Acne - this is due to pores clogged with oils and keratin debris, making it a nidus for bacterial infection, notably Propionibacterium acnes. This can be due to an overproduction of oil and skin debris (which can be affected by stress, hormone levels, etc.) or just bad personal hygiene. There's no evidence of special diets or behavioral quirks. The menu of treatment options is on a scale:
- Benzoyl peroxide 5-10% liquid facial wash - antibacterial, over-the-counter
- Tretinoin cream 0.05% cream, 2-3 times weekly
- Tretinoin cream + antibiotic (doxycycline), good for when you have pustules
- Isotretinoin (commonly known as Accutane, Clavaris) - 5 month course
Tretinoin is a topical retinoid (vitamin A derivative) which promotes skin differentiation and maturation. It prevents skin debris and overproduction of oils. Doxycycline is a antibiotic served to target Propionibacterium. Isotretinoin is a systemic form of tretinoin where you inject it into your body. Generally the monthly injection allows enough levels to build up in your body to calm your skin down everywhere. There's no real science for anything else to help with acne.
Moisturizing - If you have very dry skin and/or eczema, it is important to keep moisture in your skin locked in via a frequent daily moisturizer. On a scale of best-to-worst for moisturizing power:
- Ointments - the greasier, the better!
- Creams
- Lotions - generally water-based, which can dry out the skin more
Recommended over-the-counter brands include: vaseline (the gold standard!), aquaphor, Aveeno or Dove for sensitive skin, Cerave, and Cetaphil. Also, stay hydrated!
General skin care - Daily facial cleansers with Cetaphil or Cerave has been recommended by our clinic for those who struggle with acne or very sensitive skin. Sun protection is key when wanting to reduce post-acne scars (called post-inflammatory hyperpigmentation), melasma, and routine dark spots. And if you want super nice-looking skin with no acne, accutane is the way to go.
And for my own purposes, I have a few notes on atopic dermatitis or autoimmune conditions. Topical steroids help with the inflammation, and these include:
- Hydrocortisone (weakest)
- Triamcinolone
- Fluocinonide/Lidex
- Clobetasol (strongest!!)
In summary:
- Minimize stuff on your skin
- Address the problem of your acne - clean your skin and evaluate if you need retinoids/antibiotics
- Stay hydrated
- Sun protection
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With that said, I've minimized my skin routine since last summer: Philosophy facial cleanser -> Caudalie Vinoperfect serum -> Shiseido sunscreen SPF 50+ and that's it!
I have had multiple empty-bottles now. The serum keeps my skin moisturized and doesn't clog my pores for me, but may not be for everyone. So far I haven't had any new sunspots and my skin has been looking clear. Now armed with Clarisonic, my skincare is going to be even better *crosses fingers*. Here's to makeup-free happy skin!
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