I wanted to compile a list for the person that is cleaning up their diet, cleaning up their skin care, cleaning up their stress, and may still be experiencing some acne breakouts. After working in dermatology for years, I’ve picked up a few things that my patients have, or have not been doing, that can cause acne breakouts, too. These small tips and tricks may not be the cure all, but sometimes they’re that last little step or that “Ah-ha” moment you were looking for.
Loofahs: We do not need loofahs, wash cloths, or other skin washing tools in the shower. All of these are huge harbors of bacteria. That warm, wet environment is a bacteria dreamland. Loofahs and washcloths can also be very irritating on the skin as they tug and pull. If you’re irritating the skin, follicles, and pores while simultaneously lathering it with bacteria, it’s no wonder people continue to breakout, especially on their backs, arms, shoulders and chest.
Speaking of wash cloths, it’s helpful to change these often. Similarly to that noted above, when we continue to use the same face towel to dry our faces, it starts to build up bacteria, too. I like to use one each day, and then toss in the hamper after using both sides. My first use on side one is in the morning after cleansing my face with plain water (more on this in a moment), and my second use is on the second side in the evening after my double cleansing routine.
Pillow Cases: While we’re on the conversation of changing things regularly, pillow cases should also be swapped. Sleep on one side night one, sleep on second side night two, and change. If you’re using skin care, hair care, and oral care without pore cloggers, there will be less build up of “the bad guys” that can transfer product back onto your face and cause acne. But we’re still sweating, losing dead skin cells, and smearing skin care onto our pillow cases. It doesn’t hurt to change them.
Cleansing: You do not need to use a cleanser in the morning to wash your face unless you want to. Our skin has built up oils over the course of the night, and while we want to rinse some of the sweat and skin care build up that has accumulated, we don’t necessarily want to strip our skin of those good, natural oils either. Warm (never hot) water and a couple rinses should be all you need to prep your skin for its morning products.
If you are going to use a morning cleanser, I recommend something gentle, without “acne fighting” ingredients in it, as oftentimes those can irritate the skin more, especially if you’re already dealing with dryness or irritation from other products.
Cleansing #2: We should be double cleansing in the evening. If you’ve never done this, try washing your face with a gentle cleanser, and then again with some sort of makeup remover, and you’ll see how much dirt, grease, and oil has been left over after the first wash. My preference changes here from time to time. I typically like a gentle cleanser, followed by micellar water on a cotton round, or an oil-based cleanser, followed by a gentle cleanser.
Mechanical Exfoliating: Mechanical exfoliating is the literal or physical act of scrubbing* on the skin. As a reminder, people prone to acne have retention hyperkeratosis, which is an accumulation of dead skin cells that build up on the surface of the skin, increasing the risk of pore blockage. For this reason, it is important to introduce some form of mechanical exfoliation a few times a week. I do like a scrubbing bead product, and my current favorite is ClearStem Bamboo Scrub.
*When I say scrubbing, I never ever mean harsh scrubbing. We cannot scrub the acne off of our skin, and quite the opposite, harsh scrubbing can worsen acne breakouts. Mechanical exfoliating should be gentle. We do not need to apply much pressure because the product should be effective enough to gently pull the dead skin cells up and away. Think about just barely trying to remove that top layer of skin.
We also do not need to mechanically exfoliate daily. This should be 3-5x a week max, and during times of intense acne breakouts, I would error on the side of caution and opt gentle cleansers until the breakout is controlled, and then resume and every other night routine.
Chemical Exfoliating: Chemical exfoliating is when a product sits on top of the skin and does the exfoliating for you (like a retinol or an acid). Because these are helping aid in skin cell turnover, they can cause some dryness and irritation when adding into your routine. We should start these 2x weekly, then increase to every other night, and then increase to nightly as tolerated. We should also be cautious when adding multiple chemical exfoliators. Examples of these are: lactic acid, glycolic acid, malic acid, salicylic acid, mandelic acid, retinol, tretinoin, and bakuchiol. If you have sensitive skin, make sure you can tolerate one acid product daily before adding additional acids into your routine. This includes morning and nighttime use. If we use too many chemical exfoliators too early, the skin can become red, irritated, and possibly increase acne breakouts. Start slowly, tolerate your current products, and then add from there.
Trialing New Skin Care: Speaking of starting slow, when you get a new skin care product, chemical exfoliator or otherwise, slowly build it into your regimen. This one can be hard because when you get something new, it’s fun and exciting to lather it everywhere. But if you are acne prone, or have sensitive skin in general, it’s worth trying a small sample spot at the corner of the face for the first 1-3 days to determine you’re not going to have a reaction to it, and then build from there.
I do want to mention something about this further. My forehead is very sensitive. If I start a new product, my forehead is the first to react. I don’t get acne breakouts, but I will develop a very mild red, bumpy rash. Does this mean that skin care product doesn’t and can’t ever work for me? Not necessarily. When this happens, I reduce my use of the product to every other day. I never apply directly to my forehead, but apply everything to the rest of my face and neck first, and then massage anything left over on my hands into the forehead last. After a week or so, I increase to daily use, still applying product to my forehead last. After another week or so, I can apply product to my forehead at any point, and my skin tolerates it fine. This is something that works for me. I have never had to stop using a skin care product following these steps.
Listen to your skin: Is it red, painful, or burning after application of a skin care product? Is it irritated and flakey? Is it dry, yet somehow, you’re still developing acne in the same area? If any of these are true, your skin is saying, please listen to me! I need something from you! One thing I cannot do as a practitioner is listen to your skin for you. If you’re given a recommendation that works for one person, but doesn’t work for you, it’s okay to let that product or regimen go.
If we listen to our skin, it will tell us things. It will glow when it’s happy. It will burn when it’s hurt. It will say I like that moisturizer! Or say please stop feeding me dairy (hello acne around the mouth and chin).
And by the way:
Red, painful, or burning after application of a skin care product: rinse it off. Be gentle, provide moisture, and go without chemical exfoliators for a night or two.
Irritated and flakey: your moisture barrier might be compromised. Be gentle, provide moisture, and go without chemical exfoliators for a night or two.
Dry + acne: your moisture barrier might be compromised and the dry skin is leading to more trapped/clogged pores, allowing acne bacteria to flourish. Be gentle, provide moisture, and go without chemical exfoliators for a night or two. Slowly introduce chemical exfoliators back in over the course of a few weeks.
Less is More When Just Getting Started. So many people with acne run to their local dermatologist, esthetician, Sephora, Ulta, or friends for recommendations on skin care, and leave with 8 new products that they have no idea what, how, or when to apply. Maybe I’m not the best sales person, because when patients come to me, I typically like to recommend a maximum of 2-3 products to get started with, and encourage them to return to me in 1-2 months so we can tailor their skin care needs after everything has calmed down. An extremely basic routine would include a gentle cleanser, sunscreen, and moisturizing product. I do believe acne fighting products are helpful, but I typically find reducing the inflammation of the skin is the first step to reducing acne.
Your Partner: if you have a partner, think about his/her hair care, oral care, and skin care. For instance, if he/she is using shampoos with pore clogging ingredients in them, and then resting his/her head on your face, the product can transfer onto your skin and cause acne breakouts.
And more on that, Be Inquisitive: Have acne on one side of your face? Think about what comes into contact with that side. Is that your sleeping side? Is that your cell phone side? Do you rest your head in your hands that you’re constantly rubbing in Dove lotion? Do you only get acne around your mouth? What lip balm are you using? What toothpaste? Only you can see the day-to-day changes in your skin. Especially once you clear your skin with all the other recommendations previously given and shared here, you’ll be able monitor and manage new breakouts so much easier. And they won’t stress you out as much, because you’ll be able to say, Oh! It must have been this! And you’ll know that no longer works for you.
Be Kind To Your Skin. I mentioned this earlier: when your skin is breaking out, or red, or irritated, or dry, it’s trying to tell you something. Be kind to her. She’s doing the best she can, and this is her way of discussing this with you. I have another article on stress, and stressing about our skin can worsen, create new, and prolong acne breakouts. It’s not fun to have acne – I know this, you know this, and the millions of other people around the world suffering with acne know this. But take a deep breath. Tell your skin you love her. And move on gently, both in products and in thoughts for your skin.
Comments