My daughter, who is now 22, has recently had some acne flair ups. I've watched her skin go through ups and downs over the last decade, and like most of us she has tried a multitude of treatments and products, just waiting to find something that will help. There are sooo many over the counter products that promise all sorts of results, making it easy to overdo it, potentially making your skin worse, or else causing you to feel like you’ve tried everything, but nothing has worked.
There are some main root causes of acne and generally it’s not caused by just ONE issue. Before going overboard on treatment products, here are some things to keep in mind when treating your acne:
Nothing is going to be a quick fix, or a one-time treatment, that will render perfect skin
Get recommendations from your provider including in-office treatments and at-home products
Don’t overdo it with too many products - cleanser, toner, retinol, moisturizer (and OF COURSE an SPF!!) It's OK to add in other corrective products but go slowly when changing or adding in new products. If you add-in or change more than one at a time and you have a reaction of some sort, you won't know which product is problematic.
Here are some of the main causes of acne flair ups, and product recommendations that may help with each underlying cause (this is lengthy so jump around as needed to find what is most helpful to your concerns):
1) Oily skin - Sebaceous glands become overactive with sticky sebum that can block pores, causing a build up of cells that can result in infection.
2) Bacterial presence - Too much bacteria will make the skin inflamed and red.
3) High pH of skin - Can be caused by genetics or products - balance this with facial wash and toner.
To treat these issues, start with your cleanser and toner. Here are some options and what they each target:
LHA Cleansing Gel is recommended for aging skin prone to breakouts. It contains lipo-hydroxy acid, glycolic acid, salicylic acid to remove excess oil, clean pores and brighten skin.
Clenziderm is purely 2% glycolic acid to unclog pores, target excess oil and has menthol for cooling. This is great for teens.
Toner, toner, toner!! I can't stress this enough. Toner is a wonderful and under-utilized product that balances pH. Three options:
LHA Toner is a glycolic acid toner ideal for combination or oily skin, and is designed for aging skin. It contains three exfoliating agents to efficiently removes excess residue and surface cells to get rid of clogged pores. It also has a low pH.
Equalizing Toner: This toner is for dry, sensitive and normal skin types. I use this every single day after I wash my face. If you ever have that dry, tight feeling on your face after washing, toner will relieve that instantly. Equalizing toner will balance pH, gently exfoliate with hydroxy acids, and will soothe skin with botanical extracts of witch hazel, rosemary, aloe, and chamomile.
Clenziderm Pore Therapy: A 2% salicylic acne treatment, designed to be used in conjunction with the Clenziderm Foaming Wash and followed by Clenziderm Therapeutic Lotion which contains 5% benzoyl peroxide to help dry up active acne.
4) Hyperkeratosis - Skin cells form irregular growth patterns due to impairment from genetics or certain products. Treat with a retnoid. Retinoids help with skin cell turnover, collagen stimulation and can reduce inflammation and help even out skin tone and pigment issues. If appropriate, we can offer a prescription strength retinoid, or else you can try any of the Alpha Ret products. How do you know which one is best for you?
Original Alpha Ret: a retinoid combined with alpha hydroxy acids, with a delivery system that allows for little to no irritation. Significantly improves skin texture, lines, and tone.
Alpha Ret Intensive: This is the same as the original but there is a more intensive concentration of glycolic acid which can help with more rapid skin cell turnover. This is great for men too, as they have thicker skin than women.
Alpha Ret Exfoliating Peel Pads: These peel pads have the same retinoid in them as the Alpha Ret creams, but they also exfoliate (one side of the pad is slightly abrasive), and they include a triple-acid complex (lactic, glycolic, salicylic) that provides additional exfoliation, skin brightening, and pore cleansing benefits.
Alpha Ret Clearing Serum: Includes the same retinoid as the other Alpha Rets but has a higher concentration of salicylic acid to help with oilier, blemish-prone skin. If you tend to have acne you would choose this Alpha Ret over the original or Intensive.
5) Dehydration - Topicals that treat acne can cause dehydration so counteract it with products that repair the skin barrier. Options are Skin Ceuticals Triple Lipid and Skin Better’s Trio:
Triple Lipid is an anti-aging cream that contains: 2% pure ceramides: 4% natural cholesterol: 2% fatty acids This is a proven combo that helps restore skin's external barrier and support natural self-repair, while nourishing the skin for improvement in the visible appearance of skin smoothness, laxity, pores, and overall radiance. It also shortens the adjustment period to retinoids up to 1 week while reducing dryness.
Trio: Contains hyaluronic acid, urea and botanicals to hydrate skin, and cholesterol, ceramides, lipids, squalene and essential fatty acids to support the skin barrier. It helps balance your skin's hydration levels while also targeting fine lines, restoring smooth and supple skin, and restoring radiance. It also slows the breakdown of your natural hyaluronic acid.
6) Hormones: Changes in hormone levels, whether from puberty or monthly changes or even peri-menopause, can cause flair ups. Sometimes hormonally-caused acne can be cystic and may best be treated via prescription oral medication. However, if yours is more mild, you can always try a retinoid.
There are of course a multitude of other preventative and corrective products available but a good, basic skincare regime is cleanser, toner, retinol, moisturizer, SPF. Sunscreen is essential, particularly if you have acne, because the sun can cause your acne to hyperpigment, leaving brownish spots on your skin after the acne heals.
A few additional products that can be useful:
Skin Ceuticals Phyto Corrective Gel: an oil free moisturizer, that is botanical-based product to reduce redness and inflammation
Skin Better Even Tone: Targets all types of pigmentation, including PIH, which is the pigment left behind after acne heals
Any of our facial masks (here's a blog on what they each target)
Skin Ceuticals Blemish and Age: Salicylic acid treatment for aging skin (can be used all over or as a spot treatment for blemishes...think Clenziderm Therapeutic Lotion for aging skin)
Any Skin Better or Elta MD sunscreens
In-Office Procedures
HydraFacial There are various options for customization depending on exactly what your skin needs. Hydrafacial includes deep cleansing, extracting, and hydrating, a salicylic acid treatment, specialty booster serums and LED light therapy that helps control bacteria. Add-on options are: (1) lymphatic therapy which can help with inflammation, and (2) extra extraction time if needed.
BroadBand Light (BBL) Forever Clear This is the same machine that we use for all of our photofacials. BBL Forever Clear uses light therapy to treat acne. Step 1: Skin is first treated with blue BBL light to eliminate acne-causing bacteria at its source, deep down in the pores. Step 2: Skin is then treated with yellow BBL light to reduce the inflammation and acne-associated redness to give you healthy, luminous skin. Step 3: The skin is treated with SkinTyte using infra-red light in rapid, gentle pulses to initiate the body’s natural healing process.
BBL delivers the light energy deep into your skin to stimulate and regenerate your skin cells, leaving you with clear, healthy, radiant skin.
If you’re dealing with acne, we know how frustrating it can be. Many of us here have dealt with cystic acne, and have taken multiple rounds of antibiotics and/ or Accutane. Hopefully that’s not the case for most, and these treatment options can work. Talk about your issues with your provider and decide which course of treatment is best for you, then stick with it for awhile to really give it a chance. Treating those root causes and returning your skin to a normal, uninflamed state takes time!