Also stay away from bar soaps and bar cleansers—they can leave a film or residue on your skin, which in turn can clog pores and reduce the effectiveness of any anti-acne products you apply after cleansing. [58]
Avoid skincare and makeup products that can cause irritation. Irritation = inflammation, and that’s bad news! Unfortunately, many skincare and makeup products, including many claiming to treat acne, contain irritating, drying ingredients. Don’t use products that contain SD or denatured alcohol because it dries out skin and actually can lead to increased oil production. [3,4,53]
Also on the “do not use” list are mint (including menthol and peppermint), witch hazel, eucalyptus, or citrus ingredients, as they will wreak havoc on your skin—yet these ingredients show up in a shocking number of products claiming to help acne.
Be sure to remove all your makeup before going to bed. Sleeping with makeup on will prevent skin from exfoliating and also block pores, which increases the conditions that promote acne. If you wear heavy makeup or just want to feel extra clean (without causing inflammation), it can help to use a Clarisonic brush or a washcloth with your gentle water-soluble cleanser. After you’ve rinsed your face, follow with a gentle toner that contains anti-inflammatory ingredients or a gentle makeup remover to be sure every last trace of makeup is gone before your head hits the pillow.
Avoid overly emollient or thick moisturizers. These types of products not only make oily skin feel more oily and greasy, but also can block pores and even absorb into pores, adding to the clog that’s already there or creating a new one. No matter how you look at it, these types of products are usually a problem for someone struggling with breakouts and oily skin.
Exceptions to this are the small percentage of the population who have acne, clog-prone skin and dry skin with little to just-visible pores. This confusing skin type is not easy to treat. More emollient moisturizers may be necessary to deal with the dryness, but they can also clog pores. The best way to deal with this is to follow our skincare routine suggestions and then experiment to find the lightest lotion moisturizer that will take care of your dry skin and not trigger more breakouts. Layering two or three thin-textured hydrating products (for example, a water-based serum layered with a lotion moisturizer) may be necessary.
Does wearing makeup cause acne? Not for most people. Foundations are designed to stay on the top of skin; they don’t absorb into the pore and cause problems like thick, emollient moisturizers can. But what can cause acne is not getting all of your makeup off at night. So don’t blame your breakouts on the makeup you’re wearing, blame it on being a bit too tired at night to follow your skincare routine.
Use lighter hair-care products. If your hairstyle is such that your hair touches your forehead or the sides of your face, traces of the products you use to style your hair will also end up on your skin. Therefore, if you have acne-prone skin, you should avoid thick, waxy hairstyling products along the hairline because they can clog pores and lead to breakouts. Conditioners can also trigger acne breakouts, so avoid getting these on your face. If you have neck or back acne, try rinsing the conditioner in a way that prevents those areas from coming into contact with it.
Protect yourself from the sun. You might have heard that a good dose of sunlight can “clear up” acne breakouts, but there’s no research indicating that sun exposure clears up acne. Sun damage is yet another form of inflammation, and inflammation is necessary to avoid. [4,27] If you’re concerned that the emollient texture of your sun-protection products might cause breakouts, look for lightweight options. See the end of Chapter 9, Managing Oily Skin, for a list of some of our favorite lightweight, matte-finish sunscreens.
We realize that this is a lot of information to digest all at once, but preventing (or at least reducing) acne once you know what to use and what not to use can be surprisingly simple. We hope the information in this book will make your decision process far easier.
Acne Myths: A Reality Check
Regarding acne, there’s no shortage of advice and there are all sorts of theories as to what works and why. Among them are the following myths that turn up all the time, no matter how many times they’ve been debunked.
MYTH: You can dry up blemishes. Water is the only thing you can “dry up,” and a pimple has nothing to do with skin being wet. Drying up the water and other moisture-binding substances in skin actually hurts its ability to heal and fight inflammation, which encourages bacterial proliferation. [3,4,53] Absorbing oil that’s on the skin’s surface or in the pore is radically different from “drying up” skin with harsh ingredients such as SD or denatured alcohol, sulfur, camphor, and witch hazel.
MYTH: Acne is caused by not cleaning your skin well enough. This mistaken belief often leads to over-cleaning or scrubbing of the face with soaps and strong detergent cleansers, which only increases the risk of irritation, inflammation, and dryness, while doing nothing to prevent pimples. [53]
MYTH: You can spot-treat acne. Although you can greatly reduce the redness and swelling of a breakout with a salicylic acid (BHA)–based product or with a benzoyl peroxide disinfectant (both explained below), that doesn’t help prevent other breakouts from popping up on other parts of your face. Dealing with only the pimples and pustules you see means you’re ignoring those that are in the process of forming. [27,34]
As you may have guessed, spot-treating leads to a never-ending cycle of chasing acne around your face. Spot-treating tends to be most useful for those whose breakouts are consistently infrequent and localized (for example, always on the chin, nowhere else), rather than for those who experience them more frequently and/or randomly all over the face.
MYTH: If it tingles or feels cooling, it must be working. Ingredients that make your skin tingle, such as menthol, peppermint, eucalyptus, and lemon, show up in countless anti-acne products, yet there’s no research showing they have any benefit for acne or oily skin.
In fact, these ingredients irritate and inflame skin, only making matters worse! Irritating skin triggers stress-sensing nerve endings at the base of the pore, which in turn stimulate oil production. [4] That cooling sensation, however nice, has no ability to reduce acne.
MTYH: Eating chocolate or greasy food causes acne. Although it’s absolutely true that eating healthy food and an overall anti-inflammatory diet is good for your skin and your overall well-being, specifically eating chocolate or greasy food isn’t going to give you acne. [53] If that were true, then everyone who ate either of these things would have acne, and that’s simply not the case! On the other hand, diets high in sugar, dairy products, gluten, nuts, and fish may worsen acne for some people. [59,60,61,62,63]
MYTH: You can scrub acne, whiteheads, and blackheads away. It can help to use a gentle scrub as an extra cleansing step, but it won’t change acne conditions in skin. None of these problems are about skin being dirty or needing a “deep” cleansing.
In terms of blackheads, gentle scrubbing can remove only the top portion of the problem, kind of like mowing over a weed rather than pulling it out of the soil, roots and all. That’s why, within a day, if not within hours, of scrubbing blackheads, the dark dots are again lining your nose and cheeks. [64] The same concept applies to blackhead-removing pore strips, and the adhesives on these strips can be quite irritating. Depending on the scrub and how you use it, you most likely will be inflaming your skin, making matters worse!
MYTH: “Non-comedogenic” products won’t cause breakouts. You’ve no doubt seen the term “non-comedogenic” dozens of times—you may even look for it when shopping for makeup, in the belief that a product with this claim won’t clog pores or cause acne. Unfortunately, non-comedogenic is a totally unhelpful claim; the term was coined under test conditions that are not even remotely applicable to how you, or anyone else for that matter, use beauty products.
How did the non-comedogenic myth get started? It stems from a 1979 study published in the British Journal of Dermatology. [65] This study examined the potential of various ingredients (cocoa butter, for example) to clog pores and lead to the formation of comedones (a fancy word for blackheads and whiteheads). This potential was determined by applying