From AM to PM.
To help navigate the best products, tips, and routines for treating acne-prone skin, we spoke to two top dermatologists for their expert advice.
What Is Acne?
By definition, Johns Hopkins defines acne as a quite common skin condition that's a "disorder of the hair follicles and oil glands (sebaceous glands). The sebaceous glands secrete oils (sebum) to keep the skin moist. When the glands get clogged, it can lead to pimples and cysts."
According to the American Academy of Dermatology (AAD), it's the most common skin condition in the United States, affecting up to 50 million Americans annually, and approximately 85% of people between the ages of 12 to 24 experience at least minor acne.
Thankfully, there are options to care for and treat even the most stubborn, severe acne. The AAD says, "Thanks to advances in treatment, virtually all acne can clear with a dermatologistâ€™s help."
Causes and Prevention of Acne
So, what exactly causes acne? More than one thing, explains Brendan Camp, MD, a board-certified dermatologist at MDCS Dermatology. "Clogged pores, excessive oil production, bacteria that trigger an inflammatory response, hormonal changes, and even diet can contribute to acne formation," he says.
Because of this, he says that it is a "good idea" to develop an acne routine customized to your skin's needs. And "while there may be no one-size-fits-all regimen, building a foundational skincare routine that can be modified to suit a personâ€™s needs is a good place to start," Camp says.
Arash Akhavan, MD, FAAD, board-certified dermatologist, also points out that it's important to keep in mind that "not all acne treatment requires prescription products. A solid home skincare routine may be all you need to control milder acne."
When it comes to caring for acne-prone skin, consistency and routine are key, as is ensuring you're using the right, quality products.
Below are the doctors' recommendations for your AM and PM skincare routine:
Morning Skincare Routine
Akhavan recommends that those with acne-prone skin cleanse their face twice a day. He also suggests that if you have oily skin, it's best to kick off your morning skincare routine with a creamy, oil-free cleanser with salicylic acid, such as Clearasil Rapid Rescue Wash, and "avoid using abrasive exfoliant sponges or brushes to minimize traumatic inflammation of the skin."
"Using toner is an additional step that helps remove extra oil and impurities from the skin as well as rebalance the pH of the skin, which is normally slightly acidic (the ingredients in some cleansers may nudge the skin pH towards basic)," explains Camp. Because some toners can be drying, if you have less oily skin, you may not need to use one. But if you do, he recommends, La Roche- Posayâ€™s Effaclar Clarifying Solution Acne Toner, which contains both salicylic acid (which flushes out pores) and glycolic acid, to help remove dead skin cells that can clog pores and make the skin look dull.
Proper UPF protection is a key step to maintaining healthy skin. Akhavan recommends using a sunscreen "with anti-inflammatory niacinamide in it, such as Elta MD UV Clear." Apply this as a base to be protected from the sun's harmful UVA and UVB rays.
The products used in this step may look different for everyone, but Camp says that the morning is a good time to begin targeting new or existing blemishes. "Spot treatments are helpful for zeroing in on acne bumps with products that contain active ingredients like salicylic acid, benzoyl peroxide, and sulfur," he says. He recommends Neutrogena's Rapid Clear Salicylic Acid Acne Treatment with Witch Hazel, or La Roche-Posayâ€™s Effaclar Duo Acne Spot Treatment, which contains 5.5% benzoyl peroxide, "which is effective for inflammatory acne like deep-seated stubborn lesions."
Moisturizing your skin is an important final step in your AM routine. But why? "Llipids, or fats, in the top layers of the skin help retain moisture and function to create an impermeable barrier between your skin and the environment," says Camp. "Skipping this step could leave the skin dry, vulnerable to infection, and/or dull in appearance."
He recommends that when selecting a product, "look for the words 'non- comedogenic,' which means the product is less likely to clog pores and contribute to the formation of acne papules."
Camp is a fan of Elta MDâ€™s UV Clear Broad-Spectrum SPF 46 as well as Cetaphil DermaControl Oil Absorbing Moisturizer SPF 30, which "has a slight mattifying effect helpful for those with oily skin."
Now you're ready to apply your favorite oil-free, mineral-based makeup, should you so desire!
Nighttime Skincare Routine
Camp says, "The best results come with consistency and compliance," and that by simplifying your skincare routine, you'll make it easier to complete and increase the likelihood of repeating it each day and night. "Mirroring your evening routine after the morning routine is one way to accomplish that."
"Washing your face in the evening removes oil produced during the day, as well as dirt, makeup, and other impurities you have been exposed to." Camp advises that those with more severe acne may want to stick with cleansers that contain active ingredients, and that alternatives to acne washes are gentle cleansers and micellar water.
"CeraVe has covered all bases when it comes to cleansers for acne-prone skin," Camp says. "It offers a hydrating cleanser for dry skin, a foaming cleanser for normal-to-oily skin, and cleansers that each contain benzoyl peroxide and salicylic acid."
As mentioned above, if your skin is oily, you can repeat applying toner in the evening, too, for an extra-squeaky-clean feeling.
Try AvÃ¨ne Gentle Toning Lotion, which Camp says is a good option for those with sensitive skin or those needing something to help calm irritated skin. He also recommends Paulaâ€™s Choice Skin Balancing Pore-Reducing Toner, which "reduces pore size, while the niacinamide helps calm redness."
Because not everyone needs or can tolerate acne medications applied to the whole face, how you medicate may look different from how another person with acne medicates. Product recommendations are typically individualized, but a gentler option that Camp recommends is azelaic acid, derived from grains.
"Azelaic acid helps to kill bacteria, exfoliate dead skin, and brighten skin complexion" he explains. Both he and Akhavan recommend The Ordinary's Azelaic Acid Suspension 10%, the strongest concentration available without a prescription.
Camp says that while Retin-A is still only available by prescription, "retinoids work to prevent acne by regulating or normalizing the process of cell turnover, which prevents blocked pores and the formation breakouts." So, without a prescription, try an adapalene gel, like Differen Gel, a retinoid that is available in stores without a prescription.
Moisturize/Apply Night Cream
As opposed to in the morning, your evening moisturizer or night cream should not contain SPF. Instead, look for moisturizers containing a retinoid derivative of hyaluronic acid, a humectant that attracts water molecules to the skin. Camp recommends TriAcnÃ©al Night Smoothing Lotion by Avene for a retinoid option and Neutrogena's Hydro Boost Gel-Cream for more oily skin.
For clarifying hydration, Camp also recommends U.F.O. Ultra-Clarifying Acne Treatment Face Oil by Sunday Riley, a facial oil that "helps complement natural skin oils by further hydrating and smoothing skin." It contains 1.5% salicylic acid and helps treat acne, too.
While this is the order of application the doctors tend to recommend to patients, some dermatologists recommend a general rule of applying thinnest to thickest. But Camp says, "I donâ€™t think that is a hard-and-fast rule. For the most part, patients with acne-prone skin should probably limit the number of products they use because too many products can cause skin irritation and aggravate acne or potentially block pores.
And, keep in mind that "no acne treatment works immediately or overnight," says Camp. He usually recommends that patients use a prescription acne product for at least 8 to 12 weeks consistently before deciding if it is helping or not, unless the product is causing skin irritation or a rash.
"Adult acne may (also) be a symptom of other health conditions, such as polycystic ovary syndrome (PCOS), which is associated with irregular periods, facial hair, scalp hair loss, and weight gain," says Camp. He stresses that if you think your acne may be the result of an underlying condition or is not responding appropriately to over-the-counter treatments, you should make an appointment with a board-certified dermatologist.
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