Acne Advice: Skin Care Solutions For Both Teens and Adults Alike
Medically reviewed by Carmen Fookes, BPharm. Last updated on Jan 11, 2021.
Dead Skin Cells + Excess Sebum = Clogged Pores
Acne is caused by dead skin cells sticking together and clogging up pores. Bacteria can play a role, too.
Our body constantly makes and sheds skin. Normally, dead skin cells rise to surface of the pore, and just flake off our body. At puberty, hormones trigger the production of sebum - an oily substance that helps moisturize our skin.
Sebum sticks dead skin cells together, increasing their chances of becoming trapped inside a pore. Clogged pores become blackheads, whiteheads or pimples. If bacteria are also present, redness and swelling can occur resulting in progression of the pimple into a cyst or nodule.
Acne Now More Common in Children and Adults
A big trigger for the onset of acne is puberty. At puberty, hormones trigger oil glands surrounding our hair follicles to make sebum - the thick, oily, substance that ends up blocking skin pores and forming the lesions.
Better nutrition and living standards has seen the age of puberty, especially in girls, decrease significantly over the past 40 years. It is now not uncommon for girls as young as 7 to develop acne. Acne is also affecting more adults later in life and doctors are not sure why. A growing number of women have acne in their 30s, 40s, 50s, and beyond.
Why Do I Get Massive Breakouts When Other People Don't?
Unfortunately, some people suffer from acne worse than others. Bad acne tends to run in families - your mother, father, aunt or uncle probably had severe breakouts when they were a teenager. Some people also have naturally higher hormone levels, and make more sebum, so their skin pores are always clogging up.
If you have severe acne you need to be very proactive with skin cleansing and using acne treatment. Seeing a dermatologist early on for prescription products lessens the chances of being left with permanent scars. Beware of over-the-counter product side effects, too.
Humidity, Greasy Jobs, Hair Products, and Medicines Can All Cause Breakouts
If you live in a part of the country that gets very humid, or have a job which exposes you to moist heat (such as in a food kitchen) or grease or tar (a mechanic or road worker) then you are more likely to get acne.
Chin straps, head bands, and even hair products applied too close to the skin can precipitate a break out as can a number of different medicines - most notably prednisone, phenytoin (Dilantin) and certain hormonal contraceptives that are high in androgens (for example, Microgestin 1.5/30 and the Depo-Provera shot).
Out Spot Out
The most important thing you can do to reduce the chance of breakouts is to take good care of your skin. This doesn't mean scrubbing it raw several times a day with soap. It means gently cleansing it with a mild soap-free wash twice a day, every day. If you play a lot of sport or work in a greasy or humid environment, cleanse your skin as soon as you finish training or right after work.
Be gentle. Your aim is to cleanse away excess sebum and dead skin cells so they don't clog up your pores - not to irritate your skin even further.
What To Look For in a Good Cleanser
The first step to clear skin is clean skin. Look for a cleanser that is soap-free and does not contain any harsh detergents such as sodium lauryl or laureth sulfates, which can cause redness, irritation, and inflammation.
There is a huge range of products out there. Try to find one that suits your budget and doesn't contain any pore-clogging ingredients (such as algae extract, carrageenan, lanolin, myristyl myristate, octyl palmitate, octyl stearate-5, and oleth-3).
Acne Treatments Unclog Pores or Help Skin Cells Shed
The good news is that virtually every case of acne can be treated. People with more severe acne may need to see a dermatologist, but people with mild acne should be able to find a product at the drug store that works for them. Anti-acne products are used on clean skin.
Look for products that contain ingredients such as benzoyl peroxide (for example, AcneClear, ClearPlex, generics) or salicyclic acid (such as Acnevir, OxyFace Scrub, generics). Ingredients such as resorcinol (for example RA Acne, Resinol) are also effective. Anti-acne ingredients work by removing dead skin cells, unclogging pores, or reducing bacteria numbers on the skin.
Prescription Medicines For Acne: Topical Acne Treatments
There are a number of different topical and oral medications that doctors or dermatologists can prescribe to treat moderate-to-severe acne.
Retinoids and retinoid-like creams, gels, and lotions are derived from vitamin A. They have anti-inflammatory effects and act inside the hair follicle to normalize hyperkeratinization. Examples include tretinoin (Avita, Retin-A), adapalene (Differin) and tazarotene (Tazorac, Avage). Some redness, skin peeling, or worsening of acne may occur initially. This may be minimized by using the product every second day instead of daily.
Topical antibiotics kill excess skin bacteria and reducing inflammation and products also include benzoyl peroxide to reduce the likelihood of antibiotic resistance developing. Examples include clindamycin with benzoyl peroxide (Benzaclin, Duac, Acanya) and erythromycin with benzoyl peroxide (Benzamycin).
Azelaic acid is a naturally occurring acid found in whole-grain cereals and animal products that has antibacterial properties. It is usually used twice daily for at least four weeks and prescription azelaic acid (Azelex, Finacea) is an option during pregnancy and while breast-feeding.
Dapsone gel (Aczone) contains a sulfonamide-type antibacterial agent that may be applied twice daily to treat inflammatory acne. Side effects include redness and dryness.
Winlevi cream contains 1% clascoterone cream which is an androgen receptor inhibitor. Winlevi prevents the binding of androgens, specifically DHT, to the androgen receptor, which reduces sebum production and inflammation associated with acne.
Prescription Medicines For Acne: Oral Acne Treatments
There is a range of oral prescription medications that may be used to treat acne.
Antibiotics kill bacteria and reduce inflammation. Tetracyclines, such as minocycline, doxycycline, or sarecycline (Seysara) may be given, usually in conjunction with topical retinoids and/or benzoyl peroxide. Side effects may include abdominal discomfort or diarrhea and an increased sensitivity of your skin to the sun.
Some combined oral contraceptives (such as Ortho Tri-Cyclen, Yaz) are approved by the FDA for acne therapy in women who also wish to use them for contraception. It may take a few months to notice an effect, and side effects include weight gain, breast tenderness, nausea, and a slightly increased risk of blood clots.
Oral isotretinoin (Absorica, Claravis) is a vitamin A derivative that may be considered for severe pustular acne characterized by deep painful cysts and nodules. Each course of treatment takes 4-5 months, and females must take measures to avoid getting pregnant while on this medication.
Other possible treatment options include spironolactone (Aldactone), lasers and photodynamic therapy, chemical peels, and steroid injections.
What's New For Acne Sufferers?
In 2019, three new products were approved for acne sufferers. All are prescription medicines.
Aklief (trifarotene) is a new type of retinoid cream that can be used on the face, neck, chest, shoulders, and back in adults and adolescents aged 9 years or older. Trifarotene is the first new retinoid to hit the market in 20 years and the first to be able to use for multiple sites across the body. It delivers the same benefits as other retinoids, such as unclogging pores, clearer skin, and exfoliation, with fewer side effects, such as redness, irritation, or skin peeling.
Amzeeq (minocycline topical foam) is the first topical form of minocycline to be approved by the FDA. Minocycline is one of the main antibiotics used to treat acne, and having a topical product avoids the potential side effects associated with oral forms, such as abdominal upset, diarrhea, or severe rashes. Amzeeq is applied once daily and is recommended to only be used for up to three months and always in combination with a benzoyl peroxide wash or gel to prevent antibiotic resistance.
Arazlo (tazarotene) is a new formulation of the retinoid tazarotene that has been available to treat acne and skin wrinkles for a number of years now. The lotion includes hydrating agents and it has proved to be better tolerated than other formulations of tazarotene, meaning that more people with most types of acne, not just severe acne, can take advantage of its efficacy.
Tips To Get The Most Out Of Your Acne Treatment
Your anti-acne products will be more effective and your acne more likely to clear up if you:
- Apply products 15 minutes after cleansing to dry skin
- Use clean hands and apply the product to the entire affected skin area, not just to each individual pimple. Stop using a product if it stings and ask for further advice
- Give products time to work - usually 4 to 12 weeks
- Always apply anti-acne products before applying make-up
- Always cleanse your skin after sweating, especially if you have been wearing a hat or helmet.
Whatever You Do - Watch What You Put on Your Skin
This applies to moisturizers, make up, shaving foams, sun blocks, and even hair products. If you are prone to acne, be careful what you put on your skin.
Unfortunately, even natural products or products labelled “non-comedogenic”, “Won’t Clog Pores” or “Hypoallergenic” can still contain agents that worsen acne.
Look on the label and check that it doesn't contain any pore clogging ingredients. You may need to experiment with several different products before you find success.
The Master of Disguise
Need to really hide that shining beacon of a spot for an important date, wedding or interview?
Circular, stick-on, protective patches that hide pimples or work like a sponge to absorb pus and oil are available and can be used by men or women alike, even under makeup.
If you wish to use foundation, choose a foundation that doesn't contain any pore-clogging ingredients. Most acne experts recommend natural mineral-based powdered foundations over liquid foundations. Remember to always remove make-up completely at the end of the day using a gentle soap-free wash.
Does Your Skin Really Reflect What You Eat?
Unfortunately, because of a lack of good research, experts are still unsure as to how much diet affects acne. In many reviews, it is not clear if the reduction in acne was due to the weight loss achieved with a specific diet (such as a low glycemic diet) or the diet itself.
The limited research available does point to a low glycemic diet rich in plenty of fruits and vegetables as being less likely to cause or aggravate acne. Possibly, daily supplementation with omega-3 fats and zinc may also help. However, it may be that your time is better spent treating your skin properly rather than embarking on an as yet unproven acne diet.
Best Natural Treatment Options For Clearer Skin
While there is no miracle treatment for acne, several supplements can help clear skin. The most notable are:
- omega-3 fatty acids (EPA only): healthy fats that combat acne inflammation
- probiotics: improving amounts of good bacteria in the gut can improve skin
- vitamin A: an antioxidant that helps shed skin cells (avoid in pregnancy)
- vitex agnus-castus (Chaste tree): balances hormone levels in hormonal female acne
- zinc sulfate: supports the immune system and reduces inflammation.
When Should I See A Doctor?
If your acne makes you shy or embarrassed, if you have a lot of acne, cysts or nodules on your face or back, or if nothing you try seems to work, see a dermatologist as soon as you can. A dermatologist can prescribe stronger topical or oral treatments that are much more effective than products you can buy at a drug store.
It is a myth that you have to let acne run its course. Treatment helps prevent dark spots and permanent scars from forming as the acne clears and it also boosts your self esteem! And consider joining the Drugs.com Acne Support Group.
Take Home Messages About Acne
- Gently wash your face twice a day and after sweating.
- Shampoo your hair regularly.
- Do not pick or squeeze your acne; this increases the risk of scars.
- Keep your hands off your face. Wash your hands before applying make-up.
- Be careful what you put on your face, and avoid ingredients that promote acne.
- Stay out of the sun and off tanning beds; excess tanning can damage your skin.
- See a dermatologist if you feel shy or products don't work.
Finished: Acne Advice: Skin Care Solutions For Both Teens and Adults Alike
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- Acne. American Academy of Dermatology 2021. https://www.aad.org/dermatology-a-to-z/diseases-and-treatments/a---d/acne/who-gets-causes
- Acne. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/acne/symptoms-causes/syc-20368047
- Diet and acne. Dec 28, 2020. Acne.org. http://www.acne.org/diet.html#glycemic
- Goldberg, J. L., Dabade, T. S., Davis, S. A., Feldman, S. R., Krowchuk, D. P. and Fleischer, A. B. (2011), Changing Age of Acne Vulgaris Visits: Another Sign of Earlier Puberty?. Pediatric Dermatology, 28: 645–648. doi: 10.1111/j.1525-1470.2011.01643.x
- Pore Clogging Ingredients. Acne Treatment Center 2020. http://acnetreatmentcenterwa.com/acne-facts/pore-clogging-ingredients/
- Hebert A, Thiboutot D, Stein Gold L, et al. Efficacy and Safety of Topical Clascoterone Cream, 1%, for Treatment in Patients With Facial Acne: Two Phase 3 Randomized Clinical Trials. JAMA Dermatol. 2020;156(6):621–630. doi:10.1001/jamadermatol.2020.0465