applying broad-spectrum sunscreen with an SPF of 30 or higher, and regularly using moisturizers. Since rosacea can make the skin sensitive and irritable, avoiding irritating products is important.¹³ 

Treatments, such as topical ivermectin, azelaic acid, and metronidazole, can be prescribed for flare-ups.¹⁴ These medications help reduce inflammation and redness. 

Post-inflammatory hyperpigmentation (PIH)

PIH is a condition in which the skin produces excess melanin or deposits it abnormally in the skin layers following inflammation.¹⁵ It’s more common in darker skin tones and often occurs after skin trauma or conditions like acne or eczema.¹⁶ 

Treatment mainly involves topical lightening agents, with hydroquinone being a common choice.¹⁷ Topical retinoids such as tretinoin, adapalene, and tazarotene help with PIH and treat underlying acne, making them suitable for long-term use. Azelaic acid is another option that is effective against both acne and PIH.¹⁸ 

Various laser treatments have been used successfully for more persistent cases.¹⁹ These treatments should be discussed and pursued under the guidance of a healthcare professional, as they require careful consideration of individual skin types and conditions.

Cold sores

Herpes simplex virus type 1 (HSV-1) is responsible for causing cold sores or “fever blisters”.²⁰ These are red, painful lesions typically found around the lips and mouth. You’re at risk of contracting HSV-1 through activities that involve contact with an infected person’s saliva, such as kissing, sharing drinkware, or sharing cosmetics.²¹

To treat cold sores, the current recommendation is oral valacyclovir, an antiviral medication.²² This treatment is effective in reducing the duration and severity of an outbreak. For those who experience frequent outbreaks, chronic suppression might be necessary.²³ This involves taking a daily dose of oral valacyclovir to prevent or minimize future episodes.²⁴

Can you prevent blemishes?

While it’s not always possible to prevent blemishes, especially those caused by uncontrollable factors like genetics or hormones, there are effective ways to reduce their occurrence and severity. It’s important to receive an accurate diagnosis from a medical professional however, sun protection is important for overall skin health. The sun’s UV rays can exacerbate many types of skin blemishes, so taking steps to protect your skin from sun exposure is crucial.

For instance, solar lentigines are directly linked to sun exposure.²⁵ Regular use of sunscreen and limiting time in the sun can prevent these spots from forming.²⁶ Similarly, sunscreen can also help prevent melasma from worsening.²⁷ Overall, pigmentation disorders, not to mention early signs of aging, are significantly influenced by sun exposure.²⁸

To effectively protect your skin, apply a broad-spectrum sunscreen with SPF everyday,²⁹ even on cloudy days or indoors if near windows. Additionally, wearing protective clothing like hats and sunglasses and seeking shade during peak sun hours can further reduce the risk of blemishes caused by the sun.³⁰ Remember, while sun protection can't prevent all types of blemishes, it’s a vital step in maintaining healthy skin.

When to see a healthcare professional

While many skin conditions that lead to facial blemishes are benign and can be initially managed at home, there are situations where consulting a healthcare provider—especially a licensed dermatology provider—is important. 

First and foremost, if you notice a new blemish that causes concern, it’s always wise to get a professional evaluation. This is particularly important if you’re unsure about the nature of the blemish or if home treatments aren’t effective.

Some skincare issues may require treatments that need a prescription or should be performed by a licensed professional. These include prescription-strength medications or procedures like laser therapy, which are best handled in a clinical setting.

An essential guideline to remember is the ABCDE rule, which is particularly useful for identifying concerning features in moles or spots that could suggest skin cancer:³¹

• Asymmetry: One half of the spot doesn’t match the other.

• Border: The edges are irregular, ragged, notched, or blurred.

• Color: The color is not uniform and may include shades of brown or black or sometimes patches of pink, red, white, or blue.

• Diameter: The spot is larger than the size of a pencil eraser.

• Evolving: The mole or spot changes in size, shape, or color.

If a blemish exhibits any of these features, see a healthcare provider promptly for assessment.³² Early detection and treatment are key in managing any potential skin issues effectively.

Regardless of the blemish type, if you’re unsure, it’s always best to seek help from a professional for proper diagnosis and treatment recommendations to ensure you’re treating it appropriately. 

Curology makes skincare accessible

If you’re dealing with blemishes from acne, dark spots, melasma, rosacea, or aging, Curology is here to help.* We offer personalized prescription products with proven-effective ingredients, like tretinoin, azelaic acid, or metronidazole. To get started, you only need to answer a few questions and take a small handful of photos of your skin concerns.

Get your personalized skincare routine with Curology

Get your personalized skincare routine with Curology

Start your skin quiz

If Curology is right for you, our licensed dermatology providers create a personalized skincare routine using our custom formulas, Future-Proofᴿˣ for anti-aging or Custom Formulaᴿˣ for acne, helping you meet your skincare goals.*** They’ll also answer any questions you may have and recommend other products to complement your custom formula

P.S. We did the homework, so you don’t have to: 

1. Sutaria, A.H., et al. Acne Vulgaris. StatPearls. (2023, August 17).

2. Sutaria, A.H., et al. Acne Vulgaris. StatPearls. Ibid.

3. Plensdorf, S., et al. Pigmentation Disorders: Diagnosis and Management. American Family Physician. (2017, December 15).

4. Plensdorf, S., et al. Pigmentation Disorders: Diagnosis and Management. American Family Physician. Ibid.

5. Plensdorf, S., et al. Pigmentation Disorders: Diagnosis and Management. American Family Physician. Ibid.

6. Basit, H., et al. Melasma. StatPearls. (2023, August 8).

7. Basit, H., et al. Melasma. StatPearls. Ibid.

8. Basit, H., et al. Melasma. StatPearls. Ibid.

9. Basit, H., et al. Melasma. StatPearls. Ibid.

10. Farshchian, M. and Daveluy, S. Rosacea. StatPearls. (2023, August 8).

11. Farshchian, M. and Daveluy, S. Rosacea. StatPearls. Ibid.

12. Farshchian, M. and Daveluy, S. Rosacea. StatPearls. Ibid.

13. Farshchian, M. and Daveluy, S. Rosacea. StatPearls. Ibid.

14. Farshchian, M. and Daveluy, S. Rosacea. StatPearls. Ibid.

15. Lawrence, E. and Al Aboud, K.M. Postinflammatory Hyperpigmentation. StatPearls. (2022, October 3).

16. Plensdorf, S., et al. Pigmentation Disorders: Diagnosis and Management. American Family Physician. Ibid.

17. Lawrence, E. and Al Aboud, K.M. Postinflammatory Hyperpigmentation. StatPearls. Ibid.

18. Lawrence, E. and Al Aboud, K.M. Postinflammatory Hyperpigmentation. StatPearls. Ibid.

19. Lawrence, E. and Al Aboud, K.M. Postinflammatory Hyperpigmentation. StatPearls. Ibid.

20. Saleh, D., et al. Herpes Simplex Type 1. StatPearls. (2023, August 28).

21. Saleh, D., et al. Herpes Simplex Type 1. StatPearls. Ibid.

22. Saleh, D., et al. Herpes Simplex Type 1. StatPearls. Ibid.

23. Saleh, D., et al. Herpes Simplex Type 1. StatPearls. Ibid.

24. Saleh, D., et al. Herpes Simplex Type 1. StatPearls. Ibid.

25. Plensdorf, S., et al. Pigmentation Disorders: Diagnosis and Management. American Family Physician. Ibid.

26. Plensdorf, S., et al. Pigmentation Disorders: Diagnosis and Management. American Family Physician. Ibid.

27. Plensdorf, S., et al. Pigmentation Disorders: Diagnosis and Management. American Family Physician. Ibid.

28. Flament, F., et al. Effect of the sun on visible clinical signs of aging in Caucasian skin. Clinical, Cosmetic and Investigational Dermatology. (2013, September 27).

29. American Academy of Dermatology Association. What can get rid of age spots?. (2021, September 28).

30. American Academy of Dermatology Association. What can get rid of age spots?. Ibid.

31. American Academy of Dermatology Association. What to look for: ABCDEs of melanoma. (n.d.).

32. American Academy of Dermatology Association. What to look for: ABCDEs of melanoma. Ibid.

33. Sutaria, A.H., et al. Acne Vulgaris. StatPearls. Ibid.

34. Lawrence, E. and Al Aboud, K.M. Postinflammatory Hyperpigmentation. StatPearls. Ibid.

Camille Dixon is a certified Physician Assistant at Curology. She received her Master of Medical Science in Physician Assistant Studies from Midwestern University in Downers Grove, IL.

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Written by

Curology Team

Medically reviewed by

Camille Dixon, PA-C