Acne – What’s the Right Skin Care?
Before reading this blog, if you’ve not done so yet, it may be helpful to read my previous acne blogs:
- Acne – How and why do we get it?
- Acne – Complications and consequences
- Acne – Does diet affect acne?
As discussed in my first blog, acne is caused by a disorder of the pilosebaceous unit – most commonly an overproduction of oil and collection of dead skin cells which block the pores. It follows that many treatments aim to reduce oil production which leads many to suffer with dry skin. A balance needs to be achieved between a reduction (rarely complete clearance) of outbreaks vs comfort. This should be in the hands of the patient to adjust as is necessary – the strength of treatment can be completely different between individuals.
A decent cleanse
Always start with cleansing but take off any heavy makeup with a wipe or makeup remover first. A good cleanser should contain a weak acid such as glycolic or salicylic - use twice a day over a basin of tepid water or in the shower morning and night. Oil control is really important and one of the best ingredients is salicylic acid – it controls oil, unblocks pores, is antibacterial and anti-inflammatory. One of our best sellers is ZO TE Pads - 60 textured cotton pads soaked in 2% salicylic acid, one to be used up to twice a day after cleansing.
Don’t make your congestion worse!
The night time routine is important as tucked up in warm beds, in centrally heated and double glazed rooms, skin will sweat and product oil… you don’t want to create any barriers to it flowing out onto the skin freely. That means never sleeping in your makeup! This will clog pores and increase the chance of congestion and breakouts. The same goes for thick creams or oils – unless there is a specific problem your product is treating, less is more and don’t use it.
Vitamin A products not only are fantastic for anti-ageing but they also reduce oil and increase exfoliation. This is one to use at night time as sunlight breaks it down. Just watch out for the fact that it can cause irritation but this is dose dependent and will reduce as your skin builds up tolerance. There are lots of different products containing different strengths of vitamin A – for those needing something stronger, I prescribe tretinoin, a prescription strength cream that is a first line treatment.
GPs may prescribe Benzyl Peroxide cream (which can now also be bought over the counter) which is a useful way to help dry the skin. However, it can cause peeling and bleaches fabrics so don’t use your best towels or bed linen!
Oil Control or too dry?
If you’ve been paying attention so far, you’ll know that suffering with acne almost always means that your skin is too oily and that many treatments aim to control oil production. This often leaves clients feeling like their skin is too dry and sometimes red, irritated and peeling which can feel like no improvement at all. The aim is to get the balance right for YOU – this is different for everyone and no-one can tell you what is right. Ultimately, you must try to run your skin a little on the dry side and hope that this is enough to control your outbreaks. If not, you need to run it a little drier still until either the acne is improved enough to make you happy or the skin is too dry to bear. If this still isn’t helping, you will need to review your programme.
Most of my clients who say they have dry skin but on examination, it looks normal. What they often mean is that after washing or showering, their skin is tight and dry. Of course, this is how all skin feels as it has just been stripped of oil! If they were to leave it for 10-30 minutes, that feeling would pass as the skin started producing more oil. Immediately heading for a thick moisturiser only makes the problem worse. If skin really is dry, a light non-comedogenic product such as SkinCeuticals Hydrating B5 Serum is perfect.
Improve skin health
What about those who have breakouts but also seem to have dry skin? these people need to strengthen their epidermal barrier function and improve their skin health. A poor epidermal barrier allows too much water to be lost through the skin leading to the dryness in addition to too much oil production that leads to the outbreaks. Read my article here to learn a little more about skin health.
Read about the treatments we offer for acne and acne scarring:
Dr Askari Townshend is a GMC registered doctor, qualified in 2002, and Member of the Royal College of Surgeons, England. He is founder and Medical Director of ASKINOLOGY in the City of London and has been practicing aesthetic medicine full time since 2008.