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What is acne
Let’s start with explaining acne in simple terms. You know that you have pores on your skin. Inside these pores, there are sebaceous glands which produce sebum (oil). Sebum helps your skin remain moisturized. Moreover, it helps the epidermis, the outer layer of your skin, protect skin from bacteria, viruses, fungi, parasites. Normal skin’s pH is around 5.5 and is considered slightly acidic, while oily skin’s pH is higher, thus, more alkaline. Skin’s pH matters because normal pH helps the skin to resist invaders and maintain good health.
Due to numerous reasons not very well-researched yet, sebaceous glands start to produce excessive sebum, which may even make your skin get very oily just several hours after cleansing. Excessive sebum together with dead skin cells get stuck in the pores, bacteria get inside because your outer layer of skin (the epidermis) lacks protection (your skin’s pH is high), your immune system tries to fight the bacteria, and inflammation in skin starts. Then you see papules, pustules, nodules, and cysts on your skin. Blackheads and whiteheads are considered acne too, however, they are noninflammatory and mild acne types. People with normal skin may have blackheads and whiteheads on some parts of their skin (usually on the nose and close to it), especially when it’s warm and their skin produces more sweat.
If you have many papules, pustules, nodules, and cysts on your face and especially when you have moderate or severe acne not only on your face, it’s a clear sign that you need to see a doctor. Whatever type of adult acne you have, make sure you don’t take some harmful advice I often see people sharing on social media. Below are common mistakes in acne treatment you should avoid at all costs if you want to have clear skin.
24 common mistakes in acne treatment
Mistakes people with acne make include:
Thinking that their oily skin requires extra cleansing
People with oily skin may have a feeling that their skin is too dirty, so they may want to wash their face (or other affected areas) or use other cleansers like micellar water, for example, not twice a day, as recommended, but more often. Skin looks better, less oily and less inflamed immediately after the procedure, indeed, but it’s only a very short-term result. In the long run, sebaceous glands will start to produce even more sebum, clogging pores, which will lead to even more inflammation and acne breakouts.
Skipping a toner
pH of tap water is between 6.5 and 9.5, while, as we know, pH of normal skin, able to resist bacteria, is around 5.5. pH higher than 7 is considered alkaline. The possible alkaline pH of water makes your skin dry no matter what pH your cleanser has. Not only will your skin become peeling but also it will start producing more sebum to compensate for the loss of protection (oil) and water inside your skin. Using a slightly acidic toner will help to balance your skin’s pH. Just make sure your toner does not contain alcohol which may disrupt your skin’s barrier and make your skin even more dry.
Skipping a moisturizer
The following applies mostly to adult acne because teenage acne is different and teenagers need to moisturize their skin less often. So, for those struggling with adult acne, if you clean your skin twice or even more times a day and don’t apply a moisturizer after each procedure (no matter whether you washed your face with a cleanser or just with water), say hello to dry and peeling skin. Does it mean less sebum production and no more acne? Unfortunately, no. Oil produced by our sebaceous glands is supposed to protect our skin. When you make your oily skin dry, using harsh skin care products or procedures that don’t benefit your skin, you damage the protective properties of your skin making it more prone to bacteria, fungi, parasites. Also, your sebaceous glands may start producing more sebum (of course, because your skin needs it for protection).
Using skin care products with alcohol
Denatured alcohol is often used in skin care products. Beauty companies claim that it helps active ingredients better penetrate the skin, preserve the product, and moreover, it is famous for its antimicrobial properties. However, alcohol in skin care products can make your skin dry, especially when it’s listed in the first or the second place in ingredients. Look for alcohol or ethanol on the list of ingredients, and if you find it, put the beauty product away. Let alone the peeling this will lead to, your sebaceous glands will start producing even more sebum than before. Sometimes I think that beauty companies use alcohol in their skin care products so that you never have normal skin and are forced to keep buying their products.
Using too many skin care products at once
We are recommended to use a cleanser, a toner, a serum, a moisturizer, something for imperfections like antibiotics, a topical retinoid, exfoliant, SPF, etc. Have you ever had a feeling that you use a hundred skin care products and yet there’s no satisfying result? Instead of buying everything someone has ever recommended, you need an acne treatment plan that makes sense for YOUR skin. Sometimes the less is the better. Using too many different products at once can lead to pore clogging or to dermatitis or to both these problems on different areas of your skin at once. Using too many skin care products may also make your disrupted skin barrier even weaker.
Choose skin care products wisely. If you’re undergoing treatment that includes a retinoid, whether a system or a topical one, use a heavier but noncomedogenic moisturizer and no chemical exfoliants (acids). Using SPF during the day is absolutely a must if you’re undergoing treatment with retinoids, acids, or benzoyl peroxide and need to go outside or go by car or spend your day sitting near a window. Windows don’t protect you from the damaging effect of the sun. However, using SPF if you don’t go outside may be redundant. In this case, use a moisturizer without SPF because sunscreen can clog pores.
Applying or taking antibiotics uncontrollably
Sometimes doctors prescribe antibiotics to treat acne. They usually tell their patients to apply topical antibiotics only to inflamed areas (to pimples) but sometimes it’s hard to resist the temptation to apply the antibiotic to surrounding areas as well. I’ve also seen over-the-counter skin care products like some serums with clindamycin which is an antibiotic. Of course, using skin care products with antibiotics will change the whole thing for you short-term if you have inflammatory acne. But what do we get as a result in the long run? Acne-prone skin already has a disrupted skin barrier function.
Applying too much antibiotic or what’s even worse, using it every day, you kill the microbiome of your skin (because antibiotics kill all bacteria, both bad ones and good ones that help your skin resist the bad ones), making it even more prone to bad bacteria. Using products with antibiotics on a daily basis you make your skin weak and defenseless, unable to function right on its own. Why would you do that to your skin? Moreover, soon the bad bacteria living on your skin will become resistant to that antibiotic which means that your acne breakouts may return and you’ll still have to search for another solution.
Some people with acne go even further and take system antibiotics. If your doctor thinks it’s absolutely necessary in your case, then just follow his or her recommendations and never take more pills than prescribed! If it’s your own decision to take antibiotics, consult with your doctor because it may give an opposite result. Your gut microbiome is very important for your overall health, including your immune system that fights invaders such as bad bacteria on your skin, viruses, toxins from the environment, and fungi. When you take antibiotics, you kill both the bad bacteria and the good ones. Yes, your skin may start looking much better while you’re taking the pills but after that your overall health will be compromised and your skin microbiome will be disrupted, making it unable to fight bacteria on its own.
Scrubbing their face and using cleansing brushes
As you already know, the skin barrier function of acne-prone skin is rather weak. Scrubbing your face, using cleansing brushes or other mechanical methods of exfoliation, you do even more damage. Actually, even people with normal skin can get a lot of problems because of such harsh cleansing procedures. When you use scrubs and cleansing brushes, not only you remove your natural barrier, you also scratch your skin, making it even easier for bad bacteria to enter it through those scratches. Dead skin cells are perfectly removed with soft cleansers. There are much better and safer chemical ways to remove dead skin cells once in two weeks.
However, I’m not a fan of harsh chemical exfoliants. First of all, everything that makes your skin peel, removes your skin’s protective barrier. Isn’t it something we should be trying to restore? Second of all, I’m not willing to spend a week or more at home because of how terribly red and peeling my face will look after using a harsh exfoliant. This is why I prefer mild exfoliants present in skin care products which I can use in my skin care routine quite safely every day. My favorite products are this cleanser with salicylic acid which I use only once a day in the evening (I wash my face just with water and apply a toner and a moisturizer in the morning to avoid overcleansing and restore my skin’s natural protective barrier) and this oil-free moisturizer with 2% salicylic acid, vitamin C and hyaluronic acid.
You surely don’t need to use harsh exfoliants every day! Give your skin some rest, it’s already damaged!
Using fabric towels and washcloths
If you have acne or acne-prone skin, you need to forget about fabric washcloths and towels for your face. Fabric collects sebum, bacteria, dead skin cells, fungi. Do you still use a towel to dry your face? Let’s imagine that your face is 100% clean after you wash and exfoliate it but how clean is the water? So you dry your face with a towel and then use it again in the evening. As your skin barrier is compromised, it can’t resist all those harmful invaders that have been thriving on your wet towel since morning. If you want to have a clear face – use clean hands to wash your face and paper towels to dry it.
Touching their face throughout the day
Thanks to coronavirus we all know the importance of washing our hands and cleaning our phones. However, all objects that surround you can’t be sterile. Moreover, your hair gets greasy and collects pollutants from the air. When your hair touches your face or when you touch your face with your hands, bacteria end up on your skin.
Not cleaning their phones
Do you know how dirty your mobile phone is? According to this source, an average mobile phone is dirtier than a public toilet. Wow!
Sharing makeup products
Let alone the fact you can catch a virus like herpes or flu, you can also catch staphylococcus and other bacteria that cause acne. Even if the person who you share makeup with doesn’t have acne, it doesn’t mean you won’t. Everyone’s skin is different. If your friend is not susceptible to acne-causing bacteria, you and your damaged skin barrier are.
Applying skin care or makeup products with dirty hands or brushes
You already know why it’s bad. Clean your hands before cleansing your face and before applying any beauty products. Clean your brushes after each use and never share them with anybody.
Changing pillowcases too rarely
Pillowcases accumulate dirt, grease, remnants of beauty products on your hair and skin, dust, bacteria, etc. It all can be contributing to your acne breakouts. Change your pillowcases every day or once in two days. But it’s not enough. Make sure you wash them on a high temperature that can kill bacteria and iron them afterwards.
Not following a hormonal acne diet
Not everyone with adult acne has problems with hormones but many do have hormonal acne. It means that your skin is too sensitive and reacts that way even to normal levels of hormones. While almost everyone with acne can benefit from following a hormonal acne diet not only in terms of skin health but also in terms of overall health, overweight women with irregular menstrual cycles can benefit from following a hormonal acne diet the most. Excessive weight, an irregular menstrual cycle and acne are linked to hormonal imbalance, polycystic ovary syndrome, risk of developing type 2 diabetes and it’s all a vicious circle. A hormonal acne diet I explained more about here is aimed at balancing the level of insulin and male hormones known as androgens.
Trying to get rid of acne not knowing its cause
Adult acne can be caused by a variety of reasons: from wrong skin care routine, excessive sugar or dairy consumption, hormonal imbalance, immune system problems, and genetics to bacteria and parasites (due to the weakened skin barrier function). All people have differences in genetics, in immune system, in their past skin care routine, also, the severity of acne is different, so acne treatment will be different for everyone. What helped your friend or a favorite blogger can be just a waste of money and never work out for you but not because the product is bad but because you should be addressing a different issue.
For example, a retinol serum will not kill demodex mites because retinol is just vitamin A. Also, there’re different types of retinoids and retinol is a weak type of retinoids and it may take years to get a satisfying result using a retinol serum for severe acne treatment. Another example: there are differences between acne and rosacea but these two chronic conditions are often mistaken. See a doctor who will help you identify your type of problem and its possible causes because otherwise you may spend years or even decades trying to fight acne unsuccessfully.
Washing their face with soap or cleansers containing soap
Oily skin is alkaline and so is soap. Soap and cleansers containing soap remove not only sebum but also good lipids your skin needs for preserving water inside it and for protection. Soap will make your skin dehydrated (you’ll know it because it feels like dry skin) and more prone to bad bacteria. When your skin is dehydrated, sebum glands start producing even more sebum. Choose cleansers with pH 5.5 or slightly less than that. If no pH is stated on the bottle, choose products for oily and/or acne-prone skin as they usually have the right pH.
Using skin care and beauty products with oils and butters
There’s a lot of information that oils and butters used as ingredients in skin care products help moisturize the skin and even help treat acne. However, don’t rely solely on information. Rely on your experience! If some beauty product causes whiteheads (comedones) on your skin, stop using it or substitute it and watch how your skin will react. Here is a comedogenic scale of oils and butters. I steer clear from any beauty products with natural oils and butters.
Using cleansing hydrophilic oils
Leave hydrophilic oils for people with dry and normal skin unless you want to do an experiment and look whether a newly bought hydrophilic oil will cause comedones or not. Most likely it will. Opt for micellar water for oily skin for effective makeup removal rather than for a hydrophilic oil. A good choice is this micellar water from Bioderma.
Using skin care products with high pH and thinking that their skin is dry
If you use soap or other cleansers with a high pH, your skin will become dehydrated. You may start thinking that from now on your skin is dry, so you need to buy a moisturizer for dry skin.
Following skin care tips that don’t work for their skin
As I said before, use what suits your skin, not what is recommended by bloggers or not what is considered noncomedogenic but causes comedones on your skin. For example, the sunscreen I’ve bought for this summer, from a famous dermocosmetics brand, claimed to be noncomedogenic, for oily and acne-prone skin, actually is too heavy for my skin and causes comedones. It’s not uncommon for mineral sunscreens to clog pores and cause comedones.
Consuming not enough food rich in vitamins vital for skin
Keep in mind that when it comes to taking vitamins, the more – the better is a wrong and terrible approach. Before taking any vitamins, consult with your healthcare provider and see the recommended dietary allowance or adequate intake. Taking huge doses of vitamins is dangerous, especially when it comes to vitamins D, A, E, and K which is why I’ve chosen what seems to be safe doses of vitamins vital for skin. However, check the adequate intake and upper tolerable limit chart on the website linked to above before the purchase.
Vitamin D is vital for the immune system which is closely related to skin. Vitamin D helps protect the skin, helps fight inflammation and improves skin disorders such as dry skin and dermatitis.
Omega-3 fatty acids help regulate sebum production.
Magnesium helps skin recover faster, moreover, it helps to balance hormones. Magnesium should be taken together with vitamin B6 because vitamin B6 helps with cellular uptake of magnesium.
Zinc is well-known for its immune system boosting properties but it also has an anti-inflammatory effect, helping those with inflammatory acne.
Vitamin C helps with skin cells regeneration and collagen production.
Caution: these vitamins also contain vitamin A. Please ask your doctor if you can take these vitamins if you’re pregnant.
Vitamin A is probably the most famous vitamin for treating acne. Vitamin A deficiency is linked to risk of developing acne as it causes overproduction of keratin, a protein in your skin hair follicles, which doesn’t let dead skin cells be removed as they normally would be, which in turn leads to clogged pores and acne. As vitamin A accumulates in the body and can be dangerous when consumed in high amounts, it’s best to consume foods rich in vitamin A instead of taking dietary supplements with vitamin A. Moreover, dietary supplements containing vitamin A and systemic retinoids must not be taken by pregnant women and women who are planning to become pregnant soon as it may be dangerous for the baby.
B vitamins like B3 – niacin and B7 – biotin, are often used for acne-prone skin in cosmetics. Make sure you consume foods rich in vitamins B1, B2, B3, B5, B6, B7, B9, B12. I am not going to recommend any dietary supplements containing these vitamins because their amounts in supplements usually exceed the upper tolerable limit. The best you can do is to consume foods rich in these vitamins. If you think that you have a deficiency, ask your doctor if you should take dietary supplements with these vitamins and how often you should take them.
Vitamin E reduces the UV damage to skin. It has an anti-inflammatory effect and helps maintain good cell health, supports the immune system and skin barrier function.
Vitamin K is known for its healing properties (it helps heal wounds, cuts, bruises, etc.). It also supports skin barrier function. Make sure you eat foods rich in vitamin K or ask your doctor if you should consider taking supplements with vitamin K. According to WebMD, the adequate daily intake of vitamin K for adult women is 90 micrograms/day. Note that some drugs can interfere with this vitamin. See the article on vitamin K on WebMD linked to above for more information.
Children and teenagers need even less vitamin K per day.
Here is a mix of adequate doses of vitamin D-3 and vitamin K-2. Note that if you make a decision to take this mix of vitamins, you should not take any other supplements containing vitamin D-3 or K-2 unless advised otherwise by your doctor.
Last but not least, a mix a vitamins I’ve been taking for some time already. It contains vitamin C, vitamin D-3, zinc, and selenium. As you already know, vitamins C, D-3, and zinc are vital for skin health.
If you decide to take this supplement, you should not take any other supplements containing vitamins C, D-3, zinc, and selenium unless advised otherwise by your doctor.
Spending too much time in the sun
If you’re undergoing acne treatment, for example, with acids, benzoyl peroxide, or retinol, your skin is very prone to hyperpigmentation. Keep in mind that many skin care products for oily and acne-prone skin contain acids – this is the first reason why you should limit sun exposure. By the way, while using benzoyl peroxide, retinol, or acids, using SPF is a must if you need to go outside, even if the day is cloudy, even in winter or if you’re going to spend your day near a window or in a car because UVA rays can pass through glass.
The second reason why you should not spend much time in the sun is that sun can dry out your skin, making sebaceous glands produce even more sebum. In addition to that, it makes skin cells harden. This makes it more difficult for your skin to shed dead skin cells and clear from sebum on its own. As a result, you may see comedones on your skin.
Thinking that their acne is caused by a disease
Although it’s true that acne is linked to a number of health conditions, it’s not always caused by a disease. Genetics, inappropriate skin care routine, comedogenic makeup products, unhealthy diet, insufficient nutrition, use of some medications, dysbiosis, environmental pollutants are linked to acne as well. However, see a doctor if your acne is severe (papules, pustules, nodules, and cysts located not only on your face).
Believing face mapping
You’ve probably seen face maps that attribute acne on cheeks to dirty pillowcases, cellphones, makeup brushes; acne on your chin and jawline to hormonal imbalance and diet; acne on your forehead to problems with digestion, stress, hair products, etc. I’ve always wondered looking at those maps whether I am the only one who happens to have all those issues. My acne is located in all of those areas. I have moderate acne; pimples and comedones arise here and there, especially in areas where I have enlarged pores which are very visible. I clean my phone every day and use it as a phone only twice a day; there are days when I don’t use makeup at all and I still get a pimple or two; I eat super healthy which means I don’t eat anything high in insulin index and I don’t eat dairy; I eat a lot of vegetables and fruit, fish, dietary fiber, drink a lot of water and green tea and if I had hormonal imbalance, I’d probably know about it because my menstrual cycle wouldn’t be regular or I would gain weight, etc.; I don’t touch my face during the day and I clean my hands before applying skin care products. It’s not the full list of everything I do or avoid doing to keep my oily skin with enlarged pores as clear as it lets me. Don’t believe face mapping! Face mapping is not based on any real scientific evidence.
Your skin is tired of harmful advice! Write down these common mistakes in acne treatment to avoid them at all costs. Remember that the way to clear skin is long, don’t give up. See Best Acne Treatment Products for my favorite skin care products that helped me cure acne and skin care routine tips.
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