The AAD (American Academy of Dermatology) defines acne as:
"Acne appears when a pore in our skin clogs. This clog begins with dead skin cells. Normally, dead skin cells rise to surface of the pore, and the body sheds the cells. When the body starts to make lots of sebum (see-bum), oil that keeps our skin from drying out, the dead skin cells can stick together inside the pore. Instead of rising to the surface, the cells become trapped inside the pore."
And unfortunately, acne can affect people of ALL ages. In fact, there is a growing number of women between the ages of 30-50 getting acne. The jury is still out on exactly why that is happening, but it is and I see it daily in my treatment room. So while this condition can be really frustrating, let's talk about the details and facts.
Grades of Acne
Grade 1(mild)-mostly confined to blackheads and whiteheads, with the occasional pustule
Grade 2(moderate)-multiple pustules, mostly confined to the face
Grade 3(moderately severe)-numerous inflamed pustules, back and chest may be affected as well
Grade 4(severe)-numerous large and painful cysts, a lot of overall inflammation
Possible Causes (including but not limited to)
-Hormonal increases during teenage years (for teenage acne)
-Hormonal changes/ imbalances and disorders
-Hormonal change post pregnancy
-Starting/stopping birth control
-Some medications and supplements (look out for excessive amounts of Biotin, often found in hair/skin/nail supplements. Triggers acne in some people)
-Certain Foods. Some that are known to possibly exacerbate acne are: dairy, excess meat, iodine rich foods, peanut butter, sugar. Possible unidentified food allergy.
-LACK of certain foods in the diet like healthy fats (particularly Omega 3) and certain nutrients deficiencies. Omega 3 in particular promotes an anti-inflammatory response in the body which can greatly improve your skin and your overall health. Some studies also suggest that many acne cases can be related to a lack of vitamins A, E, D, and Zinc.
-Lack of alkalinity in the body/a diet that is causing too much acidity in the body
-Certain cosmetics and heavy foundations(especially if you are sleeping in your make up....yuck, by the way! LOL. Let's talk and change that if that's the case.)
-Use of skin care products that are just not right for your skin.
-CONSTANT changing of skin care products/lack of product consistency and proper usage
-Use of fabric softeners and fabric softener sheets. These all leave a waxy coating on your sheets and clothes which can transfer to your skin.
Possible Treatment And Things to Consider (including but not limited to)
-If persistent, speak to your health care provider about comprehensive blood testing. Maybe the culprit can be found there.
-Consistent facial treatments with your Aesthetician
-A change in your skin care product routine
-A change in your skin care process
-Consider researching a more alkaline diet. One of my fave things for helping with this, not to mention all the amazing nutrients is The Super Elixir Green . They also have urine PH strips so you can test how acidic or alkaline your body is! The issue of being too acidic is something to research and take very seriously as it is the root cause of much disease.
Myth vs. Fact
Myth: If I cleanse 3 or 4 times a day (or more!), I will make my acne better.
Fact: This will greatly disrupt the protective lipid barrier of your skin and cause it to become extremely agitated and dry. And what will happen when it's been overly stripped? An increase in oil production. And the formation of dead dry skin that will then trap oil and debris in your pores leading to....you guessed it, clogged pores and breakouts. It's called the Rebound Effect, and isn't good. Excessive cleansing is counter productive. There is generally never a need to cleanse more than twice per day (unless playing sports all day).
Myth: Since I have acne, I can't use moisturizer.
Fact: I hear this one all the time and it makes me cringe. Here's the deal....dehydrated skin produces more pore-clogging oil than hydrated skin and causes such an imbalance to your lipid barrier. Also, it makes it near impossible to even clear out your pores during a facial if you haven't been using a moisturizer because the pores are so sealed over with dead skin! It's about finding the right moisturizer for your skin.
Myth: I don't want to get a facial because it will make me break out.
Fact: If a client has acne and I've had to do a tremendous amount of extractions, then yes, there is a possibility that you will experience a self cleansing purge. Please know that I will do everything in my power to limit this. But again, for the first few treatments when we're trying to clear out a vast amount of clogged pores, sometimes a bit of a post facial breakout is inevitable. This should improve with time, consistent treatment, and a change in your skin care.
Myth: Tanning my skin will help clear my acne.
Fact: Some MINIMAL exposure to the sun's natural rays can reduce inflammation in the body, thereby helping some skin conditions initially. However, increased UVA/UVB exposure (excessive exposure to the sun or tanning beds) will eventually cause more inflammation and dry the surface of your skin causing a major oil rebound resulting in breakouts...the very thing you were trying to prevent. Putting yourself at risk for melanoma, not to mention the mass amount of photodamage you will cause (hello lines, wrinkles and brown spots) makes this a very dangerous "treatment".
Myth: I can't wear sunscreen because it clogs my pores.
Fact: Sunscreen formulations have come along way. That said, look for an oil free physical (reflects rays, i.e. zinc oxide, titanium dioxide) sunscreen. If you choose to run with this myth, please except the fact that later down the line, you could be facing skin problems that far exceed acne. Please protect your skin. ♥️
Myth: Blackheads are dirt in my pores.
Fact: Nope, not really. You guys always hear me talk about the skin cell turnover. It's a natural process that pushes oil and debris out of the pores keeping them clean. If that isn't happening fast enough, your pores will stock pile oil, skin debris, and protein. Products with vitamin A derivatives (Retin A, Retinol etc) can be very helpful. When you come in, let's talk about products to increase your cell turnover and to help keep the pores cleared out. Another often common cause is rising insulin levels due to poor diet or stress. This then causes an uptick in oil production and inflammation.
Myth: I had to pop the pimple at home to make it go away.
Fact: At home, please please please, HANDS OFF! So, I hear this statement from clients frequently. But then in the same breath, they express so much distress over the brown marks and scarring on their face. Well, the fact is a lot of those marks could have been avoided if you hadn't tried to extract them at home. Extractions done without proper skin preparation, sanitation, and post treatment will cause PIH, or Post Inflammatory Hyperpigmentation. Another lovely fact is that you run the risk of spreading bacteria to neighboring areas of your face. Plus, the deeper the pimple, the less likely it is to even pop. And those deep ones, if they aren't treated correctly, those babies will leave deep pitted scars.
Myth: I try a new acne product every week or 2 if I see that mine isn't working.
Fact: Oh boy. No no no. All this approach is going to do is cause confusion and skin irritation. One of the biggest struggles is trying to make a client understand that nothing is instantaneous. Know this: It takes a minimum of 6-8 weeks of consistent and proper use of a product to see improvement. I know dealing with acne can be an emotional thing, but when you embark on a new treatment and/or product, please be realistic and patient.
Myth: I heard coconut oil will clear my face so I'm just going to use that.
Fact: Ohhhh, that gosh darn Internet...HA! Ok, don't get me wrong here, I'm not anti-coconut oil. I like it as a hair mask, a food ingredient, and a body moisturizer. However, more often than not, over time it can exacerbate acne. I do love that you are at least trying to hydrate your skin and looking at more natural options. Kudos for that. But, please cease use of it on your face and let's chat about a more appropriate moisturizer for your skin.
What can an Aesthetician do?
Even if you are under the care of a physician for your acne, professional skin care treatments can work in synergy with your MD protocol. Put quite simply, sometimes your skin just gets to the point that it needs a good clean out. I will cleanse, exfoliate, and safely prep your skin for proper extractions, then steps are taken to calm everything back down. Plus, it's a great time to chat about what you're currently using on your skin and to tweak your products if necessary. When the skin has been professionally treated, it functions properly thereby helping to keep it clear and increasing the efficacy/absorption of any products being used.
**A word about ACCUTANE** If you decide that you are going that route, please come in for good exfoliation and pore clean out BEFORE beginning the medication. Yes, you can still get a facial while on Accutane, but it greatly limits what I can use on you due to the severely increased sensitivity of your skin.
Ideal Skin Care Protocol
1. First cleanse to completely remove make up, sunscreen, dirt, oil and pollution. NO HOT WATER! COLD ONLY.
2. 2nd cleanse with appropriate cleanser. NO HOT WATER! COLD ONLY.
3. Spray (or apply with cotton pad) an alcohol free toner all over the face. This helps the absorption of your next products and enables a less amount of product to be used!)
4. Apply treatment serum (if applicable)
5. Apply spot treatment (if applicable)
6. Moisturize (Do so immediately after your cleanse, spray and serum. Otherwise, your skin will begin to lose hydration (water).)
1. Light cleanse
2. Serum (if applicable)
3. Moisturize (can skip this step if your sunscreen is moisturizing enough for you)
**TIP*** An example of overly stripped dehydrated (loss of water) skin is after cleansing your skin in the morning, it's super oily by mid day. This is almost always a sign that you are using something too harsh on your skin and/or not replenishing the lipid barrier with the right moisturizer.
-Stop picking at home
-If you have super inflamed acne, avoid skin brushes and harsh scrubs. This will only make it worse.
-ONLY USE COLD WATER TO WASH YOUR FACE! Hot water does nothing but cause more inflammation, the very thing you're trying to avoid.
-You absolutely must cleanse your face of ALL make up, sunscreen, dirt, oil, and pollution before you go to sleep. A little tough love coming....Letting your face marinate in filth all night, but then expecting your face to be perfect makes NO SENSE AT ALL. If you struggle with this don't wait until you're absolutely exhausted at the end of the night to cleanse. Do it right when you get home and you know you're home for the night. C'mon guys, get real. For crying out loud, wash your face. Love ya! This goes for ALL skin types.
-Cleansing wipes alone DO NOT clean your skin properly. If you want to use them at a first step to remove make up, that's fine but it needs to be followed up with an appropriate cleanser.
-Be sure to cleanse immediately after strenuous exercise.
-Please moisturize everyday, yes, even if you have acne. If you're not sure what to use, let's chat at your next facial or just reach out to me: firstname.lastname@example.org.
-If you get an inflamed blemish, at night, after cleansing, run an ice cube over the blemish for a few seconds on then few seconds off. Do this a couple times. You would be surprised how much this one simple thing can calm down a pimple.
-avoid/limit sugar, excessive alcohol intake, iodine rich foods, peanut butter, excessive amounts of dairy (especially if not organic), excessive meat intake, and soda, excessive amounts of Biotin (often found in hair/skin/nail supplements)
-avoid constant product hopping. This tactic will not only cost you a ton of money but will yield no consistent positive results.
-be sure to get a healthy intake of the "good fats": flax, chia, walnuts, avocado, olive oil. There are also great omega supplements on the market (Vegan and non vegan), Evening Primrose is an excellent supplement for skin as well.
**A Note about fish based omega supplements** This topic is ever changing and I'm keeping a close eye on it. Why? Because of pollution in our oceans and the fact that Fukishima is STILL allegedly leaking nuclear waste. Sadly, there may come a time when having anything fish based will be too great a risk. I currently take this one from Nordic Naturals because I trust their sourcing and testing process. And the benefits of taking the right omega supplements are huge (brain health, heart health, and of course soft supple healthy skin). But there is so so much conflicting info on the state of our oceans at the moment, particularly the Pacific. Do your own research, and decide what's best for you.
-employ some sort of stress relieving things in your life. Even if it's just a couple minutes a day of reading, stretching, mindful breathing...whatever brings you joy.
-Book my Detox facial and let's try to get on some sort of consistent facial schedule. I know everybody has busy schedules and budgetary constraints, but in the case of acne, you really do have to hit it with treatments every few weeks to kick it out and keep it at bay. No worries, we can chat about a plan that works for YOU😘
DISCLAIMER: Obviously, I'm not a Doctor. Nothing stated here or anywhere on my site is meant to override any physicians care or advice. Nor am I trying to prescribe or diagnose. I'm simply supplying you with helpful info on your skin care journey while also giving you a good jumping off point for your own research. As always, do what feels right for you, and be sure to consult your physician to prevent interactions with any of your current medications or treatments ❤️