By Dr. Gunn
We know that acne is caused by pore plugging, infection and inflammation. We also know that hormone imbalances, stress, diet and cosmetics can cause pimples. Acne is a very common disease, and it has a stigma that can lead to distress in any person’s life. Acne can be distressing not only because of the way it looks, but also because of the physical pain it can cause in many cases, many times leaving permanent scars.
Dermatologists are your partners in acne defense, and we have numerous weapons in our arsenal that we can use to decrease acne. Some of these are over the counter medications, and others can only be prescribed by a dermatologist.
Disclaimer: We will be discussing and recommending many products in this blog series on acne defense, which will include a discussion of different ingredients so you can choose the best products for your skin. I recommend products that I have tried and that are my personal favorites, especially when it comes to over-the-counter products and moisturizers. However, my favorites may not be your favorites. Trying multiple products over time will be the best way for you to find the one that suits you and your skin. Acne is incurable, but the more knowledge you have about clearing acne, the better chance you have to improve your skin.
This blog series is meant to educate my patients, my friends, and even my family about how to treat minor breakouts and severe scarring acne, and more importantly, how to prevent them. For my patients, please read the entire series. For the parents of my patients, please read the series and have your child read the series and then discuss their acne treatment regimen with them. It is extremely important to be an active participant in your own care.
For those reading this blog who are not my patients, who are reading for education and self-treatment, please keep in mind that if your acne is still bothersome after trying the recommended cleansers, you should see a dermatologist. Don’t wait to see a dermatologist until you or your child already has acne scarring. Acne scarring is difficult and costly to treat and is absolutely preventable.
A common misconception is that acne is a “dirty face” disease, but the truth is that acne appears for a variety of reasons, and many of the causes have nothing to do with the cleanliness of your face! However, an appropriate cleanser can be tremendously beneficial in treating your acne regardless of what caused it. Most people only need to wash their face, chest and back once daily, ideally while showering or removing makeup. In the morning, gentle toning and refreshing is all that is needed. You can’t wash acne off your face, so avoid abrasive cleansers and scrubs or brushes with stiff bristles—the best ingredients for acne are naturally exfoliating, anyway.
As you begin the process of choosing the best cleanser for your skin, know that even the best cleansers can take about 2-12 weeks to really make a difference in your acne breakouts. There really is NO substitute for trying products to see which one works best for you, no matter what skin type you have. We have created a list of cleanser and toner ingredients to look for in your products so you can find the best cleanser and toner that works for you. This is not an exhaustive list, as there are thousands of ingredients in cleansers and toners for acne, but these are the ingredients that are most common and important.
Benzoyl Peroxide (BPO)
BPO kills bacteria and decreases inflammation. It is about twice as effective as salicylic acid washes and four times more effective than any other acne wash on the market for clearing and preventing acne. It works synergistically with antibiotics, making them more effective and preventing the formation of antibiotic-resistant bacteria.
Tips
BPO can be irritating to the skin. If you get irritation, use a lower percentage cleanser or dilute the 10% cleanser down to ¼ of the regular concentration. BPO can also bleach clothing. Use white towels and avoid using “leave-on” gels or creams containing BPO if you get irritated or start noticing bleached clothing.
Some Examples of Our Favorites
Cahaba Dermatology 5% BPO Wash
Onexton Gel Mixed with a Gentle Cleanser
Oxy Maximum Face Wash
Salicylic Acid (SA) Cleansers
SA breaks down the plug in pores and decreases inflammation. It is also known as beta hydroxyl acids and willow bark.
Tips
SA can be used if even the lowest concentrations of BPO are too irritating. SA is also great as a leave-on spot treatment or in a chemical peel. It can be more effective if combined with other gentle exfoliating acids. It also helps clear pigmentation and helps with wrinkles.
Some Examples of Our Favorites
Eminence Clear Skin Probiotic Cleanser
Skinceuticals LHA Cleanser
Oil-Free Acne Wash
Sulfur Washes
Sulfur is a smelly mineral found near volcanoes. It has anti-inflammation and antibacterial effects that can be beneficial for acne and rosacea. Some of these washes/masks are too smelly but my favorites are the ones they do not smell and it can even help with rashes around the nose.
Some Examples of Our Favorites
ZO Sulfur Mask
Ovace Face Wash
AcneFree Sulfur Mask
Glycolic Acid and other Alpha Hydroxyl Acids
Glycolic acid is derived from sugar cane. It decreases pore plugging and also decreases pigmentation and wrinkles. Other alpha hydroxyl acids include citric, tartaric and malic acids derived from fruit, lactic acids from milk, and mandelic acid from nuts. All of these can be helpful for acne and healthy skin when used correctly.
Some Examples of Our Favorites
SkinBetter Oxygen Infusion Wash
NeoCleanse Exfoliating Cleanser
Mario Badescu Glycolic Toner
Tea Tree Oil
Tea tree oil comes from the leaves of Melaleuca alternifolia, a small tree in Australia. It has anti-inflammatory, anti-septic, and soothing properties.
Some Examples of Our Favorites
Eminence Clear Skin Probiotic Cleanser
Trader Joe’s Face Wash with Tea Tree Oil
Witch Hazel
Witch Hazel is a plant that has medicinal properties including antiseptic, anti-inflammatory, and as an astringent it tightens the skin.
Some Examples of Our Favorites
SkinMedica Rejuvenating Toner
Eminence Rice Milk Cleansing Water
Biore Witch Hazel Toner
We mentioned above that you can’t wash acne off your face and that the best ingredients for acne are naturally exfoliating. but we get so many questions about Clarisonic and other cleansing brushes. We also hear questions about deep cleansing methods like Hydrafacials. So where do these fit into your acne defense arsenal?
The brushes are not necessary to clear acne, however there is some evidence that they can help the medications used for acne medications to absorb into the skin better. They also do a great job of removing makeup. If you do choose to use these brushes, be careful and get a gentle brush like the Clarisonics. Many of the copycat spin brushes are overly irritating to the skin and can cause rashes. Also, you may only need it once or twice a month, not daily as many companies suggest.
And for Hydrafacials—these are special cleansing procedures performed in many spa and dermatology offices. They deeply cleanse, extract, and infuse the skin with healthy ingredients. If you have acne or just want healthy glowing skin, this procedure is right for you no matter your skin type.
Want to open a conversation with us about acne treatment? Contact us today.