I’m going to tell you something. I think everyone with acne can get better. In my practice I’ve seen a lot of acne. Over the last 15 years, I think I’ve seen it all. It’s a complicated, volatile and misunderstood disease that is sadly so common, that it’s almost normal. And whilst I think skin positivity is a wonderful thing, I think getting rid of the damn spots is even better.
The most common scenario I see in my practice is that of a blemish-prone grown-up girl who’s become concerned with anti-ageing – because the beauty industry focuses so aggressively on this. But unfortunately a huge number of these products are unhelpful or downright counter-productive in the event of breakouts. And the onslaught of evermore twinkly, desirable skincare products showcased on social media has led to an epidemic of product hopping that literally serves no one. Not those concerned with premature ageing, not those with acne. No-one. Except perhaps the brands and influencers on commission... And let me say, that a massive 40% of women over 25 will be concerned about this. Heck, 70% of all women experience physiological acne.
That’s right, it’s considered medically normal for women to get blemishes once a month.
A quarter of your reproductive life spent expecting blemishes. When you could be doing something much more interesting instead. So here’s a distillation of what I’ve learned over the years – actions you can take today to get your skin back on track and make you feel in control.
THE BEST ACNE TREATMENT STARTS WITH PREVENTION
Not just reaction. The sheer volume of individuals with blemish-prone skin has resulted in an expansion of the offerings available. Light-based treatments... masks... spot-reducing stickers. The problem I have with all these options is that they work by treating existing acne – not preventing it. And there are only a few routes to achieving this. And it starts with a magical thing called a retinoid. Or if you’re planning pregnancy, an accommodating acid called azelaic acid. These ingredients actually normalise a process called comedogenesis, which unclogs pores. This is the primary problem in all blemishes so solving this just makes sense. You’ll need to make a long-term commitment to this step if you want to keep ahead of the problem. Acne taming requires consistency.
YOU’LL NEED AN ANTI-INFLAMMATORY
Again, a few ingredients do this particularly well. BPO (Benzoyl peroxide). Salicylic acid. Niacinamide. These have the cleanest side effect profile and don’t utilise antibiotics so are helpful in the long-term
CUT OUT HABITS THAT DON’T SERVE YOU
That means stepping away from the magnifying mirror. And eliminating any sort of extraction tool or generally squeezing/picking behaviour. And I consider acne facials under this category too, as more often than not they trigger a flare. Like I said, consistency is key. It’s what you do every day that matters; extractions and masks are not the route to solving acne.
ELIMINATE UNHELPFUL MAKE-UP PRACTICES
Most patients I see have a sneaking suspicion that long-wear foundation isn’t serving them well before I deliver the bad news. They are troublesome for multiple reasons. Firstly, they are almost as bad as indelible marker pens to remove. They are a big part of the reason that double cleansing became a thing. And what we know now from studies, is that the more aggressively you cleanse, the more wound-up acne gets. Even though it feels good to get mad at your skin and scrub, resist. Acne really is best handled in a calm, meditative way with a single cleanse – so seek out make-up formats that are easily removed. And skip the powder. Blotting is the way to handle shine safely. A note on makeup brushes – hygiene is of course important. But I’ve never seen a case of acne solved by solely addressing make-up application practices so it’s not the source of your problem.
PROTECT YOUR SKIN
I see more acne flares in September than I see at any time of the year. Sun exposure whilst perhaps having a mild anti-inflammatory effect, has the rather nasty side effect of clogging up pores and triggering a rebound. It will also make any post-acne marks darker. So do the right thing and protect your skin from harmful UV rays. And the plus side of this is you won’t have to stop your retinoid either, so good acne control can continue uninterrupted.
WINTERY ACNE SKIN NEEDS HYDRATION TOO
All too often I see women who are dry as a crisp in the face of the cooler months, and soldier on with acne actives, despite skin so tight and sore they can barely eat. Yet we now know that dry, scaly skin is ceramide deficient and this promotes acne – so you can consider a good emollient as an important part of your acne arsenal. This inherent phobia of moisturiser comes from bad experiences based on bad choices. The key label is noncomedogenic, meaning a product won’t clog pores. It’s not absolutely foolproof, but it’s a good place to start.
UP YOUR ZINC INTAKE AND THAT OF OMEGA 3 FATTY ACIDS
And whilst you’re tuning into what you eat, keep an eye on refined carbs and dairy. Whilst I don’t believe in eliminating food groups, these dietary shifts can help as part of a cohesive strategy.
IS IT A SCAR OR PIGMENTATION?
Don’t wait, this is a sign that you need prescription-based treatment. Scars are potentially permanent defects in your skin’s dermis and it’s a sign that time is of the essence to switch the inflammation off. Scars are best seen when viewing skin in lighting from the side – there will be an actual dip in the surface of the skin, as opposed to flat red marks that are often mistaken for scars but are in fact pigmentation following on from the inflammatory process and therefore are easier to treat. Phew.
IN SUMMARY TO STRUCTURE A SIMPLE ROUTINE:
Active Anti-inflammatory step
(Buffer layer Moisturiser)
PRODUCTS I RECOMMEND
Cerave Hydrating Cleanser
Dr Sam’s Flawless Cleanser
La Roche-Posay Toleriane Dermo-Cleanser
La Roche-Posay Effaclar Duo
Medik8 Blemish SOS
Acnecide 5% Gel Benzoyl Peroxide
Cerave Moisturising Lotion
Dr Sam’s Flawless Moisturiser
Dr Sam’s Flawless Moisturiser Light
Avène Tolérance Extreme Emulsion
Avène Skin Recovery Cream
La Roche-Posay Toleriane Ultra
Dr Sam’s Flawless Moisturiser
Dr Sam’s Flawless Moisturiser Light
Dr Sam's Nightly 2% Retinoid Serum
The Ordinary Advanced Retinoid
Dr Sam’s Flawless Nightly Serum
Medik8 Crystal Retinal
La Roche Posay Shaka Fluide SPF50
Dr Sam’s Flawless Daily Sunscreen SPF50
Eucerin Sun Protection Sun Fluid
Mattifying Face SPF50+
Heliocare Gel SPF 50
Jan Marini Physical Protectant
Dr Sam's Flawless Gossamer Untinted SPF 50
La Roche Posay Anthelios Comfort Cream
MAKE-UP BRANDS I RATE
NARS Sheer Glow Foundation
Armani Luminous Silk
Lancôme Teint Miracle
NARS Radiant Tinted Moisturiser or Velvet Matte Skin Tint
Lancôme Teint Idole Foundation Stick
NARS Radiant Creamy Concealer or Soft Matte Concealer
THE FINAL MESSAGE – BE PATIENT
Acne treatment is a bumpy road. And yes, things might get worse before they get better. But to be forewarned is to be forearmed. And investing this time in your skin for its future health isn’t something you’ll ever regret.
Because good skin looks great on everyone!