Mini Treat: Living with acne-prone skin

A good portion of my acne has been a product of my own hands.

Lots of people think dealing with acne follows a simple, linear path, but it’s actually rarely that straightforward. From personal experience, as well as chatting with lots of acne-prone clients during my consultations, I’ve found that more often than not, people experience acne in phases. For example, it’s common for someone to go most of their life without having any breakouts, and then erupt in hormonal, jawline acne in their thirties. It’s also pretty standard to have stretches of consistent closed comedones or whiteheads for a couple of months every now and then.

As far as my journey goes, most of my young adult life was spent dealing with extremely uncomfortable cystic and hormonal acne that plagued my chin and jawline. My dermatologist recommended I start taking Accutane (a derivative of vitamin A that you take orally), but I opted for hormone-balancing birth control instead, which massively helped curb my breakouts. I’m off the pill now, and it frankly hasn’t been easy on my skin—it’s nowhere near as cystic and relentless as it was back then, but my skin is still pretty reactive (things easily clog my pores) and I deal with consistent closed comedones that sprout up weekly.

Acne is confusing, frustrating, and can make you feel this really weird disconnect with your body where you’re like, “Uh, what’s happening to me?” There are so many things that can contribute to acne, including hormones, stress, environmental and life changes, and even adverse reactions to products (I don’t just mean skincare products; more on that in a sec.) As someone who’s considered acne since a young age, studied and written extensively about it, and tried a trillion products, I’m super aware of my triggers and have a refined, stocked-up arsenal in my medicine cabinet that I’ve long relied on, which I thought I would share with you today.

Haircare might be causing your breakouts

Haircare is a major trigger that’s consistently overlooked when it comes to acne. A few years ago, I was interviewing Dr. Loretta Ciraldo, a board-certified dermatologist and founder of one of my favorite brands, Dr. Loretta, and she explained that rich, heavily fragranced shampoos and conditioners are almost always an issue with her acne-prone clients, but people just don’t think to consider it. If you’re using tons of hair masks, oils, and creams that are super dense and rich, it’s possible those formulas are sinking into your skin when you’re washing or styling your hair and clogging your pores.

If you have any kind of acne, but especially those bumpy, closed comedones all along your cheeks and hairline, you should consider switching to non-comedogenic haircare and seeing if that helps. If you’re currently experiencing breakouts and you’re in the phase of trying to figure out what could possibly be causing it, haircare is a really good place to start, as it’s a pretty simple change that can make a really big impact.

• Neutrogena T-Sal
  This shampoo was originally formulated for psoriasis, but its formula has 3% salicylic acid in it and has since become a dermatologist pick for acne-prone skin because of its exfoliating and acne-fighting benefits.

• SEEN brand
  This whole line is formulated specifically for acne-prone skin, so their shampoos and conditioners are free of any of the standard triggers such as sulfates, silicones, phthalates, parabens, dyes, pore-clogging oils, formaldehyde-releasing preservatives, cocamidopropyl betaine, or gluten. I love their deep conditioner, hair oil, and shampoo.

@riovn00Hair dye can also be a culprit, so be sure to mention this to your colorist and they can maybe select products with this in mind. #closedcomedones #cheekacne #foreheadacne #acneshampoo #acnesafe #neutrogenatsal #seenhaircare

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How much of your acne is self inflicted?

I was speaking to a dermatologist a while ago, and she asked me a question that, all jokes aside, changed my life. I was venting about the frustrating consistency of my breakouts, and she asked me if I picked my skin. When I said yes, she handed me a mirror and asked me to point out any inflammation or redness I saw that was created from simply leaving the pimple alone. As I scanned my skin in the mirror, I realized that every visible mark, scar, or swollen spot was something that I had picked at or extracted. I was forced to face the fact that at least a good portion of my acne has, all this time, been a product of my own hands.

This information alone might be enough to stop someone from picking their skin, which is incredible. However, skin picking exists on a spectrum, and like many others, I have dermatillomania, a skin picking disorder that I discuss with a psychiatrist. Acknowledging it as a symptom of my anxiety and working through it with a professional has been massively helpful, but there are environmental things I’ve done that have also been game-changing for me.

• Your bathroom is your enemy
  When you’re a skin picker, simply being in your bathroom is a massive trigger, but it’s obviously not a place you can avoid all together. One of the best things I've done to reduce my time in the bathroom is to avoid turning on the bright overhead light. Nighttime is when I tend to pick the most, so in the evenings, I shower and do my nighttime skincare routine exclusively by candlelight. It's bright enough that I can function and apply my products, but dim enough that I can't see little spots or individual pores, preventing me from picking at my skin. This approach not only helps with my skincare but also creates a relaxing and cozy way to wind down at the end of the day. Also, if you have a roommate or live with your partner, have them hold you accountable for the amount of time you spend there.

• Reach for an ice cube instead
  A good trick for combating skin picking is icing. I take an ice cube, wrap it in kitchen roll (to avoid burning my skin), and massage the area—ten seconds on, ten seconds off—for about ten minutes. On a basic, tactile level, icing your skin makes me feel like I'm doing something "productive,"  and in my experience, it's the closest sensation to skin picking I can have without actually damaging my skin. Not only does it feel satisfying to touch the area I’d normally pick at, but it also helps reduce swelling and makes pimples smaller. The Sofie Pavitt Nice Ice Toner Pods are a more elegant option, as they’re designed especially for your skin and have additional acne-fighting benefits.

• In pimple patches, we trust

  Out of sight, out of mind! Whenever you feel the urge to pick, just put one of these on. The physical barrier protects your skin from your fingers and bacteria, even if you accidentally touch the area. Plus, some pimple patches they sell these days are so cute that I don't mind wearing them out in public. I use Cosrx’s at night and Starface during the day.

Spot your triggers and find your “hero” ingredient

It’s no secret that the beauty industry is deeply oversaturated. The sheer amount of “resurfacing serums” or “illuminating creams” can make shopping for skincare a nightmare. I mean, everything sounds the same, most brands do a terrible job at explaining what’s actually in their formulas, and the absurd fluctuation in pricing can just add to the chaos. This can be especially grueling when you’re someone dealing with break outs, and are hoping to find products that will actually help rather than make your situation worse.

If you’re acne-prone, my best word of advice is to figure out what your triggers are, as well as become familiar with what ingredients do work for you. Everyone’s triggers are completely different, so it’s pretty difficult to generalize, but the most common culprits are things like silicones, mineral oils, fragrance, isopropyl myristate, and isopropyl palmitate. But it’s really not always a one-size-fits-all thing. For example, I’m extremely sensitive to essential oils, but synthetic fragrances (even creams that straight up smell like perfume) don’t bother my skin whatsoever.

When it comes to spotting your triggers, if you’ve used a couple of products in the past that your skin does not agree with, look up the formulas, compare them, and see if there are any common ingredients in all of these things. That’s how I discovered my skin hates lavender oil.

While you’re doing this, try to see what the main ingredients are in formulas that have worked well for you. A few years ago, I did this and learned that all the serums, toners, and moisturizers that work well for me include botanical ingredients like Centella asiatica, propolis, and mugwort, as they reduce swelling without stripping my skin barrier.

In my book Let’s Face It: Secrets of a Skincare Obsessive, I go into way richer detail, explaining what certain ingredients are, how they function, and why they might be right for you. But a few common ingredients you’ll find in formulas created for acne-prone skin are:

• Benzoyl Peroxide
  This is an ingredient that works by killing bacteria and reducing inflammation, helping to clear up pimples and prevent new ones from forming. Even though this works extremely well, it can be pretty dehydrating on the skin, so be sure to use lots of moisturizing ingredients in conjunction with it. I like Panoxyl’s 10% cleanser the best; even though it’s strong, it’s a wash-off treatment, so it reduces the possibility of irritation.

• Salicylic Acid
  This is probably the most commonly used ingredient when it comes to fighting acne. This works by exfoliating the skin and unclogging pores, helping to reduce and prevent breakouts. I like using Cosrx BHA Power Liquid, as it’s gentle but still really effective.

• Azelaic Acid
  Azelaic acid primarily focuses on reducing inflammation, unclogging pores, and targeting hyperpigmentation. It does this by helping the shedding of skin cells inside the follicle, reducing the buildup of keratin (a protein that can block pores), and inhibiting the production of melanin (which causes pigmentation). So this is a really great pick for both acne and hyperpigmentation. My favorite Azelaic Acid Emulsion is from Naturium.

• Mandelic Acid
  Mandelic acid is a type of alpha-hydroxy acid (AHA) that’s particularly effective for acne-prone skin because it has a large molecular size and slower penetration rate compared to other AHAs like glycolic acid, which is why it’s good for sensitive skin. Mandelic acid works by gently exfoliating the outer layer of the skin, removing things like dead skin cells, which can clog pores and cause acne. It also has antibacterial properties, so it' helps eliminate acne-causing bacteria. Sofie Pavitt Skincare makes an excellent serum.

• Retinoids
  Retinoids are effective for acne because they regulate skin cell turnover, prevent the formation of clogged pores, and reduce inflammation. Adapalene is specifically formulated for acne-prone skin, but beware; there can be an adjustment period for a few months where you can expect purging and flaking.