What's the big deal about washing your face? You slather on some soap, splash your skin with water, pat dry, and you're on your way.
For people with problem acne, however, skin care involves a little extra time and effort.
If you have acne, choosing the right cleanser can help rid your skin of the bacteria that make their way into clogged hair follicles and lead to breakouts. Thorough cleaning also removes dead cells on the surface of your skin, which makes it easier for your skin to absorb acne medication.
To help control breakouts, look for a cleanser that's mild but still strong enough to clean your skin. Avoid face soaps that strip your skin of its natural oils. Harsh cleansers and scrubbing will only leave you with red, irritated skin that can promote flare-ups of your acne.
You can ask your dermatologist to recommend a prescription or over-the-counter cleanser that works on acne-prone skin, but also pay careful attention to your daily skin care routine. Here are a few tips on choosing skin care products and cleaning your skin to keep it looking its best.
Which Cleansers Should I Use?
You can buy an inexpensive over-the-counter cleanser at your local supermarket or pharmacy. Or, if you're willing to spend a little more, you can splurge on one of the high-end cleansers that are sold at your dermatologist's office. It's not how much you spend that's important, but how well the product works.
Some brands of face soap have a very alkaline pH level, which can be irritating and drying on your skin. When shopping for cleansers that work well on acne-prone skin, here's what to look for:
- Choose a gentle, non-abrasive, and alcohol-free cleanser.
- Ask your dermatologist to help you find an acne cleanser that’s right for your acne treatment program. Look for an acne cleanser that matches your skin type – oily, dry, or a combination of the two.
- Some acne cleansers and face soaps have added ingredients to fight acne and improve the skin's appearance. Medicated cleansers contain acne-fighting ingredients like salicylic acid, sodium sulfacetamide, or benzoyl peroxide, which can help clear up skin while cleaning it. Salicylic acid helps clear blocked pores and reduces swelling and redness. Benzoyl peroxide exfoliates the skin and kills bacteria. Sodium sulfacetamide interferes with the growth of bacteria.
- To keep your skin hydrated, look for cleansers that contain emollients (petrolatum, lanolin, mineral oil and ceramides) or humectants (glycerin), which hold moisture in your skin, or exfoliants (alpha hydroxy acids) to smooth rough areas.
Other skin care products you can include in your routine:
Sensitive skin face wash. If you have sensitive skin, look for a foaming face wash or other gentle cleanser labeled for use on sensitive skin. Avoid medicated cleansers with ingredients like salicylic acid or benzoyl peroxide.
Adapalene (Differin) gel or lotion. This over-the-counter medicine is a retinoid, a group of topical medicines (meaning they’re applied to your skin) that comes from vitamin A. It affects the way skin cells grow and helps prevent clogged pores. It used to be only available by prescription.
Benzoyl peroxide gel or lotion. This treatment helps to unclog pores, dry out pimples, and kill bacteria. It prevents new acne.
Using benzoyl peroxide and adapalene together is a common starting point for acne treatment. Make sure you give them a chance to work. It might take up to 12 weeks to see full results.
Toner. After cleansing, you can add a toner to restore a more natural pH balance to your skin. These products gently remove any makeup or dirt that might be left behind after you wash your face. (They’re not the same as astringents, which are alcohol-based and can be harsh.) Some contain acne-fighting ingredients like salicylic acid.
A mild exfoliator. Exfoliating regularly removes dead skin cells and helps keep your pores open. This allows your skin's natural oil to drain before it can clog your follicles and lead to more breakouts. People with acne-prone skin should avoid harsh scrubs. Gently exfoliate your skin with a clean washcloth. Or use a mild chemical exfoliator that contains ingredients like alpha or beta hydroxy acids. (Don’t use an exfoliator if you also use adapalene or benzoyl peroxide.)
Moisturizer. After washing, use a moisturizer labeled "non-comedogenic," meaning that it doesn't clog pores. A moisturizer helps keep your skin hydrated, especially if you're using an acne treatment that tends to dry the skin, such as benzoyl peroxide. If you have oily skin, a cleanser that already contains a moisturizer may be all you need.
Acne Skin Care Basics
Follow this acne skin care routine to limit breakouts and prevent skin irritation:
- Twice-a-day routine. Wash your face every morning when you wake up and again before you go to bed. If you've been working out and you're all sweaty, wash, or at least rinse your face, as soon as possible. Perspiration can make your acne worse.
- Clean technique. Each time you wash your face, apply a little bit of cleanser to your fingertips. Gently rub it into your face, and then rinse with lukewarm water. Don't scrub, because it can dry out and damage your skin. Also avoid using a washcloth or sponge, which can be rough enough to irritate the skin.
- Be thorough. Your acne skin routine isn't just for your face. Treat other parts of your body where you have acne, too.
- Protect your skin. Skin care doesn't end when you leave your bathroom. Wear a non-comedogenic (non-pore clogging) sunscreen with an SPF of 30 or more that offers both UVA and UVB protection to shield your sensitive skin against the sun's harsh rays. A water- or light liquid-based sunscreen is best for acne-prone skin. Limit your time in the sun, especially between the hours of 10 a.m. and 2 p.m. While outside, wear a hat with at least a 2-inch brim and clothing to cover exposed skin.
When to See a Dermatologist
Make a dermatologist appointment if you want professional help managing your acne. If over-the-counter products don’t work within 3 months, it might be time to see a dermatologist. Go right away if you have acne scars, painful nodules (hard bumps), or deep cysts.
At your appointment, your doctor will look at your acne, prescribe topical medicine, and maybe also pills to help further.
Topical Medications for Acne
Tretinoin (Retin-A). This retinoid is more powerful than adapalene. It’s especially useful for clogged pores and blackheads. It sloughs off dead skin cells so they don’t stick together and clog your pore openings. Tazarotene (Avage, Fabior, Tazorac) is another prescription-strength retinoid your doctor could prescribe.
Clascoterone (Winlevi) is a topical treatment that targets the hormones that can cause acne. It’s prescribed to people over age 12 of any gender.
Oral Medications for Acne
Antibiotics. Types like doxycycline and erythromycin kill bacteria on your skin and cut down on inflammation. That’s particularly good for inflammatory acne, which is when you have tender red bumps and pus-filled whiteheads.
Oral contraceptives. For cisgender women (those who identify with the gender they were assigned birth), birth control pills can clear up skin. Pills that contain both estrogen and progestin work, like Ortho Tri-Cyclen and Yaz. Doctors don't generally prescribe these to men or trans men because they can have feminizing effects.
Spironolactone. This medication is another hormonal option for cisgender women. Created as a benzoyl peroxide pill, it stops your hormones from making too much oil.
Isotretinoin. You might have heard of its first brand name, Accutane. This oral retinoid is used for cystic acne or acne that scars. This is a powerful medicine, so your dermatologist will monitor you closely while you take it. Isotretinoin can dry your lips, nose, and skin. If you were taking it and got pregnant, it could cause severe birth defects.
Procedures for Acne
Your dermatologist might also recommend therapies like extraction, where they remove stubborn whiteheads or blackheads. (Don’t try to do this yourself!)
They can also do chemical peels, which is when they apply solutions like salicylic acid or glycolic acid to your face. Or they can try photodynamic therapy, which uses lights and lasers to improve your skin.
Skin Care During Treatment
Plan to pamper your skin with extra lotions and creams while you treat your acne.
Also, it’s extra-important to use daily broad-spectrum sunscreen during acne treatment. Retinoids and certain oral antibiotics make you more prone to sunburn. Regular sunscreen use also helps reduce the pigment changes you can see in your skin after your acne heals.