So what to do about these skin changes that lead to acne? Let's break it down.
1. What to do about excess oil production?A number of products handle sebum in different ways.
First, mattifiers are products that control shine, but
they don't all work the same! Pay attention here. Most desirable is a water-based lotion with oil-absorbing polymers such as
Derma Doctor's Tease Zone. This type of mattifying lotion absorbs excess oil and lifts it away from the skin's surface, and works for a period of time (usually 8 hours or so) to keep skin looking un-shiny.
Another easy option is blotting papers. These are small squares of thin paper made of an absorbent fiber. Blot them on your face, and they absorb oil without disturbing makeup. I really like
Boscia's Fresh Blotting Linens, but I also just found out that e.l.f. has
blotting papers for $1 per box. I may have to try these.
Other mattifying products may contain alcohol or other astringent (drying) agents. These remove oil from the skin's surface temporarily, but don't control oil produced throughout the day. They are not recommended because wiping alcohol on your skin can cause over-drying, irritation, and can upset skin's pH balance and normal oil production.
Still other mattifying products are silicone- or dimethicone-based. According to
Derma Doctor, these work by creating a barrier close to the skin's surface and trapping oil underneath. The skin stays looking matte, but trapping all that oil can lead to breakouts and other problems. This is not a good option for daily use on oily skin.
Second, topical retinoids decrease oil production, among other actions (more below). These include Retin-A, Differin, Tazorac, and over-the-counter retinol products.
Third, many other acne treatments also remove oil from the skin. Glycolic acid, salicylic acid, and benzoyl peroxide temporarily decrease surface oil (among other actions - see below), but they don't alter the underlying amount of oil produced by the skin.
Finally, birth-control pills and other hormone-altering medication (such as spironolactone, an anti-androgen)
can decrease oil production by changing levels of the hormones that partly control sebum. My personal opinion (and I'm not a doctor!) is that taking hormones purely for cosmetic purposes is probably not the best thing for your body. I would try other products first to try and get oil/acne under control. Read on for more options.
2. What to do about retention hyperkeratosis (excess dead skin cells clogging pores)?The star of this category may be the
retinoids. They "normalize keratinization," meaning that they make skin cells act more like those of people without acne. Retinoids decrease the abnormalities that cause dead skin to hang on in your pores and cause blockages.
Glycolic acid, salicylic acid, and other alpha- and beta-hydroxy acids also promote cell turnover and decrease dead cells "sticking" around. Azelaic acid (prescription Azelex) may also normalize keratinization.
Many of these agents are available in multiple forms - cleansers, toners, moisturizers, treatment serums, and treatment creams. Usually you'll need to use some type of treatment that stays on your face for a while, rather than just a cleanser, in order to see results. Remember that any of these products can dry skin and make it sensitive! For that reason, start off using retinoids or alpha- and beta-hydroxy acids every other night, and do not layer them one on top of the other. You can use them at different times of day (morning and night, for example), but not at the same time.
Also
sunscreen is a MUST if you use any of these products, as they increase your skin's susceptibility to sun damage.
3. What to do about bacteria?As I mentioned in the previous article, bacteria does not cause acne. It does contribute, though. Several products are designed to kill bacteria on your skin in order to reduce blemishes.
First are antibiotics. Systemic antibiotics (taken internally, in pill form) act throughout your body, including on your skin, to reduce the number of bacteria available to colonize clogged pores.
Topical antibiotic creams or gels are applied to the skin and work to kill bacteria only where applied.
Antibiotics require a prescription and ongoing use. In my opinion (and again, I'm not a doctor!) systemic antibiotics are probably not the best thing for your body. We have all types of bacteria colonizing our bodies, good and bad, but antibiotics kill all of it. This can potentially lead to imbalances of beneficial bacteria and related problems.
Second is benzoyl peroxide. This is applied to your skin and is slightly different from other antibiotics. While other antibiotics contain some toxic compound that kills bacteria, benzoyl peroxide alters the environment on your skin so that
P. acnes can't thrive.
P. acnes is an anaerobic bacterium (lives in the absence of oxygen), and benzoyl peroxide is an oxidizing agent that makes more oxygen available. Thus it alters skin chemistry to provide more oxygen than
P. acnes likes.
In my limited experience, benzoyl peroxide works well for some people and not at all for others. It's cheap and readily available over the counter, so try it for yourself and see if it works. This is the basis of the
Proactiv Solutions line of products.
Third is sulfur, which works in an unknown fashion to reduce bacteria. Sulfur is a component of several prescription treatments and, again, some of the Proactiv products, and it's also available in some facial masks. It may decrease oil as well as controlling bacteria. One downside to sulfur is that it smells like, well, sulfur. Think matches or some chemistry experiments. It's not terrible, but it does linger on your skin.
Fourth, the Zeno Acne Clearing Device works by applying focused heat at a constant temperature to a blemish in its beginning stages. The heat purportedly kills bacteria and heads off the formation of the pimple. The product information says it doesn't work on cystic blemishes, and I found this to be true.
This is a fairly thorough but not exhaustive list of your options for managing acne. General rules for caring for acneic skin include:
- Wash only twice a day, or a third time if you've worked out.
- DO NOT use grainy scrubs to exfoliate. This will irritate blemishes. Instead, use an alpha- or beta-hydroxy acid product or retinoid. These exfoliate dead cells without mechanical friction.
- Start slowly and don't mix products on your skin. Pick one agent and try it for 8 weeks to see if it works. If not, try something else.
- If you have insurance or can afford it, by all means go to the dermatologist. They can really help in ways that poking around at the drugstore cannot.
Finally, for lots more information, check out
Derma Doctor's Articles section. Granted, this is a website devoted to selling products, but I have found her articles to be full of non-product-related information and up-to-date on dermatological research and innovations.
Good luck with your skincare! You
can manage acne; it's a matter of finding the right products for the acne contributors that are affecting your skin.
...an eyeliner brush! How I lived without this tool for so long I have no idea. I've long been a fan of wetting an eyeshadow applicator (yes, the cheap foam ones, don't laugh) and using wet, dark eyeshadow to line my eyes. This gives a thick smudgy line that I am quite fond of.
