Acne Skin Care

Acne Skin Care At A Glance

  • Best Results6-12 weeks
  • Treatment RecoveryNA
  • Procedure Time1-2 min daily
  • Skin SpecialistDermal therapist, nurse
  • Duration of ResultsVariable
  • AnaestheticNA
  • Back to WorkNA
  • Cost$

Acne Skin Care

Simple acne skin care & good lifestyle modifications can treat over 80% of acne. Start with a good face wash, add ingredients including retinol or retinoids, niacinamide, ascorbic acid & beta hydroxy acids. It takes 6 to 8 weeks before optimal results are seen.

FactsFacts on Acne Skin Care

  • Start with a good face wash
  • Cerave & La Roche Posay make salicylic acid washes
  • Add a retinol or a retinoid-based product
  • Consider azelaic acid or niacinamide to reduce skin inflammation
  • Acne patches or hydrocolloid dressing are extremely useful especially for hormonal acne
  • Give yourself 2 days make up free to allow your skin to breathe
  • Add a well researched acne diet
  • Give a structured skincare routine 6 to 8 weeks to work

Acne Skin Care

Look for the following ingredients –

Retinol, retinaldehyde, hydroxypinacolone retinoate: These are retinoids that can be purchased without a prescription in Australia. They require conversion to retinoic acid (HPR exception). Start with a good formulation of 0.5%.

Adapalene: If you can get your hands on this, it is more effective than over the counter retinoids. Hint: this is available over the counter in the United States. This is classed as a third generation retinoid. In Australia, this requires a prescription. You can ask your GP for a script.

Retinol is more forgiving than prescription retinoids. Use every second night, increase SLOWLY as tolerated.

Salicylic acid: Best used as a face wash. See below for instructions. 2% wash, start once a day, increase as tolerated. La Roche Posay & Cerave makes great formulations.

Niacinamide: Or vitamin B3 can reduce redness, inflammation & aid in restoring barrier function. 5-10% recommended. Goes well with retinol and retinoids.

Benzoyl peroxide: Can be considered if you have nasty pimples & zits. It can be drying, so be careful. Good as a wash if you are treating larger areas such as the back, chest.

Azelaic acid: Can be bought without a prescription in Australia. Formulations range from 10 to 20%. Good for reducing inflammation & pigmentation associated with acne.

Ascorbic acid: Is awesome when you get your acne under absolute control. Do not mix this with other stuff or you will get skin irritation. Ascorbic acid or vitamin C can help repair scars & most importantly reduce pigmented scars; namely post inflammatory hyperpigmentation. This is one ingredient which you should get right in the context of good formulations. Think Obagi, Medik 8, Aspect Dr, The Formulated. 

Vitamin C is a good starting point. It can reduce pigmentation & stimulate collagen. It also protects your skin from UV radiation.

Tea tree oil: can be effective in some. Most dermatologists will go for mainstream treatment, however, there is evidence that this essential oil can exert powerful anti-inflammatory effects. It is also  bactericidal and fungicidal. Beware of skin irritation & allergies.

How long does it take skin care products to work?

As a guide-

Retinoids take between 4-10 weeks before effects are seen. A transient purge is not uncommon.

BHA or beta hydroxy acid works quicker, as it has an exfoliating action.

What is the best ingredient for acne scars?

Firstly let us start with basics. Sunscreen is your best friend. This can reduce red and brown acne scars and can markedly reduce post inflammatory hyperpigmentation. This is especially important if you have darker skin type.

The next ingredient is a retinoid. If you have access to adapalene or Differin, apply this nightly as tolerated. This is OTC in the US, in Australia, ask your GP for a prescription. The second best option is a good formulation of retinol. Start at 0.5%, increase to 1.0% as tolerated.

Retinoids are useful in treating pigment, wrinkles & acne.

Niacinamide & azelaic acid can be useful as this is anti-inflammatory. Best for red acne scars. You can use this in the morning, and retinol at night.

Brown acne marks can respond best to L-ascorbic acid. Again choose a good formulation at 10%, increase to a maximum of 20%. Ascorbic acid or vitamin C can suppress pigment cells & conversely stimulate collagen producing cells.

Recommended formulations include The Formulated, Aspect Dr, Medik 8, Obagi, & Skinceuticals. If you have sensitive skin, consider Murad. 

What supplements can help with acne?

Zinc sulfate has many good papers behind it. It can help modify your immune system to help fight bacteria.

Probiotics can be considered if you are on long term antibiotics.

Anti-acne diet may work in some cases. It requires marked discipline with no cheat days.

Davin’s viewpoint: acne skin care

The absolute majority of acne (80+%), can be treated with lifestyle modifications including good make up practices, product selection, diet, and really simple skin care. The minority of acne may require medical intervention by a general practitioner. Another small percentage may require management by a medical dermatologist.

A few practical hints. Never ever go by how you feel about the progress of your acne treatment, alway go by objective measurements , namely what your actual progress is (or lack off). Take a photo before you undertake a skin care routine. Count the amount of zits-pustules- papules. Record this down. Embark on simple acne directed skin care. This may include acne washes, retinoids, retinol, azelaic acid, & other topicals. Stick with this program for at least 6 weeks. Take another photo, then do a lesion count. Ideally you should improve by 20-30 % every 6 weeks. If not, swap your routine until you get a decline in lesions.

The next step? Seek an option from your general practitioner. They can prescribe topical retinoids such as tretinoin, adapalene, retinoids with BPO (Epiduo), as well as antibiotics & anti-hormones. If your acne fails to respond within 6 – 8 weeks a referral to a dermatologist may be prudent.

Dermatologists may approach your acne from another angle.  We may investigate your acne, conduct a hormone profile, optimise your skin care &  often prescribe anti-hormones, anti androgens as well as oral retinoids. Consider seeing a medical dermatologist for treatment if your acne is recalcitrant to normal management, if you have evidence of acne scarring, or if your acne has significantly affected your social & mental well being.

Spironolactone is a great molecule that reduces oil or sebum production, hence it’s use in treating normal acne & oily skin.
Spironolactone is effective in over 80% of normal acne cases. This medication is relatively banal. It takes 6-12+ weeks for maximal efficacy.

*Disclaimer: I am a procedural dermatologist, my work is focused around surgery,lasers, deep peels & complex injectables. I do not treat medical conditions including acne. Please see one of my colleagues @cliniccutis for management.

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