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Blasting Away At Acne

By Megan Griffith

Reviewed for medical accuracy by Dr. Jaggi Rao,
MD, FRCPC Double board-certified dermatologist

If you think you have heard about every technique that has ever been invented for eliminating acne, think again. The latest treatment for the world’s most common skin condition involves blasting away acne with ultrasound.

Clarisonic Pro for Acne
The Clarisonic works by removing dead skin cells from pores before sebum and bacteria can accumulate and form a blemish.

There Isn’t Just One Cause Of Acne

Ultrasound, which we’ll consider in more detail in a moment, is not a miracle cure for acne. It brings acne care to a new level, but it is not a stand-alone cure or even a stand-alone treatment for any kind of acne.

The treatment of acne is always multifactorial because the causes of acne are always multifactorial1. While there are literally hundreds of contributing factors that determine the severity of acne, there are primarily four processes that create acne-related blemishes:

  • Follicles become plugged2 with accumulations of dead skin from the lining of the pore.
  • Sebaceous glands at the base of the pore produce more sebum than the pore can drain.
  • Acne bacteria, primarily a species known as Propionibacterium acnes (P. acnes) accumulates underneath the plug of dead skin cells from the lining for the pore and accumulated sebum.
  • Inflammation generated by the immune system causes redness, irritation, and swelling.

There are more pores on the face, neck, back, and chest than anywhere else on the body, so we get more acne on those locations. We don’t have many skin pores, say, on our feet, so essentially no one ever gets acne between their toes.

The standard treatment for acne consists of3 a retinoid, benzoyl peroxide, and an antibiotic. Throughout this site you’ll find many suggestions about better combinations of treatments that will give you faster and more complete results, but this typical trio of prescription meds has a sound scientific basis.

Retinoids are derivatives of vitamin A that stimulate the growth of the skin. The skin pulls away from the sides of the pores and the contents can simply fall out. Retinoids can be helpful for both non-inflammatory blemishes, such as whiteheads and blackheads and inflammatory blemishes, such as pimples and cysts.

Benzoyl peroxide is antibacterial. Killing acne bacteria is just about all that benzoyl peroxide does, although in some skin types it also strips away dead skin over pores and helps them drain faster. The nearly universal problem with benzoyl peroxide treatment is that a formula that is strong enough to kill acne bacteria is also strong enough to dry out and irritate the skin. If the only treatment you use for acne is benzoyl peroxide, there will be a point at which the drying and irritation of your skin closes as many pores and forms as many new blemishes as the antibacterial action of benzoyl peroxide heals.

Antibiotics are a second line of attack against acne bacteria. Most prescription antibiotics also kill other kinds of infectious bacteria on the skin. Benzoyl peroxide and antibiotics together4 reduce the risk of leaving “stray” bacteria that can come back with a vengeance when treatment is stopped.

It’s easier to write an advertisement about “fighting” acne bacteria than it is to create a sound bite explaining why blemishes start with the accumulation of dead skin. If the pore is never blocked by the accumulation of dry, dead skin cells then acne bacteria and sebum production are a minimal problem or no problem at all.

Ultrasound For Stopping Acne Before It Starts

Pacific Biosciences in Seattle has created an ultrasound deep cleaner for removing dead skin cells from pores5 before sebum and bacteria can accumulate and form a blemish. The device is known as the Clarisonic. It has a rotating head that generates 300 vibrations per second to jostle dead skin loose from the lining of pores with the help of nonabrasive cleansers.

It’s probably stretching the meaning of the term to refer to the Clarisonic cleaner as operating with “ultrasound.” The kind of ultrasound used in medical diagnostic imaging operates at about 3 million vibrations per second. A “sonic knife” operates at about 5 million vibrations per second. The home therapy kits you can get for applying skin treatments run at about 1 million vibrations per second.

These true ultrasound devices create standing waves that rearrange the cells in the skin. They force a tiny opening in the skin that is large enough to admit molecules of certain skin treatments in to the skin but not large enough to admit viruses, bacteria, or other microorganisms, good or bad. Tiny tunnels in the skin stay open for about 100 vibrations, or 1/10,000th of a second. That’s long enough to for a treatment that ordinarily stays on the skin to get into the skin.

Of course, you want to be very careful what you use on your skin with you follow up with true ultrasound treatment.

The Clarisonic does not have this kind of power. It only has enough “oomph” to break up a kind of protein glue that keeps dead skin cells in clumps on top of and inside pores. It also can remove makeup much more thoroughly than any other cleansing technique. If it is used twice a day it can help remove excess oil from pores.

True ultrasound can deliver6 a skin care treatment into the skin. The Clarisonic can just force a treatment into pores. It can force a treatment below the normal contour of the skin, but it does not send anything to a level that can find its way into the rest of the body.

Using The Clarisonic To Fight Acne

Pacific Biosciences tells Clarisonic customers that just 60 seconds with the “ultrasound” wand is enough to open pores. That allows everything else you do for acne to work just a little better. The manufacturer also claims that Clarisonic will relieve puffiness—but don’t apply it to pimples. You don’t want to apply just enough pressure to open the skin and let still more infection in without opening the pimple to let existing infection drain out.

Clarisonic costs about US $119 plus shipping and taxes. It’s not a bad investment for skin care, but it’s better for preventing acne than it is for treating it. If you need to get your acne under control, you will probably be better off spending $99 on Exposed Skin Care, which offers a kit of 10 products for taking care of your skin, and then graduating to other products to keep your complexion clear.


  1. Rocha M.A., Bagatin E. Adult-onset acne: prevalence, impact, and management challenges.Clinical, Cosmetic, and Investigational Dermatology. 2018;11:59-69.
  2. Johnson B.A., Nunley J.R. Use of Systemic Agents in the Treatment of Acne Vulgaris. American Family Physician. 2000;62(8):1823-30,1835-6.
  3. Kraft J., Freiman A. Management of acne. Canadian Medical Association Journal. 2011;183(7):E430-5.
  4. Kircik L.H. The role of benzoyl peroxide in the new treatment paradigm for acne. Journal of Drugs in Dermatology. 2013;12(6):s73-6.
  5. Akridge R.E., Pilcher K.A. Development of sonic technology for the daily cleansing of the skin. Journal of Cosmetic Dermatology. 2006;5(2):181-3.
  6. Fabi S.G. Noninvasive skin tightening: focus on new ultrasound techniques. Clinical, Cosmetic, and Investigational Dermatology. 2015;8:47-52.
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