Acne 101

I get questions about acne everyday. When a client asks me for my opinion about either their child's acne or their own skin, before I offer them advice I first probe for lifestyle information. Acne doesn't discriminate against age, although teens are more vulnerable due to increased hormones and over-active sebaceous activity. There are two main components to acne: It requires bacteria to grow and sugar to survive. Avoiding bacterial contact with face is a KEY component in maintaining healthy skin; read-on and you'll find out how. 

"Propionibacteria acnes" (or "P-acnes") is the bacteria responsible for acne breakouts. A simple tweak in your lifestyle (such as using a tissue to dry your face) can improve the look of your skin exponentially. Why a tissue? Because drying your face with a clean tissue, will ensure that bacteria will not contaminate the face. Even a freshly laundered towel will harbor some bacteria, so seemingly insignificant actions, like using a tissue to pay dry, can be a game changer for skin. 

Be conscious of your diet and sugar in-take. I'm talking about white, refined sugar as seen in junk foods or cupcakes. I'm also talking about hydrogenated foods, processed foods and foods with a high glycemic levels....they ALL cause inflammation in the skin and compromise skin-health. Enjoy sweets in moderation, but be aware that sugar allows acne to thrive.

(This photo is an example of Grade 4 Cystic acne).

ACNE COMES IN FOUR FLAVORS:  The severity of ACNE is based on it's grade: Grade I, Grade II, Grade III and Grade IV.  GRADE I Acne is the mildest forrm, consisting mainly of sporadic blackheads and whiteheads. It is non-inflammatory, typically seen in the form of blackheads and minor legions, and can be treated easily with OTC topical treatments. GRADE II  is moderate acne and, as opposed to Grade I, slightly inflamed lesions appear as a result of follicular build-up. Grade II can be treated at home with OTC products such as salicylic acid and benzoyl peroxide lotion. The presence of black and whiteheads are more abundant than in Grade I, and slight inflammation may now occur. This type of acne should be treated daily, as a proactive measure to avoid progression into Grade III.  GRADE III acne is considered severe acne.  Much more inflammation is present at this stage, as well as an abundance of papules and pustules.  It is not uncommon for Grade III acne to involve other body areas, such as neck, chest, shoulders and upper back lesions.  How do you treat acne at this stage? Consult with a Dermatologist! The treatment protocol is usually a combination of topical as well as systemic therapies, which are available only by prescription. If not properly treated, Grade III can quickly progress into Grade IV acne. GRADE IV acne is the most severe form of acne, also known as "cystic acne". Grade IV will manifest itself by displaying numerous papules, pustules, nodules and cysts.  A great deal of inflammation is associated with Grade IV acne and will usually spread beyond the face, and onto the entire back, chest, shoulders and upper arm region.  Cystic acne will almost always develop scarring, so an aggressive treatment protocol by your Dermatologist can be expected. This acne will usually consist of strong systemic medications, as well as topical prescription treatments. If your doctor prescribes "Accutane" (actual drug name is "Isotretioin") do not be afraid. Although the brand "Accutane" is no longer in existence, it is still referred to by this name. Regardless of what you call it, one or two rounds of Accutane, monitored by your Board Certified Dermatologist, can be an acne game changer and can make an enormous impact on actinic skin. If you do not consult with a Dermatologist to get this cystic acne managed, the acne-causing bacteria will eat away at the collegen in the skin, leading to mild-severe scarring. 

IMPORTANT STEPS TO TAKE

Control your sugar in-take, keep your skin clean by CLEANSING twice per day (morning and night), and TONING twice per day (preferably using a salicylic acid toner) after cleansing. Moreover, proactively treat your acne legions with Benzoyl Peroxide. 

Toning, after washing, is a key step in skin care because it balances the skin's pH. Healthy skin is ACIDIC, around 5.5 on the scale. Cleansers, even the mild versions, leave the skin with a higher alkalinity than you'd want, so toning the skin is an easy yet essential step. 

Salicylic Acid and Benzoyl Peroxide BOTH kill the P-acnes bacteria, therefore, when the bacteria disappears, so does the acne. The added bonus of Benzoyl Peroxide and Salicylic Acid is that they infuse the follicle with oxygen, this is key. Acne is anaerobic and cannot survive in oxygen, therefore, keeping the follicles flushed (so that oxygen can flow in and out freely), and keeping the skin acidic, is setting the skin up for success. 

(This photo is an example of Grade 3 acne which requires the care of a Dermatologist)

Knowing that acne cannot survive in oxygen is KEY information. Imagine a clean test tube, where oxygen is flowing in and out freely. Now imagine that same glass tube filled with dirt, oil, dead skin cells and debris. Your hair follicle is like this tube. If you maintain clean, flushed-out follicles, oxygen will be able to penetrate and acne will not be able to bloom. How do you keep the follicle flushed? Easy peezy: cleanse, tone, moisturize (CTM) 2x per day and exfoliate 2-3x per week, depending on skin type (I prefer "acid exfoliators" such as Glycolic or Salicylic Acid for skin with acne. Granular scrubs can be irritating, so try to avoid these).  Skin is NOT one size fits all, so I suggest you consult with a licensed skin care expert or a Board Certified Dermatologist to design the proper protocol for your skin.

Using Retinoids is a skin game-changer and will absolutely keep those test tubes clean. Retinoids (such as the nAme brand "Retin-A") is "Retinoic Acid" and actually changes the DNA of skin cells. They stimulate the production of new skin and turn over the old cells. Retinoids are strong and by prescription only, but are what I would consider skin's "miricle cream". Most people stop using Retinoids once they experience irritation and peeling, however, once the skin adapts and gets used to the Retinoid, it will absolutely see a significant change. A pea size amount is all one needs for the face, so when using a Retinoid, make sure that you never overdo it. Starting slow with a 1-2 day per week application, then eventually building up (slowly) to a daily protocol will change your skin.

SALICYLIC ACID:  Products containing Salicylic Acid (a Beta Hydroxy Acid,  BHA) is great for treating mild acne. It melts away the mortar that keeps the skin cells glued together, resulting in skin that is smooth and turned-over. Salicylic can be found in cleansers, serums, toners and lotions. The main benefit of Salicylic Acid (aside from it's exfoliating benefits) is the fact that it infuses the follicle with oxygen (remember that clear test tube?). Since acne is anaerobic, it cannot survive on oxygenated skin, so Salicylic is an essential protocol. 

CONSULT WITH A DERMATOLOGIST: Acne consists of four levels: Grade 1 - Grade 4. The first two levels are mild to moderate acne, which is my target audience for this blog post. Many times mild acne, Grade 1 in particular, is hormonal and can be managed easily. Level 3 and 4 acne must be seen by a Dermatologist, this is beyond the skin-care-scope of an Esthetician because this type of acne must be controlled with with oral meds, topical meds, or sometimes a combination of both. Cystic acne that is not addressed by a doctor can result in permanent scarring.
 

DONT EVER TOUCH YOUR FACE!

Another tweak that will improve your skin's health is to NOT touch your face throughout the day and to dry your face with a clean tissue after cleansing, morning and night. I prefer generic tissues because they are not as fibrous as their fancy name-brand counterparts.  Using a bacteria-free tissue, can SIGNIFICANTLY help to clear up acne simply by preventing contamination. Just make sure to handle skin gently, never pull or tug, and blot skin dry, rather than wipe.

KEEP MAKE-UP BRUSHES CLEAN:

An additional issue I'd like to point out is the importance of keeping your make-up brushes clean. Do you wear foundation? How is it applied? Are you using the same grungy latex sponge you bought in 1997?  Do you wear blush?  What about facial powder?  How do you apply these products onto your skin?  Are you using a makeup brush to apply your cosmetics? Do you keep these brushes clean?  Did you even know that you needed to keep them clean? We've already discussed how simple tweaks in your lifestyle can positively affect your skin. The same theory holds true for make-brushes. You should clean your dry brushes at least once per week (dry brushes are used for powders, blush and eyeshadow) and wash your WET brushes every day. A wet brush is used for foundation, concealer, contouring creams or any other non-dry cosmetic. A wet brush will quickly harbor bacteria, so the simple act of washing them (using basic hand soap) is another skin game-changer.  If you like to use a latex sponge to apply foundation, use a NEW one for each application! Latex sponges are one time use, so toss those bacteria traps once you're done with them!  As for pressed powder, I never, EVER recommend using those little round cotton applicators that are provided with the compact.  Always use a fluffy, natural  hair brush to apply powder to the face, even pressed powder. If you like to travel with your compact in your purse, purchase a retractable travel powder brush that can be washed weekly.  

A simple way to clean your brushes: Rinse the brush (hair facing down) under warm water, apply a gentle cleanser or baby shampoo into the palm of your hand. Forming a cup with your palm, swirl the brush in your palm so that the dirt, oil and make-up within the hairs loosen. Rinse and repeat this process. Using a tissue, gently squeeze the water out of the brush, then lay the brush on a slight incline (bristles facing down) to dry. That's it. You should do this at least once per week for dry brushes and everyday for wet brushes. 

For more on skin health, visit my blog posts:  Skin-Care 101, Quick Tip: use a TISSUE to dry your face! and EXFOLIATE! Or follow me on all social media platforms (@Beauty and Brow Girl) for weekly skin care and beauty tips. 

  --CIAO for now  xoxo