One of the biggest misconceptions I've had about acne is that my breakouts would stop at a certain age. In reality, my relationship with acne spans decades.
From the odd pimple on my cheek to full-on hormonal breakouts along my jawline, I've seen (and tried it all) when it comes to acne-fighting skincare products. Because, hey, while I'm all for the skin positivity movement, I'd be lying if I said my self-confidence doesn't take a hit from a bad breakout.
And I'm not alone in my acne struggles. According to the American Academy of Dermatology (AAD), up to 50 million people in the US experience acne each year. Breakouts in adult women are also on rise, affecting up to 15% of women.
Several misconceptions and myths about skincare routines for acne-prone skin have risen out people trying to get rid of pimples fast.
Does picking a zit help heal it? Do all of the products you're using have to be for acne? Are there any over-the-counter products that really treat hormonal acne? Dr. Corey L. Hartman, board-certified dermatologist in Birmingham, Al. says no to all of the above.
As for what your skincare routine for acne should look like, we checked in with Dr. Hartman as well as Dr. Katie Beleznay, board-certified dermatologist in Vancouver, Canada, for their expert tips.
Step One: Cleanse
"Washing your face twice per day can be used to remove any oil, dirt, and makeup, but it's important to remember that acne is not a result of 'dirty' skin and over-washing can damage the skin barrier and aggravate acne," says Dr. Beleznay.
A gentle cleanser like CerAve will get the job done without stripping skin, but if you have more severe acne, or your skin can tolerate it, both Dr. Hartman and Dr. Beleznay are fans of using a cleanser with alpha hydroxy acids, like glycolic, for example.
"Alpha hydroxy acids tend to be a little milder, and not only do they help with acne, they treat hyperpigmentation, fine lines, and wrinkles as well," Dr. Hartman explains. "Hyperpigmentation comes from the inflammation and acne itself. If you're not treating the acne effectively, the longer you let it sit, the more it's going to lead to hyperpigmentation, which will be more difficult to treat."
We're fans of Glytone's Mild Cream Cleanser, a lathering cleanser that's formulated with and 3.5% glycolic acid and non-irritating surfactants.
To shop: $33; dermstore.com
Step Two: Retinoid Cream
Retinoids are the gold standard of skincare because they address common skin concerns like aging, texture, and yes, acne.
"I commonly recommend a retinoid (or retinol), with the strength of that based on a combination of the severity of the acne and what your skin can tolerate," says Dr. Beleznay. "Long term consistent use of retinoids has been shown to help with acne, as well as stimulating collagen and improving fine lines, skin texture, and tone."
Over-the-counter options include retinol and adapalene (up to 1%), while prescription options include tretinoin and tazarotene. Just don't use a retinoid as a spot treatment — it won't be as effective.
"Some people think retinoids are to be used as a spot treatment and that's a misconception we have to dispel all the time," Dr. Hartman says. "Although they can be beneficial that way, we know they are even more beneficial as a means of stopping the buildup of dead skin cells, oil, and debris in the hair follicles, so pores don't get clogged and contribute to the development of inflammation and acne."
Dr. Hartman suggests Skin Better's AlphaRet Overnight Cream. "It helps wth aging, discoloration, and acne, and it's great for patients who are retinoid naive. Or those with sensitive skin who have difficulty finding a retinoid they can tolerate," he says.
To shop: $125; skinbetter.com
Step Four: Moisturize
If the retinoid you're using doesn't double as a hydrating cream, it's best to include moisturizer in your routine. "Keeping your skin hydrated is important. This can help prevent your skin from getting too dry, and many of the treatments we use for acne can dry out the skin, Dr. Beleznay explains. "When your skin is overly dry and your skin barrier is compromised, your skin can overproduce oil to compensate, potentially leading to clogged pores, blackheads, and further exacerbate acne."
This moisturizer from La Roche-Posay is oil-free and non-comedogenic, meaning it won't clog pores.
To shop: $32; dermstore.com
Step Five: Sunscreen
Sunscreen should never be skipped over, but it's especially important to protect your skin from UVA/UVB rays when you're using active ingredients for acne, which can sensitize the skin.
Dr. Hartman recommends a mineral sunscreen because chemical formulas can cause contact dermatosis in some people. "For people with acne, we tend to not so much see irritation from certain ingredients, but the vehicle it's in," he says. "Oil-based or heavier formulas can cause comedones, so then the sunscreen can make your acne worse." Look for a mineral SPF that's emollient, rather than heavy creams.
Supergoop!'s Mineral Sheerscreen also protects against blue light, in addition to UVA/UVB rays.
To shop: $38; sephora.com
VIDEO: When You Apply Sunscreen in Your Skincare Routine Actually Matters A Lot
Step Six: Spot Treatment
"Your best bet is to use your topical all over for prevention of acne as part of a long-term strategy," says Dr. Beleznay. "But if you happen to get an acne lesion that you want to try and deal with fast, topical benzoyl peroxide or salicylic acid can be used — just be sure not to overdo it."
This drugstore staple spot treatment contains 2% benzoyl peroxide to treat existing pimples and prevent bacteria from forming new ones.
To shop: $9; target.com
So, What About Hormonal Acne?
The hard truth is that there isn't a lot that can be done for hormonal acne at home. Both Dr. Beleznay and Dr. Hartman call out spironolactone, a prescription pill, as a great option for treating hormone-induced breakouts. Additionally, contraceptive pills are sometimes recommended as a treatment option.
"A dermatologist can inject one of those nodules with a steroid because they come out at the wrong time, but that goes to show you how few effective treatments there are," Dr. Hartman says.
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