What you didn't know you needed to get rid of acne

Acne is a really tricky condition. Although it is very common (between 80 and 90% of teenagers suffer from it at one point or another), it is not that well understood or treated, because it has very different forms and can occur for various reasons that are not always clear.

Let's start from the beginning.

Acne develops as a result of blockages in the pores by sebum. Sebum is vital to keep the skin supple, but when it is produced in excess, it can block the hair follicle and create a comedo. 
There is two kinds of comedo : whiteheads and blackheads. They are basically the same, except a whitehead is trapped behind the skin when a blackhead isn't. Depending on the severity of the acne, you can also get nodules, which are solid elevations of the skin with no visible fluid. When scratched, they can get infected.

Acne comes from the excess production of sebum. Contrary to some beliefs, acne does not come from poor hygiene. You can be the cleanest person on earth and still get acne. This excess production of sebum generally comes from hormonal activity - hence the apparition of acne during puberty. It can also be genetic, or stress-linked. It can also be a consequence of a diet - but more on than later, because this is a controversial topic.
Because the causes of acne are varied, you can get acne at every point of your life. For a lot of people, it will clear out after puberty. But you can still get acne later in your life, should it be from a change in your hormonal activity, or an increased stress-level, or a pregnancy. Infortunately, you are never too old for acne and it can point its head when you least expect it.


With this little summary, let's talk treatment.


To get rid of acne, you will need :


A dermatologist

The first thing to do is go see a specialist. Even if you have to most common form of acne and the least severe, you should go see someone. Getting informed on your own is essential, of course, but the first step to informe yourself is to get the opinion of a specialist. If you don't have the money or can't go see a specialist, a GP will suffice.

I will take this opportunity to repeat that I am not a doctor, and that this post just countains general knowledge about acne that I gained from personal research. It is by no mean a tool to diagnose yourself. I will not advise any medical treatment for acne, although they are numerous and the first thing you should try before cosmetics. Only a specialist can give them to you.

It doesn't matter how young (or old) you are, you should go see a dermatologist, and the sooner the better. There is no shame in having acne. If the treatment s/he gave you didn't work, go back and tell him so.

Medical treatments are varied. They can go from topical creams, to antibiotics, to hormonal treatments, to vitamins. I will not discuss them here, because I do not have the slightest qualification for this. 
I will however say that they are not magic potions, and if one of them don't work, you should go back to your doctor and discuss a change in your treatment.


A good hygiene

Although acne doesn't come from poor hygiene, it can be managed with a beauty routine which keep the skin clean. It can avoid or decrease the risk of inflammatory acne, especially since the skin is vulnerable to infections because of the spots. This is why you should always clean your hands before touching your skin. This is also why going to bed with make-up is absolutely wrong.

When you have acne-prone skin, it can be really tempting to overwash your face, because the oilyness makes it seem like it is dirty. It is not, and overwashing your face actually worsen the problem. So you have to find a way to keep the skin perfectly clean without washing it with agressive soaps or treatments. It has to be clean, because if it isn't, there is no way any product will penetrate the skin.

The first thing is to get a cleanser designed for acne-prone skins. I would recommand La Roche-Posay Effaclear Purifying Foaming Gel for Oily Sensitive Skin. It is a really efficient and respectful product. It really cleans it well, without attacking it. 

Effaclear Purifying Foaming Gel by La Roche-Posay


The Balancing Cleanser with Aloe Vera by Alpha-H is also great, but more expensive. 

Kiehl's makes a good cleanser too : Rare Earth Deep Pore Daily Cleanser. It is a little exfoliating, so you don't need to use it every day for it to be effective. It does a good job at purifying the skin. 

Rare Earth Deep Pore Daily Cleanser with Amazonian White Clay by Kiehl's


If you have a lot of money, there is always the Eve Lom Cleanser, best cleanser in the world. A cult product which comes in a pot and leaves the skin radiant.

Generally, I find that products that come in oil (like Shu Uemura Skin Purifier, a wonderful product but unfortunately unfitted for my skin) are not right for acne-prone skin, because they have a tendancy to clog the skin. 

Cleansing Beauty Oil Premium A/l by the wonderful brand Shu Uemura


As for the products that are very foamy, like The Body Shop Foaming Cleanser, they tend to dry it. So, careful with this product, it is not for a daily use.

Teat Tree Skin Clearing Foaming Cleanser


You might think that drying your skin will balance it, because acne come from to much sebum, but you will actually make it create more sebum to compensate. Drying products are bad for acne-prone skins (except for medical treatments ; some of them really dry the skin, but it is intended. A good rule, on your own, is to avoid drying or agressive products).
Milky makeup removers are a little tricky. The thing is, it is not recommended to leave them on the skin, even if the bottle says you don't have to rinse it. I got this trick from my beauty therapist. It can be comedogenic after a while, so be careful with these cleansers. Generally, always take the ones intended for combination, oily and sensitive skin. If you absolutely prefer milky makeup removers, I find that ultra-mild cleansers for babies are really effective.

When you have used your cleanser, to make sure your skin will be completely clean, you can use a micelle solution designed for your type of skin. The best micelle solution I found is Bioderma Sébium H2O for Combination or Oily Skin. It is really soft, but really efficient. You can also use it durig the day when you think your skin gets a little oily, or in the morning after waking up, it is really refreshing.

Bioderma Micelle Solution for Combination and Oily Skin


A good hygiene will help manage acne and will get your skin ready so the products can act.

Products that respect your skin and work for you

Unfortunately, acne-prone skins are really sensitive to all kinds of things, and a product that doesn't do anything in one person will trigger a breakout in the next. It is really difficult to say what your skin will bear and what it won't ; you just have to try and see. 

For a daily routine

An acne-prone skin is still a skin with the same basic needs as the others. So, always moisturize. You just have to find a light moisturizer which will work well without drowning your skin.

Alpha-H Hydrator Gel does a good job and is especially fitted for oily skins.

Alpha-H Clear Skin Daily Hydrator Gel with Eucalyptus


Nuxe "Crème Prodigieuse" is also very respectful of the skin, and leaves it soft and well hydrated.


Karin Herzog is a very good but expensive brand. Their moisturizer, Oxygen Face, can be used with oily skin, it balances it. You apply it on the skin and let it work. It is a little heavy for a daily use, I find, so I generally only use it on week-ends.

A really great moisturizer. Karin Herzoh makes wonderful products, and is one of the favourite skincare lines of Kate Middleton - and she certainly has great skin!


If you don't know where to start, brands like La Roche-Posay, Avene or what you will find in your pharmacy are generally good quality products and they will not attack the skin.

It can be difficult to find efficient and respectful makeup, but with experience, you will know what products are comedogenic on your skin. 
In general, it is a good rule not to cover your face with powders, or oil-based products, or rich creams. Powders can be okay if they are dermatologically tested. I find that the Bare Minerals are really respectful and generally don't trigger any kind of breakout. The cheaper brand by Sephora is also fine. Most others do, however. 

Bare Mineral MATTE Foundation with SPF 15 - Fairly Light


It is extremely important to find these products that will work just well with your skin, because the comedogenic products are more efficient at triggering breakouts than the anti-acneic products are at eliminating them. 

For other skincare products

There are all kinds of products on the market that claim to treat acne : masks, serums, exfoliants... Here is what I have gathered from my research.

- Do not exfoliate that much. Or at all, actually. If you absolutely have to, do it with a soft exfoliant, and not more than once a week. The softest I found is the Exfoliating Gel with organic angelica water and essential oil by L'Occitane. It is really pleasing to use, the texture isn't aggressive. 

Exfoliating Gel by L'Occitane en Provence

But in general, for acne-prone skin, chemical exfoliating products are really better against spots.
The best one I ever tried is Liquid Gold by Alpha-H. It is glycolic acid in a bottle : you use it every other night alone on the skin. It really does wonder against breakouts, acne scars and wrinkles. Really, really effective to give the skin a clearer and plumper look. 

- Masks are not magic treatments. They don't clear out the skin in one evening, but they can help, purify it if you use them well. Open your pores with hot water in a bowl and a cloth over your head, apply the mask and let it really work. Take it off with a hot cloth or warm water. Use it once a week ; more, and they tend to dry the skin.

- The secret overnight treatment : Payot "Pâte grise". With acne, there are no magical treatments. Except this one. You apply a little bit of the paste on the spot that starts developping and keep it there during the night. It is not supposed to penetrate onto the skin. It really helps reducing spots.

Pâte Grise by Payot


Keep things simple

I believe Eve Lom when she says we are doing far too much for our skin and the skin doesn't like it. It stops functionning properly. 
When you have acne, it can be really tempting to use a whole lot of products on your skin and hope they will work. It is good to let the skin breathe and work by itself sometime. 
As a rule, it is not a good idea to drown the skin with lots of products. Acne-prone skin is very sensitive, and you don't want to attack it, you want to balance it gently, not attack it to change its nature.
Cleanse, moisturize and treat. You don't need that much more. Keep things simple.


Money (but not that much)

Acne requires money, unfortunately. Visits to the doctor, trials of products... : it can quickly add up. 
The good news is, you don't have to ruin yourself to treat acne. A lot of products can be found with a budget : stick with the ones you find in your pharmacy, they are generally between 10 and 20 euros, and will last several months.
Avoid fancy make-up which promise the moon and keep things simple on your skin. Get freaky with the eyes and the mouth if you absolutely have to.


Self control

Don't pick your skin. Just don't. It will worsen your acne, while leaving your skin scarred.


Patience

This is probably the most important item in my little list. When you go to the dermatologist, and get out with a prescription, or when you buy really good products, you are under the impression that your acne will clear out for good with one product.
Actually, it never works this way. Acne takes time to clear out. Even with the most effective products, you generally see the effects after weeks of using them. It is actually quite logical, because acne comes from an unbalanced skin, and you want to balance it again. It can't happen overnight.

Managing it takes time. The time to try a product which happen to be inefficient, or to worsen your condition, to try another one and see if it works... The time to find that one product which used to work doesn't anymore, and you ave to find a replacement.The time to understand why your acne came back, what changed in your life to make it reappear... 

Patience is the key. It is hard, but necessary. With a good beauty routine, products you can trust and a good knowledge of yourself and your skin, it does get better, eventually.

Good luck!