Your Most Annoying Beauty Problems — & How To Fix 'Em For Good

Illustrated by Mallory Heyer.
Here's a hard fact of life that nobody at a beauty counter is ever going to tell you about: Some skin issues just happen, regardless of how diligently you cleanse, tone, serum, and moisturize. There are factors beyond our control (thanks, genetics!) or, perhaps, beyond our scope of knowledge, that can cause difficult-to-treat things like melasma and cystic acne.
Here's the good news: Even though we can't prevent the natural from occurring, we can treat it. Your remedy could be as simple as regular facials and a stricter at-home regimen, or it could get slightly more, well, involved.
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Ahead, we outlined some of these serious skin-care issues, and then talked to an aesthetician (Kerry Benjamin), a dermatologist (Sejal Shah, MD), and a plastic surgeon (Chia Chi Kao, MD) to find out their recommended solutions.
Before we get started, though, let's just get one thing straight: Nobody is saying things have to be "solved," necessarily — what you choose to do to your face is entirely up to you. But, assuming you're searching for a fix, we hope you find this information helpful.
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Illustrated by Mallory Heyer.
Acne
“Acne is the most common skin condition diagnosed in the United States,” explains Dr. Shah. (You’re not alone!) Many things can cause it, including excess sebum (oil) production, an increase in skin cells lining the hair follicle, overgrowth of acne-causing bacteria, and inflammation.

But, that’s not all — acne can vary from the mild (but annoying) blackhead to the deep and painful cyst. That makes sweeping statements about treating it rather problematic — there’s no prescription or miracle face wash that’s just going to get rid of it; it’s almost always a multi-pronged approach.
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Illustrated by Mallory Heyer.
How To Treat It
“The treatment of choice always depends on the severity of the acne,” Dr. Shah says. If you’re on the mild end of the spectrum — say, with regular or recurring whiteheads, blackheads, and pimples — you should try seeing a facialist and adjusting your skin-care routine before committing to any sort of medication.

“I recommend patients with acne get treated every two weeks with a series of deep-exfoliation treatments that are designed to slough off the dead skin, pull out debris, kill bacteria, reduce inflammation, and repair the barrier function,” says Benjamin. “I usually combine chemical and physical exfoliation methods, along with an infusion of key ingredients to kill the bacteria, moisturize the skin, and calm inflammation.” Benjamin recommends twice-daily cleansing with a Clarisonic, following up with products that contain either salicylic acid or retinol (we love Verso Skincare), and wearing a daily SPF to avoid scarring.

If your acne is more severe, the treatment is different: “For severe or nodulocystic acne, I would recommend topical treatments like benzoyl peroxide, salicylic acid, retinoids, or antibiotics, plus oral medications,” Dr. Shah says. (This is where spironolactone comes into play.) “Individuals often require a combination of treatments.”

Medical options are also available. “Steroid injections are best for nodules and cysts,” Dr. Shah says. “I typically reserve laser and light treatments for patients who have failed other treatments.” If you're seeing a dermatologist and using topical or oral medications, then you should go easy on the at-home routine: “I generally recommend the CeraVe line initially, but once a patient has been on the regimen for a while, I add in more targeted products,” she says.
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Illustrated by Mallory Heyer.
Acne Scars
“Acne scars come in a few varieties,” explains Dr. Shah. “People often refer to dark marks that occur after acne as ‘scars,’ but this is really just discoloration that we call 'post-inflammatory hyperpigmentation.' True scarring, where there is change in the skin texture, can either be depressed or raised. The depressed versions are further divided into ice-pick, boxcar, and rolling scars.”

Ice-pick scars are small, deep holes that look like the skin has been punctured with a sharp object. Boxcar scars, on the other hand, are round or oval depressions, a.k.a. “craters.” "Rolling" refers to bands of scar tissue under the skin that has an uneven appearance.
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Illustrated by Mallory Heyer.
How To Treat Them
Your treatment entirely depends on what kind of scarring you have. “Post-inflammatory hyperpigmentation, or dark marks, generally just need a broad-spectrum sunscreen and topical lightening agents, along with maybe a chemical peel,” says Dr. Shah. She often prescribes hydroquinone to her patients, but OTC options generally also contain vitamin C and other brightening components. (We like Clinique Even Better Clinical Dark Spot Corrector.)

If your scarring goes beyond dark marks, you should see a professional to assess exactly how severe the damage is. “Atrophic acne scars are best treated with resurfacing laser treatments,” Dr. Shah says. For deeper scars, she will perform a subcision (where a needle goes into the dermis under the scar to release fibrous bands) before lasering. Laser treatments could generally be done every two weeks for up to a 12-week period, and could continue beyond that to ensure the healing is progressing. Benjamin and Dr. Kao recommend microneedling treatments to supplement the laser. (You can book these through your derm or even a local spa.)
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Illustrated by Mallory Heyer.
Sun Spots
“Sun spots are created from overexposure to the sun, resulting in sunburn,” says Dr. Kao. “They’re often seen on the left side of the face, due to driving.”

“We call them solar lentigines,” Dr. Shah adds. “They are similar-looking, bigger, more persistent freckles, and are caused by an increase in melanocytes, the pigment-producing cells. Even though they’re a cosmetic concern, it’s important to have them checked out by your dermatologist regularly.”
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Illustrated by Mallory Heyer.
How To Treat Them
Our doctor friends recommend lasers, naturally, but Benjamin insists these guys can be handled without (dramatically) pricey procedures. “I treat them with a series of deep-exfoliation treatments to lift the pigment, and then supplement with topical actives that are designed to block the production of melanin,” she says.

This means your facialist should be booking you for a combo of slightly scary procedures, like microdermabrasion, peels, dermaplaning, and microneedling. When combined, all these act like as a detox to UV damage, lifting the spot. “To lift the pigment totally, you should be seen every three weeks, typically for a minimum of six treatments,” says Benjamin. Oh, and load up on vitamins C and E, and retinol. Benjamin favors PCA Skin C & E Strength Max.
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Illustrated by Mallory Heyer.
Melasma
“Melasma is a hyperpigmenting skin condition that causes brown to gray-brown patches on the face — cheeks, nasal bridge, forehead, chin, and upper lip,” explains Dr. Shah. “It can also appear on other parts of the body that have excess sun exposure, and it’s more common in darker skin types. The exact cause is not clear, but exposure to UV radiation is the most important factor in its development. Hormones may also play a role, as we often see it in women who are pregnant or taking birth control.”
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Illustrated by Mallory Heyer.
How To Treat It
If you have melasma, here are three key letters to remember: S-P-F! Dr. Shah recommends searching for broad-spectrum sunscreens with physical blockers, like zinc oxide, such as Drunk Elephant’s.

Melasma can vary pretty severely in how it covers the face, but the treatment doesn’t tend to change much. “It’s challenging, because it’s hormonally driven and can be deeper than UV damage,” Benjamin says. “The safest way to treat it is with medium-depth peels and SilkPeel microdermabrasion — they’re gentle enough to exfoliate without causing undue trauma to the skin.”

Above all, protect yourself from the sun, wear UV-protective clothing and wide-brimmed hats, and be diligent about your SPF application. “Also, consult your gyno or endocrinologist, because they might be able to pinpoint your hormonal imbalance and eliminate whatever’s causing the flare-up,” Benjamin adds.
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Illustrated by Mallory Heyer.
Skin-Sagging
“This is exactly as it sounds,” Dr. Shah says. “One area where sagging is most noticeable is the lower face and neck — you may feel that your laugh lines or jowls are more prominent. You may also see it in the upper face, in the brow and eyelid area. As we age, the underlying bone structure changes, further contributing to sagging of the skin.”
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Illustrated by Mallory Heyer.
How To Treat It
“Those who protect themselves from extrinsic factors — sun exposure, alcohol, smoking, and environmental pollutants — at a young age can significantly reduce many of the avoidable visible signs of aging,” Benjamin says. For the rest of us, there are…other options.

In all seriousness, being diligent about SPF, starting a monthly or bimonthly microdermabrasion session, and using serums with peptides will help prevent sagging. If it’s already present, however, needles are a good option for milder cases. “For the fine lines, instead of using fillers, which are temporary, we use micronized fat, which is longer-lasting, to fill the fine lines from the top of the head to the bottom of the neck. We go over every wrinkle in the skin of the face and neck,” Dr. Kao says. “We use super condensed fat with regenerative cell isolation to give the skin more structural support, and to add regenerative cells to the skin to enhance and stimulate collagen production.”

Severe sagging, however, generally requires plastic surgery to be corrected. Dr. Kao suggests a ponytail lift — his “facial-rejuvenation procedure that simulates the lifting effects on the face while wearing a high ponytail.” (Instead of cutting the upper eyelids or around the ears, like traditional lifts, this procedure leaves tiny scars behind the hairline.)
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Illustrated by Mallory Heyer.
Facial Redness
“People with sensitive skin are typically plagued with redness," says Benjamin. "This can be due to rosacea, an impaired barrier function, psoriasis, eczema, acne, allergies, or a condition called perioral dermatitis, which causes redness around the mouth, chin, nose, and even up near the eyes.”

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Illustrated by Mallory Heyer.
How To Treat It
“Since there are so many causes of facial redness, it’s important to have a dermatologist examine and diagnose you,” Dr. Shah insists. Sure, it’s likely rosacea or broken capillaries, which are cosmetic concerns — but it could also be lupus, and that’d be pretty difficult to treat with soothing face wash.

“There’s a prescription topical medication called Mirvaso that temporarily treats persistent redness due to rosacea,” Dr. Shah explains. “Laser treatments can also help rosacea, as well as redness and broken capillaries. They would be the most likely course of treatment.”

However, your at-home regimen is equally important to any in-office treatments you may elect to get. “You should exfoliate, but gently, using peels,” Benjamin suggests. “Also, look for hyaluronic acid, which absorbs 1,000 times its molecular weight in water. You would also benefit from humectant moisturizers, which contain things like shea butter, silicones, plant oils, and squalane.”
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Illustrated by Mallory Heyer.
Undereye Bags
You may be thinking this is what happens when you wake up in the morning, but these could actually be a much more serious concern. "When they're hereditary, undereye bags are due to the anatomy of the lower orbital and cheekbones. As we age, the cheek tends to descend, and if the cheekbone is shallow, the descent is earlier in life," explains Dr. Kao. "The muscle of the lower eyelid then gets thinned out, so the intraorbital fat (read: in the cheekbones) herniates out, creating visible bags."
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Illustrated by Mallory Heyer.
How To Treat Them
You can try all the de-puffing, rolling, and massaging you want — but usually, undereye bags are persistent, which means they require more than a topical solution. "A skin-tightening treatment, like Thermage, might be helpful to less severe cases," Dr. Shah says, but she points to surgical correction to truly get rid of the issue.

"Traditional treatment for bags is a lower-eyelid surgery from the inside of the eye to remove the fat," Dr. Kao says. "But, that tends to hollow out the intraocular fat, which you need as you get older and your eyes grow more sunken. So, fat redistribution moves the fat into the cheek area, but also reduces the volume of intraorbital fat."

Translation: You take out the fat from one part of your eye and put it somewhere else, which fills it — but then leaves you looking skeleton-like later in life. That's why Dr. Kao recommends a "multimodality approach," which lifts the fallen cheek, tightens the muscle, and then pinches a little of the excess skin. "By tightening the muscle, the fat bag is hoisted back into the orbit, and micronized fat is injected to blend in the eyelid-and-cheek junction."
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Illustrated by Mallory Heyer.
Dark Circles
"Dark circles under the eyes may have a few different causes," Dr. Shah explains. "The skin there is very thin, so the blood vessels are more visible, which results in a bluish hue. As we age, the skin thins, which worsens the appearance. Hyperpigmentation is another cause, which is often genetic."
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Illustrated by Mallory Heyer.
How To Treat Them
"An increase in circulation is needed," Benjamin says. "I use a high-frequency device to promote circulation, and then apply a layer of a light peel with a Q-tip. I follow up with a Clarisonic Opal with eye cream to help drain the lymph and drive product deeper to moisturize, smooth out fine lines, and brighten under the eyes." She recommends using the Opal twice a day to apply your eye cream, and following up with an ice roller to reduce puffiness and encourage circulation.

"You could also consider fillers for the area, since volume loss worsens the appearance of dark circles," Dr. Shah suggests. She also recommends brightening eye creams, such as Peter Thomas Roth Power K.
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Illustrated by Mallory Heyer.
Enlarged Pores
"Your pores are enlarged due to several factors, including bacteria and sebum trapped in the follicle; aging, since we lose elasticity when we get older, which causes pores to look bigger; and, simply genetics," explains Benjamin.
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Illustrated by Mallory Heyer.
How To Treat Them
"Most patients' pores are enlarged due to bacteria, sebum, and dead skin cells that are trapped in the follicle," Benjamin explains. "So, I suggest deep exfoliation and extractions." But, she cautions, this could take several treatments — including at home — before you start to see significant changes.

For more severe cases (or a quicker fix), "you could also consider a retinoid, preferably prescription-strength," says Dr. Shah. You could also try an OTC retinol (Benjamin recommends PCA Skin Intensive Clarity Treatment.)

On top of that, our pros recommend properly cleansing with a skin brush and a wash that contains an alpha-hydroxy acid (if you're sensitive, skip the latter part). "Regular use of an AHA product can help," Dr. Shah says, recommending Dr. Gross' Alpha Beta Peel.

Finally, Dr. Kao notes that microneedling can also help supplement deep exfoliation and peels.
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Illustrated by Mallory Heyer.
Dullness
"This is when your skin lacks glow," Benjamin says. "This can be due to several factors, including a buildup of dead skin, dark spots, or uneven pores. As we age, our cell-renewal factor reduces by half, so it's super important to encourage cellular turnover with advanced exfoliating treatments."
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Illustrated by Mallory Heyer.
How To Treat It
If you're worried that skin appears flat, ashy, or dull, the derm's office is the quickest fix: "A chemical peel combined with the Clear + Brilliant laser treatment is my favorite treatment for dullness," says Dr. Shah.

Luckily, this is one issue that you can treat at the spa. "Exfoliate and hydrate," Benjamin says. "As we age, it's so important to get professional exfoliation treatments monthly to speed up your cellular turnover and reveal your fresh, healthy skin." (She recommends the usual: microdermabrasion, peels, microneedling, and oxygen.)
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Illustrated by Mallory Heyer.
Forehead Lines
"These are caused by strong muscle movements with facial expressions, [which cause the] collapsing of the collagen fibers," Dr. Kao says. "Dynamic lines are there only when animating, and static lines are visible at rest."
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Illustrated by Mallory Heyer.
How To Treat Them
Sure, wrinkles and lines can (and should!) be treated by your regular microdermabrasion and peel appointments, which, for many, become essential after a certain age to maintain cellular turnover and skin health. But, there's really only one surefire way to lessen wrinkles.

"Botox works great in this area," Dr. Shah says, specifically for dynamic lines. "I may also recommend laser resurfacing if the lines are deeper, and present both with movement and rest."

For static lines, Dr. Kao also suggests facial detailing with micronized fat injections — it's not enough to just weaken the muscle movement; restoring volume also becomes important.
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Illustrated by Mallory Heyer.
Crow's Feet
Yep, you guessed it! "Crow's feet are wrinkles that develop around the eyes," says Dr. Shah.
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Illustrated by Mallory Heyer.
How To Treat Them
"My first line for crow's feet is botulinum toxin, like Botox, Dysport, or Xeomin," says Dr. Shah. "I will often discuss resurfacing laser treatments if the lines are very deep, or if there are other areas of concern on the face."

Regularly hydrating with a great eye cream and using microcurrents in the area will only help matters — consider a denser product, like Sisley Sisleÿa Eye & Lip Contour Cream.
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Illustrated by Mallory Heyer.
Frown & Laugh Lines
"These are deeper lines that we see in the lower face as we age," Dr. Shah says. "Laugh lines are the natural folds that run from the nose to the mouth — the nasolabial folds — and as the skin ages, they can become more prominent. Frown lines are the vertical lines that often develop between the eyebrows as we age. People often refer to them as the '11s.'"
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Illustrated by Mallory Heyer.
How To Treat Them
"For frown lines, the best method of treatment is still Botox," Dr. Shah says. "But, for laugh lines, I would recommend fillers with or without a resurfacing laser, like Fraxel, and a skin-tightening treatment, like Thermage."

This all depends on the severity of the issue: "If the lines are still mild, we can usually start with just the fillers. But, if there's a lot of wrinkling, I like to start with a resurfacing laser treatment," she adds.
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Illustrated by Mallory Heyer.
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