The Gentle Approach to Treating Stubborn Breakouts
If it feels like everyone you know is waking up with painful, angry zits right now, you're not mistaken. Dermatologists are getting cries for help from a growing number of acne patients, and it's no wonder. "Because of the pandemic, people who don't usually break out are dealing with flare-ups from chronic stress and disrupted sleep," says Laurel Geraghty, M.D., a dermatologist in Oregon. "Plus, daily mask wearing is making acne a more common complaint."
But here's the good news: There are three new FDA-approved medications for treating moderate to severe acne and a slew of excellent OTC topicals (including adapalene, a retinoid that used to require a prescription). There's also an entirely different game plan for getting clear. Forget drying out your skin and smothering it with products, which typically leads to inflammation and more breakouts. Dermatologists advise a gentler — and more effective — approach. Here's your guide on how to treat acne without breaking out the big guns.
A Less-Is-More Routine
Who hasn't thrown the kitchen sink at a pimple problem in desperation? You try a glycolic acid cleanser, then a salicylic acid spot treatment, followed by a retinoid, only to wind up with irritated skin and possibly more acne. "Overdoing it with products causes a breakdown of the skin's protective barrier," says Shari Marchbein, M.D., a dermatologist in New York. "Once that barrier is compromised, you can get an inflammatory response in the form of more acne. It's a vicious cycle." (Related: The Beauty Junkie's Guide to Using a Ton of Skin-Care Products Without Ruining Your Skin)
Instead, use fewer active ingredients in a smarter way. "Apply only one acne product in your a.m. and p.m. routine," says Dr. Geraghty. "Cleanse in the morning with a benzoyl peroxide wash to kill acne bacteria [short contact time on the skin minimizes the potential for irritation], or use a gentle cleanser and then a product that helps unclog pores, like one with azelaic or salicylic acid."
Try Paula's Choice 10% Azelaic Acid Booster (Buy It, $36, paulaschoice.com) or Skinceuticals Silymarin CF (Buy It, $166, skinceuticals.com), which includes 0.5 percent salicylic acid and silymarin, "an ingredient derived from the milk thistle plant that helps control sebum production and inhibit blackheads and whiteheads," says Dr. Marchbein.
At bedtime, go for a gentle cleanser followed by adapalene, a proven retinoid for acne. Try Differin Gel 0.1% (Buy It, $12, amazon.com). Apply this every other night, then gradually bump it up to nightly to help avoid inflammation," says Dr. Geraghty. Like other retinoids, adapalene also helps with any dark spots left behind.
Moisturize the Right Way
There are lots of misconceptions about acne, and one is that you should avoid moisturizer. "But you can actually improve acne and prevent breakouts just by moisturizing alone, even if you don't do anything else," says Dr. Marchbein.
The key for how to treat acne gently is to use ceramides, hyaluronic acid, or glycerin. Plus, acne is an underlying condition of the skin barrier, like rosacea or eczema, so if you don't moisturize, you can trigger inflammation from your acne treatments, and your breakouts will get worse.
Dr. Marchbein, who has acne and eczema, uses "a sandwich technique to layer active ingredients between a hydrating formula in order to avoid irritation and get better results." For instance, after cleansing at night, apply an oil-free moisturizer with hyaluronic acid, then a retinoid, and top that with the same moisturizer. Try Neutrogena Hydro Boost Water Gel (Buy It, $15, amazon.com).
And no matter how you're treating acne, you need to wear a noncomedogenic moisturizer with a broad-spectrum sunscreen every day, such as La Roche-Posay Anthelios Mineral SPF Moisturizer With Hyaluronic Acid (Buy It, $35, amazon.com)
When to See a Derm
Even if you know how to treat acne gently and apply those tactics to your routine, your breakouts might still linger. "If a diligent at-home acne routine isn't doing the trick after eight to 12 weeks, or if you're getting cystic acne, scarring, or a lot of post-inflammatory hyperpigmentation, then it's time to see a dermatologist," says Dr. Marchbein.