14 Powerful Ingredients that Can Zap Acne Wherever It Lives
When a pimple pops up, send it packing with these powerful zit-zapping ingredients.
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The acne fight
Acne is something most people have to deal with at some point in their lives, with many having to manage it on an ongoing basis. But skin science has come a long way since your teens and there are some powerful tools for clearing up acne for good. (And some even reduce wrinkles and scarring as well!)
When you first dive into skincare for acne, prescription retinoids are often one of the first products recommended. But not everyone needs prescription strength. "Milder versions known as retinols can be purchased over-the-counter and are featured in many well-formulated anti-aging and anti-acne creams," says Faiyaaz Kalimullah, MD, a dermatologist at the Center for Dermatology and Aesthetic Medicine in Chicago, Illinois, and a diplomat for the American Board of Dermatology. "It's important to remember that not all retinol products are formulated alike—the efficacy really depends on the exact retinol compound being used and it's concentration, among other factors." One over-the-counter retinol that has been getting rave reviews for years is RoC Retinol Correxion Cream.
Retinoids are derivatives of vitamin A and are some of the most powerful acne fighters we have as not only do they treat acne but they reduce wrinkles, and firm up and brighten skin, Dr. Kalimullah says. Of these, Tretinoin (the generic name for Retin-A) is the most commonly used. It works by increasing collagen production, increasing cell turnover, regulating sebum production, and reducing inflammation in the skin, he says. The one downside is it can be very irritating to skin so you should start with the lowest percentage, only applying it every few days, until your skin gets used to it, he says. While it takes a prescription to get this medication, you can do an online consultation and get prescription-strength tretinoin cream from companies like Curology.
There are numerous dermatologist-approved ways to treat breakouts, and now one of their top pimple fighters, Adapalene, has become available over-the-counter as Differin Adapalene Gel. Adapalene is a synthetic, prescription-grade retinoid that doctors have been using for over 20 years. "Topical retinoids are the best ingredients for unclogging pores and helping bring new skin cells to the surface while shedding old ones," explains Tsippora Shainhouse, MD, Beverly Hills-based dermatologist. "Regular use of these over-the-counter retinols can help with skin texture, acne, and the appearance of scars."
Found in many cleansers and moisturizers, this beta hydroxy acid helps to unstick dead skin cells and exfoliate the skin. "Salicylic acid can help greasy skin, but can be hard on drier or sensitive, acne-prone skin types," explains Dr. Shainhouse. "For adult skin, limit salicylic acid washes to twice a week on the face, and stick with using them for unclogging the pores on the back and chest to prevent and dry up body acne." She also recommends an on-the-spot gel formula for overnight use on new inflammatory lesions to help dry them up by the morning (try m-61 PowerSpot Clear).
Other scientifically-proven ingredients that are gentler exfoliants are alpha hydroxy acids like glycolic and lactic acid, Dr. Kalimullah says. "These can give you clearer skin without as much dryness and irritation as retinoids or salicylic acid," he says. However, he cautions against using products marketed as at-home "chemical peels" made with acids. "I've seen serious burns from chemical peels done at home, you should only do face peels in a certified dermatologist's office," he says. (Try a 5 percent glycolic acid product such as NeoStrata’s Foaming Glycolic Wash.)
Sulfur washes, creams, and masks
"Sulfur is keratolytic, so it helps exfoliate skin and possibly unclog pores," explains Dr. Shainhouse. "It is antibacterial and can help mattify skin, by 'mopping up' oil and sebum. It also inhibits pro-inflammatory enzymes, thus reducing inflammation and minimizing the development of new acne lesions." (Try Tata Harper Clarifying Spot Solution or Dr. Dennis Gross Clarifying Colloidal Sulfur Mask.) The cons: It's not the strongest treatment, and it can cause mild irritation and dryness in sensitive skin.
This ingredient acts as a bleach by oxidizing and killing the bacteria that can cause acne, says Jennifer Linder, MD, dermatologist, skin surgeon, a national spokesperson for The Skin Cancer Foundation, and holds a clinical faculty position in the Department of Dermatology at the University of California, San Francisco. "You can use it to treat pimples anywhere on your body, including the face, chest, and back," she says. (Try X Out, an 8.5 percent benzoyl peroxide cleanser, spot treatment, and mask by the Makers of Proactiv.) Just be wary of bleaching fabric, as the peroxide can bleach clothing, towels, and even hair. Also, although it's very effective when used with other topical or oral acne medications, it can be drying and irritating to adult skin. These are the 11 myths about large pores everyone must know.
Intralesional steroid injections
Cystic acne—acne that develops deep below the skin—can be incredibly painful and difficult to treat. One method that may be effective is injecting a steroid directly into the pimple. "Steroid injections can be useful to treat painful, tender, inflamed, and indurated subcutaneous nodules that pop up," says Dr. Shainhouse. "We use a tiny injection of dilute steroid to reduce the inflammation within a day, and help speed the healing of the acne lesion or cyst."
"When taken at normal doses for two to three months and used in conjunction with topical medications, prescription antibiotics can significantly reduce acne lesion count and severity in teens and some adult patients," says Dr. Shainhouse. However, they are not meant to be taken long-term at this dose. "Low-dose oral tetracyclines do not kill bacteria, but rather, help block the pro-inflammatory enzymes in the skin that lead to inflamed, red acne lesions, and tender cysts in some adult women." These can be taken longer term. Don't miss these super-important questions to ask before taking prescription medications.
Oral isotretinoin (aka Accutane)
This is an oral version of tretinoin (Retin A) that works by temporarily shrinking oil glands (they grow back after treatment, so your skin doesn't stay clear forever) and training the lining of the pores to produce and express their keratinocytes and keratin, to prevent clogging. "This is usually a five-to-six-month treatment course," says Dr. Shainhouse of the prescription medication. "For many patients, their skin remains perfectly clear, or almost clear, forever." However, women should avoid this treatment during pregnancy, she adds, due to the risk of birth defects. These are the clear signs you need prescription acne treatment.
Spironolactone is a prescription diuretic pill that has anti-androgenic side effects, meaning it counteracts the effects of male sex hormones such as testosterone on the skin (yes, even women make testosterone—just much less than men). "Classically used to manage high blood pressure, Spironolactone can be very helpful in managing cystic acne in women who flare with their menstrual cycle," says Dr. Shainhouse. "It is frequently used to manage acne and other androgenic signs in women with polycystic ovarian syndrome (PCOS)." As in the case with PCOS, your acne may even be trying to tell you something important. (Do not take this medication if you are pregnant.)
Oral contraceptive pills
By helping maintain estrogen and progesterone hormone levels in the blood, birth control pills can actually reduce premenstrual acne flares. It is important to note, however, that the opposite can be true when taking high-progesterone or low-estrogen formulations of birth control. "Depo-Provera shots and hormonal IUDs do not contain estrogen and may trigger acne flares when initiated," says Dr. Shainhouse. These are the things you must know about birth control, according to doctors.
Nature has some very powerful ingredients for fighting acne and one of the best are antioxidants, Dr. Kalimullah says. "Look for serums or lotions with vitamins C and E, niacinamide, green tea extract, grape seed extract, and resveratrol, among others," he says. You can also increase your intake of these compounds by eating more servings of colorful fruits and vegetables in your diet.
Blue light therapy
"Blue light has been shown to kill P.acnes bacteria and may help reduce inflammation in and on the skin," explains Dr. Shainhouse. It can be administered twice a week for four to six weeks at your dermatologist's office or for five minutes a night at home with a hand-held device that can be purchased over the counter, such as reVive Light Therapy Spot Acne Treatment. Your dermatologist may apply a skin-sensitizing, topical prescription medication on your skin before the treatment to increase the efficacy of the treatment. "Light therapies that use blue and red light may help also calm acne."
- Tsippora Shainhouse, MD, Beverly Hills-based dermatologist
- Jennifer Linder, MD, dermatologist, skin surgeon, a national spokesperson for The Skin Cancer Foundation, and holds a clinical faculty position in the Department of Dermatology at the University of California, San Francisco.
- Faiyaaz Kalimullah, MD, a dermatologist at the Center for Dermatology and Aesthetic Medicine in Chicago, Illinois, and a diplomat for the American Board of Dermatology