Updated: May 8, 2020
I think treating acne is one of the most rewarding things I do as a practitioner. Acne can be such an emotional trigger to talk about with patients because of what emotions it stirs up. But what a wonderful feeling it is when you can put your arms around a patient that has suffered with Acne for years and tell them you are going to help them get their skin clear. However, there are many treatment regimens out there for acne which can get confusing and frustrating.
First off, what causes acne. A range of factors trigger acne, but the main cause is thought to be a rise in androgen levels. Androgen is a type of hormone. Rising androgen levels cause the oil glands under the skin to grow and the enlarged gland produces more sebum (oil). Excessive sebum can break down cellular walls in the pores, causing bacteria to grow. I explain it as, bacteria love to come make babies in that oil and that is where pimples are born.
It is unclear what role diet plays in worsening acne. Scientists have found that people who consume a diet that offers a good supply of vitamins A and E and of zinc may have a lower risk of severe acne. One review describes the link between acne and diet as “controversial,” but suggests that a diet with a low glycemic load may help.
Genetic factors may also increase the risk, especially if both parents had/have acne.
Avoid anxiety and stress, as it can increase production of cortisol and adrenaline, which exacerbate acne.
To clear acne effectively, you should be thoughtful in your approach with selecting the right acne treatment. It should exfoliate, clear the skin’s pores, & remove the buildup of acne bacteria. This is why the best acne treatments use a multistep regimen.
The way I instruct my patients to treat their acne is to wash with benzoyl peroxide (BPO) and salicylic acid cleansers. I recommend washing with BPO wash Monday-Friday and Salicylic acid wash on Saturday-Sunday. The reasoning behind switching up washes is to keep the bacteria guessing. If bacteria gets exposed to the same ingredients over and over again they get use to it and they will find a way to survive. Also, remember that these cleansers can be very drying to the skin. Breaking down that skin barrier can cause acne to get worse. A very good moisturizer is very important while you on on this type of regimen. By mixing up the products and ingredients, bacteria have a harder time building a resistance to the medication. I would also recommend using a retinoid at night to turn over the skin cycle quicker. The only OTC retinoid on the market is Differin (adapalene 0.1%). I will occasionally add oral and/or topical antibiotics to the regimen to help clear up acne, but these are prescription medications. I also will use isotretinoin (accutane) to treat acne. Lots of people have their opinion on accutane and there is a lot of misinformation out on the internet , however there is a place for it and it works extremely well.
There are natural ways to treat acne too and I'm not opposed to it at all. It just depends on you and what you'd be willing to do. Treating acne is not a cookie cutter. A treatment regimen that works for some, might not work for another.