By: Jennifer O’Connor (Medical Esthetician/Skincare Specialist, Owner Fusion Face & Body over 15 years) http://www.fusionfacebody.com
All grades of acne usually have one thing in common: the hormonal component
Hormones are responsible for all cellular actions. Essential fatty acids are vital for high quality and quantity of sebaceous secretions. There are grades of acne from I-IV varying from acne simplex to deep cystic acne. Grades III and IV may need some medical intervention if the conditions are not improved with professional treatments and home care. I’ve had great results treating many grades of acne in different skin colors with a combination of chemical peels, ultrasound, blue light and microdermabrasion. Be sure you see a skincare specialist that is experienced in acne and if you have darker skin be sure they have additional experience in skin of color.
Home care is very crucial in treating acne. Make sure you review all the products you are using and get suggestions on usage and additional products you may need. Please note, sometimes oral antibiotics with or without topical prescriptions may be necessary.
In this blog learn what I recommend to my clients. Based on my 15 years working on clients and patients and 5 years in clinical trial work, I have documented what has and hasn’t worked for many skin conditions.
The four main causes of acne:
- Increased keratinization within the follicle (Cell buildup & Oil buildup)
- Increase sebum (oil) production
- Proliferation of P. acnes bacteria
Acne can present in many ways such as:
Hormonal acne is common in adolescence and is typically accompanied by an over production of sebum.
Acne cosmetica is triggered by comedogenic or irritating ingredient in everyday products. Certain makeup, laundry detergents and hair care products may clog the pores and lead to breakouts. Be sure to change pillowcases, clean phones and makeup brushes weekly.
Inflammatory acne is red and inflamed and may be uncomfortable.
Asphyxiated acne is characterized by a rough surface, reduced cell turnover combined with sebum and other debris trapped beneath. This acne can be caused by using the wrong products such as using a product with excess alcohol then not using a daily hydrator.
Bacterial acne may be the result of an over production of bacteria within the follicle or pore. P. acne is the bacteria responsible for acne. It is anaerobic (can’t live in the presence of oxygen) and flourishes in warm, humid environments. Topical oxygen sources like benzoyl peroxide will help to control the bacteria. Another favorite of mine is Niacinamide (Vitamin B3). It has been shown to be effective in treating moderate inflammatory acne.
Cystic acne usually sufferers experience large, painful nodules beneath the surface of the skin, which can remain for week or months. The depth and inflammation associated with cystic acne can destroy the follicle, resulting in scarring.
Systemic acne may involve other areas of the body (arms, chest, back and shoulders) May be brought on by disease, illness, medication or diet-related issues.
- Gently exfoliate and increase cell turnover – the initial trigger in the production of acne is the increased buildup in the follicle and and increased oil production, resulting in clogged pores. Skin cells often don’t shed enough on their own, creating a buildup of surface cells that trap oil and bacteria, allowing the bacteria to proliferate. TIP: Receiving well rounded blended peel that control bacteria and oil production, as well as loosen impacted cells, not only opens the pores but allows treatment products to penetrate to more effectively. Products and treatment formulations containing salicylic, azelaic acid, tca, resorcinol, alpha hydroxy acids, sulfur and topical retinoids are ideal for helping address this major cause of acne. Use caution when starting Retinols. Start with low dose and increase to help alleviate an acne flare up. I recommend starting with a retinyl palmitate for more sensitive skin.
- Control Oil Production – In acne-prone skin, increase oil production and P. acne bacteria build up and can trigger an inflammatory response. Note: It is imperative to understand that over drying your skin will cause the skin to over compensate by producing an excessive amount of oil. This will cause more breakouts. Peels are great to help reduce oil and bacteria. Salicylic is one of my favorite ingredients to recommend for home care. There are several beneficial oils for the treatment of acne, they are naturally derived fatty acids and won’t clog the skin but will help balance oily and acneic skin. These include, but not limited to:
- borage oil
- grapes seed oil
- wheat germ oil
3. Decrease P. acne proliferation – Using antibacterial and antimicrobial topicals and oral antibiotics (when necessary) are suitable ways to control bacteria. Topical sources such as Benzoyl Peroxide and hydrogen peroxide, effectively deliver oxygen to the follicle, killing the oxygen hating bacteria. Acne clients that use topicals to help increase cell turnover combined with gentle exfoliation, ensure the P. acne will not be trapped. At Fusion Face & Body we use treatments to increase circulation and blood flow to deliver oxygen, leading to a decrease in P. acne and assist in the clearing of active lesions. Other products to help decrease P. acne include Salicylic, Azelaic, Lactic and Kojic acid as well as tea tree oil. Though I have had the best results by ensuring the acids are the primary ingredient in the products followed by tea tree oil. I have not found tea tree oil alone to be very effective.
4. Protect from UV rays and other inflammatory stimulants – Inflammation is both a cause and result of acne. Using anti-inflammatory topical ingredients will soothe current irritation and help avoid undue future inflammation. Look for ingredients like Aloe Vera, Salicylic acid, bisabolol, panthenol, licorice, resveratrol, gluconolactone, and green tea are top picks.
Many acne treatments & products can make skin more photosensitive thereby increasing the risk for damage and post-inflammatory hyperpigmentation (PIH). It is imperative you use a daily SPF. I favor chemical free sunblocks. My favorite brands are Elta MD, Image Skincare and Environ. We also sell a lot of our own sheer mineral tint at Fusion Face & Body. I use the Image Skincare Foundation. https://www.imageskincare.com/by-collection/i-beauty/flawless-foundation.html. It is a mineral sunblock and makeup with amazing coverage. I recommend it post procedure and it helps heal the skin faster! I often combine it with our sheer mineral tint when I don’t need as much coverage or for a more dewy appearance.
Things to be aware of in your lifestyle
- avoid heavy makeup and clean your brushes and sponges weekly
- avoid products containing talc
- avoid over drying the skin
- always apply a hydrator
- oil absorbing papers help absorb surface oil
- wash hands regularly and avoid touching your face
- clean pillowcases and phones regularly
- avoid high percentages of topicals that can induce inflammation. Not all your products should contain these active ingredients!
- Do not pick
- Do not overstimulate as it will increase inflammation and breakout
- Wear SPF
Chemical Peels are the quickest way I have found to combat acne. Depending on the peel they will kill bacteria and reduce oil as well as future breakout. and reduce post inflammatory pigmentation. We always use a light to medium peel with no downtime to get results quickly. It is recommended that you receive the peels every 2 weeks until the acne is under control then you can go to a 4 week maintenance interval. If you also have post inflammatory pigmentation or acne scarring it can be addressed better once the acne is under control. It is advised to always 1st deal with the acne then move on to the other skin concerns. But many of the ingredients for treating acne can also reduce post inflammatory pigmentation marks. Look out for our blogs on hyperpigmentation.