Acne is Essentially a Wound, so Should You Treat it as Such?

True story: Last week I had a giant cystic pimple on my cheek that wouldn't die, no matter how many spot treatments I tried. For advice, I reached out to skincare extraordinaire Renée Rouleau, who told me not to touch it and just continue with what I was doing. But as each day wore on and the breakout continued to stare me in the face, I threw in the towel and gave it a major squeeze. Of course, this made it even redder and angrier, and it swiftly scabbed over (forgive me, Renée, for I have sinned).

As I watched the blemish take on new life, I was immediately transported back to my high school days when I relentlessly picked at my skin to the point where I had certified wounds smattered across my pubescent face like fiery constellations. So when K-beauty darling Alicia Yoon recently told me that acne lesions are essentially wounds and need to be treated as such, I could relate on a cellular level. But this stands for breakouts that haven't been mangled, too. The definition of a wound is "an injury to living tissue caused by a cut, blow, or other impact, typically one in which the skin is cut or broken." In the case of acne, the impact is the inflammation and buildup within the skin.

Hydrocolloid Patches for Cystic Acne

Eastern countries took note of the concept of treating pimples as wounds many years ago, employing hydrocolloid patches (the same treatment used in medicine to heal wounds and burns) that draw buildup out of the breakout rather than dispense medicine onto the area to treat blemishes. Several mainstream brands have begun marketing similar patches, including Peace Out, Clearasil, and Peter Thomas Roth. (Yoon's own brand, Peach & Lily, sells Acne Spot Dots.) Is this the be-all, end-all treatment everyone should be doing? I did some digging.

I came across a 2006 pilot study in China where hydrocolloid dressings were applied to acne lesions. Twenty patients with mild to moderate acne applied the skin dressings every two days for up to one week. The results showed a significant improvement in redness and oiliness on days three, five, and seven. Given that the research was done over 10 years ago and the sample size was so small, we asked dermatologists if the findings hold any weight.

Raj Kanodia and Deepak Dugar, MDs, of Beverly Hills Plastic Surgeons weren't too impressed, giving "little to no clout" to the study. "Wound dressings may become another tool toward fighting acne, but alone, it will likely never be purely a solo treatment," they said. "There is excess oil in the sebaceous glands of the skin, which harbor bacteria, and the multiplication of the bacteria is what causes the breakouts."

Instead of putting all of your cards into the wound treatment, Kanodia and Dugar recommend sticking to traditional treatments like topical retinols and products aimed at reducing the oil in the glands to decrease the colony of bacteria. "Oral antibiotics can also be helpful with dealing with wounds and acne breakouts," they explain, but not without giving hydrocolloid bandages a bit of street credit. "This acne dressing is likely just another tool, which, if it helps, is exciting."

Michele Farber of Schweiger Dermatology Group in NYC has a bit more optimism. "Wound dressings can be a helpful adjunct for acne," she explains. "The 2006 study examined hydrocolloid dressings as an acne treatment and showed that they reduce oiliness, redness, and pigment changes as acne resolves. Hydrocolloids do work for acne spot treatments and are already on the market as acne dots. They work by drawing excess oil out of skin to help acne resolve more quickly."

Similarly to Kanodia and Dugar, however, she wouldn't recommend them as a sole remedy, especially in the case of more austere lesions. "They are great for a few bumps, but depending on the severity of the breakout, other medications may be necessary," she says.

Melissa Kanchanapoomi Levin, MD, a board-certified dermatologist and clinical instructor at NYU Langone Medical Center and Mount Sinai Hospital, shares similar sentiments. "The water-attracting film [in a hydrocolloid dressing] is applied directly to an open wound. In dermatology, we use hydrocolloid dressings for the treatment of chronic wounds and ulcers. To me, hydrocolloid bandages are a part of treating breakouts but not the entire answer," she says. "It's important to stay on your skincare regimen with anti-acne ingredients."

While the mechanics of wound dressings may not solve all your pimple problems, their physical design alone intrigues dermatologists. First, the dressings foster a moist environment to allow for faster and improved healing time. Second (and this is a biggie for this editor), they block you from being able to pick.

"For me, this is one of the biggest benefits, since it's human nature to want to pick and squeeze," says Farber. "But picking a pimple increases inflammation and not only slows down the healing process, it increases pigmentation and scarring."

Lastly, covering a breakout with a patch protects it against sunlight, minimizing exposure to UV radiation, and thus preventing hyperpigmentation, explains Levin.

So why not just use a Band-Aid, you ask? According to Farber, with continued use, plain bandages have the potential to irritate the skin on the face. Plus, they don't have the same moisture-inducing, water-attracting material that hydrocolloid bandages do.

What About Topical Wound Ointments?

You may have heard of some skincare enthusiasts swearing by Neosporin as a spot treatment for pimples. It's antibacterial, so it has to help, right? Not so, says Farber. "Neosporin is best for actual cuts and scrapes—stick to your acne products for your face. Neosporin is in a petroleum base, which can potentially clog your pores. It's also best to use antibiotics directed at acne, as Neosporin is directed at different bacteria. Acne products contain combinations of medications that are aimed to treat the bacteria that cause acne as well as other causes of acne."

Levin agrees: "We want the glands and pores to be cleared and not sealed over."

What Neosporin may do is help a popped pimple heal. It can keep the skin moisturized to prevent scarring, while protecting it from bacteria that can get into the open wound and cause infections. Even then, test it on your skin first— behind your ear or under the jaw—to ensure you don't have a reaction.

Tried-and-True Ways to Treat Acne

Over-the-counter creams and gels containing benzoyl peroxide are also recommended for treating acne. Unlike Neosporin, this ingredient actually kills the bacteria that causes acne. And while Neosporin blocks pores, a cleanser that contains salicylic acid clears them and calms any redness.

For a simple skin-clearing regimen, try this three-step treatment:

1. Apply a 3 percent benzoyl peroxide pad, gel, or cleanser to your acne or pimples.
2. Once that dries, apply a .5% salicylic acid pad or gel.
3. Finish with a moisturizer, as dry skin can overproduce oil and ultimately lead to more acne.

If you prefer natural products, you can also try tea tree oil (always dilute it with water because it's pretty powerful stuff). This isn't an FDA-approved acne treatment, but the oil is known for fighting inflammation on the scalp and skin.

The Bottom Line

While wound dressings help draw out oil and reduce redness, topical retinoids or antibacterial topicals are more effective as a whole at ameliorating acne lesions. To choose the best measure for your specific type of acne, speak with a dermatologist.

Chao CM, Lai WY, Wu BY, Chang HC, Huang WS, Chen YF. A pilot study on efficacy treatment of acne vulgaris using a new method: results of a randomized double- blind trial with Acne Dressing. J Cosmet Sci. 2006;57(2): 95-105.

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