Hi everyone!

Sorry I’ve been MIA over the past two weeks, getting in the flow of the new semester has been tough! I’ll try to become more consistent with new Friday posts every week, so be sure to stay tuned!

I’ve decided to do a skin series for the next couple weeks, focusing on some of the major issues many of us suffer from. I’ve started out with acne, hyperpigmentation, and dry skin… but if you have questions about more, feel free to ask!

Alright let’s get started!

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For this week, I’m focusing on acne.

As a general rule of thumb, we experience acne when our sebaceous glands (oil gland) become inflamed or infected. There are a couple reasons why this happens. Our glands are either 1.) exposed to bacteria (usually p. acne bacteria) or 2.) our body experiences some hormonal fluctuation which causes the inflammation. Of course, acne breakouts can come about from other things like stress, but for now let’s just focus on these two.  

1.       Bacteria: The oil in our skin exists in a slightly acidic state (around a pH of 5). This is called our acid mantle; it helps to protect our skin’s barrier functions and prevents infection from bacteria (which happens a lot! Just think about how many time you touch your face throughout the day.).  Occasionally our pores will collect and harbor that bacteria. When it has been starved of oxygen, an infection may occur, causing the base of the gland to become inflamed. This inflammation is the body’s mechanism to fight infection. It will send white blood cells to the area to fight the infection, which is why you see puss when a pimple looks like it is about to burst- also called a white head. Black heads are the same thing, except that the sebum (oil mixture of the pore) has oxidized and faded a dark color. The sebum may also have some melanin, or pigmented cells, mixed in. 

This is a great visual for what a follicle looks like when it becomes inflammed! 

     Treatment Advice: A lot of my new clients coming in with acne skin tell me about the harsh products they are using and a lot of the time I am shocked that they still have skin on their faces! The number one misconception about cleansing acne skin is that you have to use an acne scrub every day. PLEASE DON’T DO THAT! YOU’RE GOING TO MAKE ME CRY. Acne = inflammation. So with that logic, would you scrub over a fresh cut with acid and sand? Please tell me you answered “no.” I usually recommend having about three different cleansing products on hand.

1)      Gentle Cleanser. You’ll want to keep a gentle cleanser around like Aveda’s All Sensitive Cleanser with oatmeal and jojoba oil to condition and calm the skin. Or if you need a cheaper option, CeraVe is a great drugstore brand that combines hyaluronic acid and ceramides (both protect the skins barrier function and prevent water loss- a great ingredient to look for in the winter!). Their Foaming Facial Cleanser is a great choice. 

2)      Medicated Cleanser. When I say medicated, I mean that it either contains salicylic acid or glycolic acid.

a.       Salicylic is a Beta Hydroxy Acid (BHA) that helps in exfoliating the skin gently, also helping to dry excess oil that you might be experiencing. Personally, I like sticking with naturally derived salicylic acid –not synthetic, which has been shown in some cases worsen acne when you quit using the product. I like Aveda’s Outer Peace Foaming Cleanser because it won’t irritate the skin because of its foamy texture and also contains naturally derived wintergreen salicylic acid.

b.       Glycolic acid is another great ingredient in an acne cleanser. Opposite to salicylic acid, glycolic acid is an Alpha Hydroxy Acid (AHA), and in some cases can be used more regularly for individuals with drier skin. It has the smallest molecular size of the AHA’s, so it can penetrate much deeper into the skin. Because of this feature, if you would like to use a cleansing brush like Clarisonic, go for it. But please, procede GENTLY and only a maximum number of 2-3 times a week. I don’t want to see red faces! I really like SkinCeuticals Purifying Cleanser because it doesn’t over dry the skin but still is very effective in treating acne. Glycolic acid is effective in mostly all skin types as it also helps to tone the skin and eliminate some forms of hyperpigmentation.  

3)      Exfoliating or Treatment step. Please be careful with this step, as I have seen a lot of people get carried away with scrubbing their faces until they look like a tomato. There are two main ways to exfoliate: mechanical and chemical.

a.       Mechanical: As I said, you can use a Clarisonic up to a maximum of 3 times a week, but usually 2 times is fine. Microscrubs are also a good option here. This is going to be a scrub with an ultrafine texture- almost like you were rubbing baking powder paste in your hands. There are a lot of good ones out there, but one that has been very effective for me has been another one of Skinceuticals products, Micro-Exfoliating Scrub.

 

b.       Chemical: Chemical exfoliation uses an AHA or BHA like I mentioned above to exfoliate the skin without being abrasive. Generally, exfoliating astringents will do this job. You can apply these with a cotton ball in the morning after using a gentle cleanser in order to control oil throughout the day, if you choose to use one.

You can also use a mask. Clay masks usually work well for skin with acne because it tends to be extra oily. The clay, usually a kaolin derived clay for you fellow geology nerds, helps to absorb excess oil and can be applied after a warm shower since the oil has melted a bit in the pores and is more readily extracted by the clay minerals. There are so many options out there, I’m sure you will be able to find one without a problem! 

2.       Hormones: Acne is tricky business when it comes to hormonal involvement. A vast majority of my spa clientele that experiences acne, complains most about hormonal acne. For women especially, this happens around the chin. PMS is a big culprit for hormonal acne because of the estrogen and progesterone fluctuations. About a week before a woman’s menstrual cycle you can generally begin to see a flair up in acne, this is likely to do with the drop in progesterone in the body. There is still a lot of conflicting evidence on what exactly causes hormonal acne in women, but this is one of the most accepted ideas.

Example of hormonal acne

     Treatment advice: For women with hormonal acne, I generally recommend coming in for a facial the week before your menstrual cycle starts so that we can help control those breakouts and calm the skin down. It all comes down to timing and figuring out how to catch it before it gets worse. Otherwise, the same treatment options can apply for this type of acne with the exception of which AHA/BHA to use. Glycolic acid has shown some promising results at deeply penetrating the skin to dry up some of those swollen follicles, so I would recommend using glycolic pads, in the chin area especially, a couple times a week.

Hormonal acne may also bring upon hyperpigmentation, but we will talk about what to do with that another time!

Here's a silly little chart I found on pinterest. It helps in simplifying some of the differences between AHA's and BHA's.

 For each of these types, I still recommend professional facials on a 2-6 week basis, depending on what your budget can allow and how invasive the procedure is. A series of facials can drastically help unclog the skin, allowing more oxygen to your cells, and a healthier appearance. 

I know we only touched on two of the main causes of acne, but another huge one is food. Many people experiencing acne centralized on the cheeks, may actually be experiencing a food allergy. We’ll talk about food sensitivity and skin on another day. 

I hope this helped to teach you all a little bit more about acne, and I’m always open to questions if you have them!

Until next week!