Answers to Frequently Asked Acne-Related Questions
By Cynthia Bailey MD.
If you are battling acne, you are not alone. Many patients in my dermatology practice come to see me about acne. You may have the same questions that plague my patients. Below I have provided the answers to some of the most common acne-related questions I have received.
What's the best makeup to use when you have acne?
For acne-prone skin my favorite mineral makeup powders are:
My Pressed Mineral Makeup Powder which is applied with a sponge pad.
My Loose Mineral Makeup Powder made with kaolin clay to absorb excess oil. This makeup is applied with a brush.
What other products work to fight acne?
You can make your acne products work even better by washing your skin with a Clarisonic Sonic Skin Cleansing Brush System. Research shows that using a Clarisonic allows your skin care products to penetrate your skin more than six times better, which means faster results. Also, using a Clarisonic gets your pores cleaner, and that’s really important for treating acne. If you’re not ready for a Clarisonic System, use a Facial Exfoliating Sponge with your cleansers to improve their effectiveness.
What is the best spot treatment for acne?
The best acne spot-treatment options include benzoyl peroxide. Even if your facial skin can’t tolerate having benzoyl peroxide applied over the entire surface, it may tolerate spot treatment. The best strength is 2.5% because it treats acne as well as higher concentrations but is much less likely to irritate skin. Use my Benzoyl Peroxide 2.5% Treatment Cream applied twice a day to pimples. It is also alcohol free to reduce skin dryness.
What is the best sunscreen for acne?
My favorite sunscreens for acne-prone skin are my Sheer Strength Pure Physical SPF 50+ Sunscreens because,
- they are oil-free,
- feel light on your skin and,
- won't clog pores.
My top choice, the Sheer Strength Pure Physical Matte Tinted Sunscreen made with oil absorbing technology and tinted with 4% iron oxide to hide complexion flaws and block visible light that can darken skin pigment problems. The tinting technology blends into all skin tones.
If you want an untinted product I have Sheer Strength Pure Physical Invisible SPF 50+ Sunscreen.
Sheer Strength Pure Physical Spray SPF 50+ Sunscreen is an excellent choice for face, neck and chest because it comes in a larger bottle, spreads easily on even hairy skin (making it the top choice for men with facial hair) and is moderately water resistant. I wear this on my neck, chest and hands daily.
Are there acne treatment masks I can use at home?
Yes, clay masks help to draw out oils from your pores. Sulfur helps to soothe redness. Using a mask once or twice a week can be helpful.
Also remember that facials, chemical peels, and extractions from a skincare professional can help.
What are some of the biggest culprits of teen acne breakouts and why?
- Stress is known to be a trigger for acne. When you can’t avoid stress, take other steps to try and control acne such as avoiding dietary acne triggers, be sure to wash you’re your skin twice a day, and avoid using pore-clogging skin care products.
- Diet: eating high glycemic foods or a lot of dairy foods have been linked to acne. I talk more about that next.
- Not washing acne-prone skin twice a day to remove oil, dirt and bacteria that can promote acne.
- Sleeping in makeup. Even non-comedogenic makeup can clog pores if you sleep in it.
- Not showering/washing after exercise. Damp oily skin promotes the growth of germs that can cause acne.
- Using products with oils or that clog pores. Look for ‘oil free’ and ‘non-comedogenic’ labeling on products.
- Be careful about hair care products used on hair that touches your face or other areas of skin prone to acne such as neck and upper back. Limit the use of oil containing products in these areas.
What are the causes of adult female acne, also called "hormonal acne" occurring in women over 25 years of age?
We don't know for sure but there are some triggers blamed on breakouts including,
- hormonal fluctuations,
- Polycystic Ovary Syndrome
- genetics (a family history of acne),
- cosmetics that clog pores,
- diet (more on this below),
- tobacco use,
What is the connection between diet and acne?
Diet is a big issue for acne. Researchers are uncovering more diet and acne information daily, but the bottom line is that what you eat matters.
What dietary interventions should people with acne consider and why?
- Work towards a diet that mostly consists of veggies, fruit, whole grains and lean proteins.
- Avoid high-carb high-glycemic foods. Eat a low glycemic diet to fight acne. High glycemic foods are those that raise your blood sugar fast. Obvious culprits are sugary foods and drinks but refined carbs are high glycemic foods too. Those include chips, white bread and crackers, pasta and even pizza are refined carbs.
- Minimize dairy products; yes, even low-fat ones because dairy seems to have a unique role in causing acne.
- Avoid eating a lot of the “bad fats” found in most animal-based meats and fast foods.
- Eat “healthy” omega 3 fats like those found in salmon, flax seeds, and walnuts.
- Drink a lot of water instead of sugary drinks.
- Eat naturally probiotic rich foods like yogurt or kefir. (Yes, they are dairy foods but research suggests that they may not have the same propensity to cause acne that milk does. I still recommend acne patients go easy on all dairy while science figures out the full story with acne and dairy.)
Why do high high glycemic foods cause acne?
High glycemic foods cause hormonal changes that can lead to acne at the level of your pores.
When your body has to produce tons of insulin because you ate tons of refined carbs (white flour, sugary foods etc.) then complex things happen with your hormones-including hormones that affect your pores. These hormones are your androgens, (like testosterone), and 'insulin-like growth factor'. They cause your pores to make blackheads and secrete more oil. They even change what's in your skin oil, making it more 'pimple forming'.
Basically, eating refined carbs causes your hormones to go crazy, your pores go crazy and you get zits.
Why do dairy foods trigger acne?
Milk contains substances that your body converts to testosterone (a hormone that affects your pores, causing oil production and acne). Milk stimulates your body to produce a natural chemical called insulin-like growth factor (IGF). This IGF increases your body's own natural testosterone hormones. It also increases how well these hormones effect your pores, causing more oil production and possibly more pimples and blackheads.
What skincare products can trigger acne? Are there certain ones that tend to cause breakouts more than others? If so, which ones and why?
Skin care products that contain oils or that are heavy creams and ointments can clog pores to start acne. I recommend light textured oil free products for my acne patients.
What bathing practices can aggravate acne and why?
Good bathing practices will help you to fight acne.
- Wash your acne prone skin twice a day. Also wash it after a workout.
- Avoid the use or really harsh soaps and cleansers. Opt for gentle and/or pH balanced cleansers that won’t irritate skin.
- Consider using cleansers with acne treating ingredients such as benzoyl peroxide and salicylic acid. Fungal acne (Pityrosporum folliculitis) can respond to anti-yeast ingredients such as ketoconazole or pyrithione zinc cleansers.
- Don’t let your skin sit in sweaty clothing after a workout – shower as soon as possible and change into dry clothes.
- Don’t share makeup brushes because they can transfer germs that add additional risk of infection to your acne. At least 30% of the population carries Staph without any symptoms. This bacteria can infect acne lesions, making them much redder, fiercer and prone to scarring.
- Be carefully not to over-dry or over-cleanse your skin with your acne treatment routine. Irritation and redness won’t help your acne. Many acne treatment products can be drying. Take a break from using them if your skin starts to become dry or irritated.
- Treat your entire acne prone area, don’t just spot treat. Acne is easier to prevent than it is to treat after the breakout is in full force. Find the right products for your acne type and skin type and use them on your entire acne prone areas of skin.
At what point should you see a dermatologist for help with your acne?
If the acne is not clearing up, if it is scarring or if it is taking a real emotional toll then it’s time to get professional help. If your acne is not clearing up with home treatments, schedule an appointment with a dermatologist because there are prescription medicines that can be added to your treatment.
Zeichner JA, Baldwin HE, Cook-Bolden FE, Eichenfield LF, Fallon-Friedlander S, Rodriguez DA. Emerging Issues in Adult Female Acne. J Clin Aesthet Dermatol. 2017;10(1):37–46.
Yosipovitch G1, Tang M, Dawn AG, Chen M, Goh CL, Huak Y, Seng LF, Study of psychological stress, sebum production and acne vulgaris in adolescents, Acta Derm Venereol. 2007;87(2):135-9.