The Ultimate Guide to Clear Skin—Once and for All

Meet Botox, the acne injection. The wrinkle smoother doesn't have the FDA's stamp of approval for treating blemishes (it's an off-label use), but most dermatologists will tell you: It works. "Botox blocks the messengers responsible for sebum production, which clogs pores and can cause breakouts," says Dr. Joshua Zeichner, director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City. "Typically, it's injected intradermally—between the layers of skin, where the oil glands are—as opposed to in the muscles." This technique significantly lowers sebum production as soon as a week after treatment, and results last up to three months, according to a recent study. "I've seen it firsthand, even when I've done traditional [non-intradermal] Botox," says New York City dermatologist Dr. Marina Peredo. "Many of my patients notice the difference, too, so they ask me to put a couple shots in problem areas, like their nose and chin."

Not ready for the needle—or a doctor's visit? Enter Skin Accumax ($115 for 120 capsules). The supplement is crazy-popular in the U.K.,but it's only just being whispered about in the States since cosmetics brand Jane Iredale started distributing it here. Iredale, president and founder of the eponymous company, explains that the capsules contain a nutrient complex that makes skin less oily (vitamin A), stimulates collagen production (vitamin C), and reduces inflammation and bacteria (diindolylmethane, found in cruciferous vegetables, with vitamin E to aid absorption). "The vitamins are also antioxidants that can improve acne by fighting free radicals that cause inflammation," says Dr. Whitney Bowe, a New York City dermatologist. The recommended dose is four capsules a day for 14 weeks, but you could see improvement in just six to eight weeks.

Cleansing gadgets aren't anything new, but now there's a different pore-clearing device to add to your arsenal: ultrasonic skin spatulas, like the Le Mieux Skin Perfecter ($189) and Labelle Ultrasonic Skin Spatula ($149). "These devices use ultrasonic technology [they emit over 20,000 ultrasonic waves per second] to remove dirt and blockages in the skin," says Zeichner, which helps explain why 65 percent of people in a Le Mieux clinical trial had an immediate reduction in the appearance of blackheads. Another benefit: The mmm-it's-working thrill you get while watching tiny plugs of sebum being squeezed out of your pores as the tool gently buzzes across your face.

Is there anything lasers can't do? The same miracle technology that removes scars, minimizes wrinkles, and corrects vision also shows promise as an acne treatment. Consider Clear + Brilliant: "Like other fractionated lasers, it creates thousands of microscopic injuries in the skin," explains Peredo. "When your skin goes into repair mode to heal these injuries, it also heals the inflammation responsible for acne." For the best outcome, you're looking at one in-office laser treatment every month (about $500 a pop) for five months, followed by maintenance as needed. But, hey, you'll brighten your skin tone and reduce fine lines while you're at it.

"Spironolactone, a high-blood-pressure medication, is a great alternative to birth-control pills if you have hormonal flare-ups," says Zeichner. "I've seen it work even better than birth control [at treating acne] in some cases." Taking heart meds for your skin makes more sense once you know that spironolactone also happens to reduce the acne-causing effects of testosterone. "Doctors are taking advantage of this side effect by prescribing it to people with acne," Zeichner explains. In fact, a Journal of Drugs in Dermatology study found that the drug boosted the results of acne patients being treated with retinoids (a standard Rx fix). And don't worry: You'd take a dose so low that plummeting blood pressure isn't a problem. For some, the drug may also work because it's used to treat polycystic ovarian syndrome, a surprising underlying cause of acne. But, as you would before taking any medication, talk to your doc.

Remember when your high school derm said what you eat has nothing to do with acne? Wrong. That way of thinking was based on flawed research from the '70s that found little association between diet and acne. "Now, thanks to more comprehensive research, there's strong evidence linking carbohydrates to acne," says Zeichner. Consider the recently published review "Diet and Acne Update: Carbohydrates Emerge as the Main Culprit." The research paper looks at 13 studies and concludes—as you can tell from the title—that carbs are the number-one skin saboteur when it comes to acne and food habits. "Refined carbs trigger the release of hormones linked to acne," says Bowe, who was also the senior author of the paper. "If you make only one change in your diet for the sake of your skin, avoid refined carbohydrates, like sugary cereals and desserts."

1. Non-comedogenic Foundation: BareMinerals Blemish Remedy Acne- Clearing Foundation, $27

2. Breakout-Free SPF: Murad Anti-Aging Moisturizer SPF 30, $48

3. Emergency Spot Treatment: Neutrogena Rapid Clear Stubborn Acne Spot Gel, $9

4. Skin-Clearing Moisturizer: Vichy Normaderm Daily Anti-Acne Hydrating Lotion, $25

5. Pore-Clearing Device: Labelle Ultrasonic Skin Spatula, $149

6. Makeup Primer: Olay Clear Skin Swirled Mattifier Redness & Pore Reducing Mattifier, $10

7. Non-Drying Face Wash: Burt's Bees Natural Acne Solutions Purifying Gel Cleanser, $10

8. Vitamin Supplement: Skin Accumax Vitamins and Nutrients Supplement, $115 for 120 capsules

This article appears in the July issue of Marie Claire, on newsstands now.