Expert Advice

What is acne?
What causes acne?
How do I deal with acne?
I scrub and scrub my face but I still get acne. What’s my problem?
Why does it matter if an acne product is alcohol-free?
Some products I’ve tried irritate my skin…what can I do about it?
When will I stop experiencing breakouts? Will I just “grow out of” acne?
What is the difference between salicylic acid and benzoyl peroxide?
Do face washes with salicylic acid work like pads with salicylic acid?

 

1) What is acne?

Acne is the most common skin condition in America, with over 85% of teens–and many adults, as well–experiencing breakouts at least occasionally. Acne is linked to the sebaceous glands, which produce sebum (or oil). These glands are attached to hair follicles. Acne occurs when excess sebum (skin cells from a hair follicle’s lining and skin proteins clump together) plugs up the opening of a follicle so sebum cannot reach the surface of the skin. Plugged follicles can take the form of either “whiteheads,” where the plugged follicle remains beneath the skin’s surface, or “blackheads,” where the plug extends to the skin’s surface and becomes visible. Once a follicle becomes plugged, it creates an ideal environment for a common sebum-eating skin bacterium, Propionibacterium acnes (or P. acnes), to multiply. This bacterium produces enzymes and chemicals that irritate and inflame the skin around a clogged follicle. “Pimples,” “breakouts,” or “zits” are common names for the lesions that result from this type of skin irritation and inflammation, though doctors have more precise ways of classifying acne lesions. For most people, acne is a mild condition. Of course, a pimple at the wrong time is never desirable, but in truth, there are far more concerning issues than acne. For some people, however, severe cases can result in permanent scarring if left untreated.


2) What causes acne?

The precise cause of acne is not known, but its onset is usually linked to a few key factors. One of the most important of these factors seems to be the increase in the production of androgen hormones that occurs in both men and women during puberty or adolescence. Increased amounts of androgens in the body cause the sebaceous glands to become enlarged and to produce greater quantities of sebum (oil). Also during puberty, the skin cells lining a follicle tend to be shed at a quicker pace, increasing the probability that they will stick together and contribute to blockages in the follicle. Other factors that are thought to contribute to acne include:

  • use of greasy, pore-clogging (comedogenic) cosmetics.
  • a family history of acne.
  • abrasion caused by over-vigorous scrubbing, frequent shaving, or other manipulation and “picking at” the skin.
  • exposure to high heat and humidity.
  • exposure to airborne pollutants.
  • the use of certain drugs, such as glucocorticoids, iodides, bromides, lithium, artificial androgens and others.

No definitive link has been shown to exist between acne and diet–even with the consumption of chocolate, fatty foods or shellfish. Surprisingly, even such factors as stress and poor hygiene are only linked indirectly to acne, even though regular cleansing is advisable for many reasons. Since normal changes in the body during puberty are the main contributors to acne, it’s no wonder virtually everyone experiences breakouts.


3) How do I deal with acne?

There is no instant (or long-lasting) cure for acne. Over-the-counter products aim at control and prevention in order to minimize scarring, and most of them require consistent use over a number of weeks (which varies by the specific type of treatment) until results can be seen. As you would expect, “proper” treatment depends on the type and severity of acne that a person is experiencing. For acne that goes beyond mild to moderate (Grades 1 & 2 in classification), it is highly advisable to consult a dermatologist to help determine a proper course of care. As a first step, daily cleansing has many benefits, including breakout control. Select mild cleansers or soaps, and be careful not to scrub your skin too vigorously. For mild to moderate acne, which includes the majority of acne cases, non-prescription products such as Stridex can be quite effective when properly used. Look for these two ingredients:

  • salicylic acid, an ingredient that acts to exfoliate skin and help unclog pores to prevent acne lesions
  • benzoyl peroxide, a substance that destroys the bacteria associated with acne

Neither of these ingredients affects the underlying production of hormones and sebum that contributes to acne, so products containing either must be used consistently and continuously over time in order to be effective.


4) I scrub and scrub my face but I still get acne. What’s my problem?

Strangely enough, maybe the problem is the scrubbing. Too vigorous scrubbing or the use of harsh cleansers can sometimes make the problem of acne even worse. Face skin should be cleaned gently in the morning and evening, and after heavy exercise. Look for cleansers that contain mild non-irritating ingredients. Also, you might try using an acne medicated pad, such as Stridex pads, after cleansing to leave an acne-fighting medication behind to provide a more lasting preventative benefit than you can get from cleansing alone.


5) Why does it matter if an acne product is alcohol-free?

Many acne product formulas include alcohol, which can be very drying and irritating, especially to acne prone skin. Alcohol is not an acne fighting ingredient, but it does give skin a “tingle” when used on the face. Acne treatment products made without alcohol rely on the proven acne fighting active ingredients (salicylic acid or benzoyl peroxide) to do the work without the unnecessary irritation and dryness that comes from alcohol. The drying, irritating effects of alcohol on skin are well understood…years ago Stridex determined that alcohol was unnecessary in its pad formulations. Typical acne pads can contain 25-40% alcohol…the resulting redness and irritation can be a bigger nuisance than the problem you are trying to solve. That’s important, because consistent daily use of acne-fighting medication is the key to effective acne control and prevention.


6) Some products I’ve tried irritate my skin…what can I do about it?

Everyone’s skin is different, so it’s impossible to pinpoint one cause of skin discomfort. Often, irritation can be caused by using a product incorrectly (too often, too vigorously, for too long of a period, etc.) or by using the wrong type of product for your skin. To solve the first problem, always follow directions carefully, and start with the minimal recommended dosage, gradually building up as needed. For people with sensitive or irritation-prone skin, it is sometimes best to use products formulated to be gentle on skin, such as Stridex Sensitive Pads.


7) When will I stop experiencing breakouts? Will I just “grow out of” acne?

For many people, acne decreases in frequency and severity, often virtually “going away,” sometime in their early twenties. It is not unusual, however, for it to persist into the thirties and beyond–and some people even experience acne for the first time as adults.


8) What is the difference between salicylic acid and benzoyl peroxide?

Salicylic acid and benzoyl peroxide are the two most common active ingredients in over-the-counter acne treatments. While they are both approved ingredients for the treatment of acne, they work to fight acne in different ways:

  • Salicylic acid, an ingredient that acts to exfoliate skin and help unclog pores to prevent acne lesions…by breaking down clogs, it allows pores to freely “flush” the sebum and bacteria that leads to pimples.
  • Benzoyl peroxide, a substance that destroys the bacteria associated with acne…to work benzoyl peroxide must get into the pore in close proximity to the bacteria.

9) Do face washes with salicylic acid work like pads with salicylic acid?

Salicylic acid acts to exfoliate skin and help unclog pores. In order for it to work, salicylic acid must be applied to skin. A face wash containing salicylic acid will be rinsed off shortly after application, thereby removing the salicylic acid from the skin. Pads and other treatment products (like lotions or gels) are applied directly to the skin and left on the skin.