Managing Acne-Prone Skin: Treatments, Tips and Products

• Acne-prone skin can be successfully managed with over-the-counter skin care products and prescribed medications  
• Acne can present with noninflamed or inflamed lesions and be mild, moderate or severe
• Adhering to a good skin care program, eating healthy whole foods and staying hydrated can help minimize acne flare-ups both in severity and frequency

Acne is the most common chronic skin disorder in the United states, affecting nearly 50 million people a year. Symptoms can be mild, moderate or severe but one factor that is common to all no matter the severity is the toll it takes on quality of life: depression, social isolation and thoughts of suicide have all been linked to acne patients. Fortunately, acne-prone skin can be managed to control and minimize symptoms and lower the risk of future breakouts and potential scarring.  

Do You Have Acne-Prone Skin?

Acne-prone skin is simply acne that is persistent or frequent.

Acne lesions can be divided into two categories: noninflammatory lesions called whiteheads and blackheads (comedones), and inflammatory acne which describes small, hard papules and pus-filled pustules and cysts.

Acne lesions develop when hair follicles become blocked with excess sebum (oils) secreted from sebaceous glands as well as dead skin cells and grime. This accumulation causes the formation of comedones. If left untreated, acne-causing bacteria can multiply and cause widespread inflammation. This results in the development of red, inflamed and tender lesions.

If you have acne-prone skin, you can develop either type of acne or a combination of both. Symptoms and severity can fluctuate depending on the cause of the breakout as well as your genetic disposition. 

The primary cause of acne is the accumulation of pore-clogging matter. You may be genetically inclined to produce more sebum, or puberty, menstruation or pregnancy can influence greater oil production caused by an increase in androgen hormones. This leads to clogged pores and acne lesions. Androgens also influence inflammation in acne.

A compromised skin barrier can also cause or worsen acne as it is unable to protect the skin against outside irritants and bacteria. Along with acne lesions, skin typically appears red, rough and dry, and can feel uncomfortable and irritated.  

Tips for Managing Acne-Prone Skin

Tips for keeping acne flare-ups at bay typically focus on prevention; this involves a comprehensive skin care routine that focuses on exfoliation to maintain clear skin and an effective moisturizer to hydrate and protect the skin barrier function.

Skin care routine

It is essential to have a good skin care routine in place and to adhere to it on a daily basis. 

Opt for a gentle exfoliating cleanser that is designed for your skin type; this is important as using the wrong product can strip your skin of natural oils, leaving it taut, uncomfortable and more vulnerable to acne breakouts. An exfoliating cleanser will clear skin of excess oils, grime and dead skin cells to prevent pore buildup.

Salicylic acid is a suitable cleansing ingredient for all skin types and is oil-soluble, making it an ideal solution for comedones; it can deeply penetrate pores to break up plugs and maintain clear pores. This acid also stimulates cell turnover by acting as a keratolytic, breaking the bonds between skin cells and allowing them to slough off.  

For inflammatory acne, alpha-hydroxy acids (AHAs) such as glycolic acid and lactic acid are ideal as they work at the surface level to loosen and break apart dead skin cells, and clear away debris and dead skin cells. This helps heal acne lesions and leaves skin smoother and more even in appearance.

Both acids have antibacterial benefits to kill Cutibacterium acnes and both help facilitate absorption of topical acne medications.

After cleansing, follow with a toner to remove any lingering residue and to prepare your skin for the important step of moisturizing. A good quality moisturizer will contain moisture-boosting agents that will hydrate skin and help strengthen the skin barrier for better skin health which will contribute to lowering the risk of acne flare-ups. 

Lastly, before leaving the house each day, ensure you apply sunscreen with an SPF of 30 or higher to protect your skin from damaging UV rays; unprotected sun exposure can also worsen acne symptoms

Be consistent

Your skin care routine and any acne treatments require time and consistency in order to be effective; typically any treatment will require several weeks or months to produce tangible results.

Additionally, most acne treatments require daily use, and inconsistency in following instructions will likely reduce the effectiveness of your product.  

Do not overwash  

While it may be tempting to wash your face more than twice a day – especially if it’s very oily, this is not advised as overwashing will dry out your skin, compromising the skin barrier and causing acne breakouts, skin sensitivity, redness and irritation.   

Overwashing can also trigger skin to overproduce oils to compensate for the moisture loss which can exacerbate acne. 

Don’t pick at your skin

Acne is an inflammatory condition that can worsen if aggravated by picking at the skin or popping pimples; this triggers the body’s immune system which in turn leads to greater inflammation and worsening symptoms. 

Touching and squeezing acne lesions also results in the spread of bacteria. 

Find the root cause

While acne is primarily caused by an excess of sebum that blocks pores, why this occurs is due to numerous risk factors. Genetics, hormonal shifts, stress, diet and skin care can all influence sebum production and trigger acne breakouts.

By finding the cause of your acne you may be able to avoid your specific triggers, as well as find a treatment that works best for you.

For example, if your acne is being caused by fluctuations in hormones, consider using oral contraceptives or antiandrogens to regulate them. If you find that you break out after eating certain foods such as processed meats, dairy products and foods high in carbohydrates, these foods may be the cause.

Treatments for Acne-Prone Skin

The main goal of acne treatment is to control and heal existing acne lesions, minimize scarring and prevent new acne lesions from forming.

Acne treatments will vary based on the type and severity of acne. As well, combination therapy is used to target acne through various modes of action to achieve greater success. However, they all work in similar ways, through exfoliation and increasing cell turnover to clear pores, or by killing acne-causing bacteria.   

Over the counter topicals

Several over-the-counter (OTC) topicals have been proven to be highly effective in treating cases of mild-to-moderate acne. 

Benzoyl peroxide is an antimicrobial and antibacterial that is an ideal treatment for inflammatory acne as it can kill P. acnes; it also increases skin cell turnover to help heal lesions and clears pores of debris.

Studies demonstrate combining benzoyl peroxide with antibiotics or retinoids is more effective than either medication used alone.

Retinol is a type of retinoid and is derived from vitamin A. This agent is a mainstay of acne therapy as it has been shown to deeply exfoliate grime, dead skin cells and oils; reduce sebum production; regular cell turnover and inhibit inflammation. 

Lastly, retinol can help strengthen skin by stimulating collagen production. As such, this agent is effective in treating both inflammatory and noninflammatory acne.

Professional treatments

If you find that OTC acne medications are proving ineffective, you can consult with a dermatologist to receive in-office treatments that may produce better results; this is true for treatment-resistant or moderate-to-severe acne. Some proven professional treatments include:   

Light chemical peels using glycolic or salicylic acid peels have been found to be effective in treating comedones as well as inflamed papules and pustules. Peels remove the outer layer of skin to get rid of damage, hyperpigmentation and scars, as well as excess oils and bacteria. This reveals new, healthy skin in its place. 

Laser and light treatments are also excellent options to reduce acne symptoms as well as related issues such as acne scars. They treat the underlying causes of acne by killing P. acnes, regulating sebum production and reducing inflammation. Several treatments are required for best results. 

Some laser treatments are better suited to specific types of acne. For instance the pulsed-dye laser has been found to significantly improve inflammatory acne, while intense pulsed light (IPL) and diode lasers can effectively treat both inflammatory and noninflammatory acne. 

Home remedies

Home remedies can help support OTC and professional treatments, or they can work as sole treatment for milder acne symptoms. At-home ingredients that have been tested and found effective in treating acne are aloe vera, green tea and witch hazel. 

• Aloe vera is derived from an antioxidant-rich plant and has antibacterial and anti-inflammatory qualities; it can clear pores of debris, reduce oil levels on skin, kill acne-causing bacteria and speed up wound healing  

• Green tea also has antibacterial and anti-inflammatory properties to help soothe acne symptoms; research also indicates the polyphenols found in green tea can also help  regulate sebum production to prevent acne.

• Witch hazel is an astringent that can effectively rid the skin of excess oils and tighten pores which is effective for noninflammatory acne; as an antibacterial it can calm inflammatory acne by reducing inflammation. 

Choosing Products for Acne-Prone Skin

When choosing the products for your skin care routine the best products will have soothing properties, be noncomedogenic and will support and protect the skin’s natural barrier.

Best moisturizer for acne-prone skin

Moisturizers can be divided into three distinct types: humectants, emollients and occlusives. Humectants attract and bind moisture to skin, while emollients and occlusives form a protective barrier on skin to seal in hydration and prevent moisture loss.  

Occlusives are not recommended for acne-prone skin as they can potentially block pores.

Look for:

• Ceramides which fall within the emollient category; these are waxy lipids that retain moisture in skin and are a natural component of the skin barrier; they relieve dryness and repair and protect this barrier   
• Glycerin which is a humectant that protects and repairs the skin barrier, accelerates wound healing, softens and hydrates skin, and helps maintain elasticity

When choosing your product, opt for one marked as noncomedogenic as they are less likely to block pores. You can also choose one that  includes one or more acne fighting ingredients such as benzoyl peroxide, salicylic acid or aloe vera.  

Best foundation for acne-prone skin

Many types of foundation can worsen acne symptoms as they can clog pores. To avoid this, select one that is labeled noncomedogenic or oil-free and that has a lightweight formula.

Depending on your skin type, you can choose among liquid, cream or powder. Liquid in a matte finish will provide the best coverage and is suitable for oily skin; cream is ideal for dry skin; and powder works best for oily skin as it will absorb excess oils.

Ensure you remove all traces of makeup at the end of the day and allow your skin time to breathe.

Best face wash for acne-prone skin

Choose a gentle nonirritating face wash that is designed for your skin type and includes active ingredients: 

• For very oily skin, choose a gel or foaming cleanser, as these are formulated to eliminate excess oils
• If you have dry or sensitive skin, a cream-based cleanser with ceramides, hyaluronic acid or glycerin will boost moisture

Products to avoid

Those with acne-prone skin should avoid using harsh skin care products and those containing   fragrances; these can irritate and worsen acne-prone skin, such as:

• Drying cleansers that have a high pH; the natural pH of your skin should be slightly acidic, between 4–5. Studies show that skin with a higher pH level is more likely to be at risk of acne occurrence or recurrences

• Exfoliants such as strong peeling agents, abrasive face scrubs or other physical exfoliating tools such as brushes. While some light chemical exfoliants such as glycolic acid chemical peels can help treat acne, harsh exfoliants can damage skin and worsen acne-prone skin

• Comedogenic moisturizers, such as those with a base of beeswax, coconut butter or mineral oil; these products tend to have a thick, greasy texture that can clog pores and contribute to acne development.   

Takeaway

Acne-prone skin is acne that is persistent or frequent. Fortunately, here are several effective strategies to help manage this chronic skin condition. 

Acne treatments can ease uncomfortable symptoms and help heal lesions. These include proven topical medications such as salicylic acid, benzoyl peroxide and retinol. These work to exfoliate skin, stimulate cell turnover and kill acne-causing bacteria.

If you are looking for a professional treatment, chemical peels as well as laser and light treatments are also effective options. 

For very mild cases of acne or to support mild-to-moderate cases, some safe and effective natural ingredients include aloe, witch hazel and green tea. 

When choosing skin care products, ensure that they are designed for your skin type and are gentle, pH balanced, fragrance-free and noncomedogenic. For best results opt for those that include active acne-fighting ingredients. 

Daily habits can go a long way in preventing acne flare-ups. Follow a good skin care program and use your chosen products consistently for best results. Eat a healthy diet and drink plenty of water to maintain hydration. Avoid touching, squeezing and picking at lesions as this will worsen symptoms and can lead to scarring.