Are you struggling with acne and feel that you are throwing everything at your skin with no improvement?
Feeling overwhelmed when you look at the array of products promising clear skin?
Let’s take a look at a simplified approach to understanding the WHY and HOW of treating those pesky breakouts.
When approaching acne, the first step is to assess the TYPE of acne you are struggling with:
- Painful red or pus-filled pimples; tender deep ‘under-the-skin’ cysts? You have primarily INFLAMMATORY acne
- Bumpy skin with white bumps under the skin or blackheads? You have primarily RETENTIONAL acne.
- Both retention and inflammation? You have a MIXED-PICTURE type of acne.
Now this is a bit of an oversimplification because you cannot diagnose acne without seeing blackheads or comedones but you get the idea!
Instead of rattling off a list of ingredients, let’s rather look at what is happening in the skin and where each ingredient is working.
NOTE: that regardless of whether your acne is retentional (primarily the process happening in steps 1 and 2) or inflammatory, retinoids remain the foundation of acne treatment. Since the comedone formation is the first step in the pathogenesis of acne, you always need to address it.
What is happening in the hair follicle is only part of the story. Here are some other factors to consider namely
- antioxidant protection to prevent free radicals causing what is known as lipid peroxidation (essentially oxidation of the sebum – another important process in acne)
- protecting and repairing the skin barrier.
A big misconception is that you want to dry out your acne. Emphatically NO! What can happen if we massively suppress sebum production? Skin gets dry, red, flaky, sensitive and itchy. Acne sufferers tend to have an impaired skin barrier with dehydrated skin owing to what is known as transepidermal water loss (TEWL): essentially losing water through the skin which is supposed to lock it in. You can see why an irritated, inflamed skin with a faulty skin barrier will only worsen this. This not only prompts the skin to produce more oil (sebum) and delays how efficiently the skin cells can move through the hair follicle without building up, but also promotes inflammation which weakens the wall of the hair follicle making it more prone to rupture. So not only will your skin feel red and irritated but you will get more breakouts too. The take home message: Moisturize! Moisturize! Moisturize! Do not skip this step at any cost! Over-drying will only amplify the problem. Look for non-comedogenic formulations with added ingredients such as ceramides, Niacinamide and panthenol to fight inflammation and repair your skin barrier.
So what would a typical skincare regimen for acne-prone skin look like? Something like this:
NOTE: This is a general guideline and skin doesn’t always follow the rules! If you are not having any luck in clearing your acne then please seek expert advice from your dermatologist. Acne treatment needs to be tailored to each individual and only your dermatologist can give you the best personal recommendations. Acne is easier to treat than acne scarring.
Lastly, remember that acne treatment takes time. There is no quick fix. So be patient and be consistent.