To achieve clear skin, we are going to go back to basics and start with washing your face. Irrespective of what type of acne you have, washing your face is an important thing to do. Facial cleansing is important because it enables you to remove dirt, oil, and other unwanted debris from the skin. During the course of a day, our facial skin can get covered with pollutants, bacteria, viruses, dirt and old skin cells. In the first blog in this series, I mentioned how all acne starts from a clogged pilosebaceous unit (aka pore). People with acne prone skin may experience poor skin turnover, which results in dead skin cells getting trapped in the follicles causing white heads and black heads. Improper skin washing can make acne worse, because excessive dirt on the surface of the skin can also block follicles. Furthermore, excessive dirt on the skin’s surface can prevent acne medications and anti-aging products from penetrating the skin and thereby prevent them from curing your acne. Cleansing also helps promote proper skin hydration, and helps maintain proper pore size. So how do you know what cleanser is best for you? It depends on three main factors – what type of acne your have, whether you have dry, oily, or combination skin, and most importantly, what other acne medications or anti-aging products you are using on your skin.
Before we dive into the details, I would like to make a quick recommendation on how to read this post. My goal is to try to help people cure their acne, so this has to be pretty comprehensive!! If you have a short attention span like me, I recommend going straight to the subtitle that pertains to what kind of acne you have. If you don’t know what kind of acne you have, please read the first blog in this series. At the end of this post, I give some general instructions that apply to everyone, so be sure you read that too.
How to choose the right facial cleanser
In my first blog in this series (making the right diagnosis), I introduced you to the four main types of acne. For a brief review they are as follows: 1) comedonal acne (non-inflammatory); 2) inflammatory acne (pustular and cystic); 3) combination acne (both comedonal and inflammatory); and 4) hormonal acne. If you are not currently using any acne treatments, then your face wash can actually be the first step in your treatment plan. Let’s discuss what ingredients may be helpful for you based on what type of acne you have.
- Comedonal acne – at the core of comedonal acne is a problem with poor skin turnover resulting a number of white heads and black heads. If you have this kind of acne, you want to get an acne wash with salicylic acid. Most over the counter salicylic acne washes contain 2% sal acid. With the introduction of Differin (a topical retinoid available over the counter), I would recommend sticking to a gentle face wash combined with Differin to treat comedonal acne.
- Inflammatory acne – If you have you have inflamed bumps or pustules on your skin, you’ll want to find a face wash that contains benzoyl peroxide (BPO). When it comes to BPO washes they come in many different strengths. BPO washes can range from 2%-10%. If you have inflammatory acne, you may be tempted to think that a stronger wash is better. This is not always the case. BPO washes can be very irritating to the skin, causing dryness and burning. As a result, I do not tend to recommend 10% BPO washes, unless it is being used for the back. In most instances, I think a 5% wash is fine. However, if you have inflammatory acne and sensitive skin, I would start with a 2% wash. BPO is the ingredient used in Proactiv. If you have inflammatory acne, then this may be just what you need. However, if you don’t have inflammatory acne… well, then that’s why Proactiv is not working for you! Take caution when using 3-step acne systems that are sold as a kit as these products will often include active ingredients in each step of the kit. When BPO is applied in excessive amounts the skin will become dry and irritated.
- Combination skin – In general, I recommend that most people wash their face twice a day. If you find that you have combination acne, and you are NOT on any other acne treatments… meaning the only other thing you apply to your skin is moisturizer, then you could try to use a sal acid cleanser in the morning and a low strength BPO wash at night – 2% tops. It will be very important to avoid over irritating the skin, so you will want to apply a moisturizer to your skin after each wash.
- Hormonal acne – When it comes to hormonal acne, I have to say out right that a wash alone will not improve this problem. Hormonal acne requires a hormonal solution, which will be discussed in another blog. Most women with hormonal acne are in their mid-late 30s or forties, which is a time where they may also be concerned about anti-aging. My recommendation for women with this type of acne is to pick a product that will help with acne, but that is also anti-aging. Look for ingredients such as glycolic acid and azelaic acid, which can help with acne, but also help with brown spots, hyperpigmentation, and fine lines. Again, it’s important to remember that less is more. Using too high concentrations of these ingredients will cause skin irritation and that may lead to more acne. I recommend concentrations between 2-5%. Hydropeptide makes a great cleanser in it’s anti-aging clarify collection that would be good for a woman with hormonal acne. It contains ingredients that will gently exfoliate and control oil, balance the skin’s pH, and sooth inflammation. Hydropeptide is on the pricier end of skin care products but I would say, well worth it. Use code ‘Doctor-Ip’ at checkout for 15% off all Hydropeptide products.
- Face wash for the individual who is already on acne medication – Let’s say that you are already on acne medication. Maybe it was given to you by your PCP or by a dermatologist. Often times, I see patients who have been seen by other dermatologists. They have received acne medications, but they feel that are not seeing results. It’s not enough to have medications… skin care matters as well. As I mentioned, if you are not using the right facial cleanser, medications may not be able to penetrate properly. For those on acne treatment, I always recommend a gentle facial cleanser. In this instance, the washes that I have mentioned above may be much too strong if acne medications are already being applied to the face. If you are looking for a gentle face cleanser, my top choices are HydroPeptide Cleansing gel (use code ‘Doctor-Ip’ to save 15%) or Vanicream Gentle Cleanser.
The last factor to consider when choosing a cleanser is what skin-type you have. If your skin is excessively dry, you will want to avoid foam-based cleansers, and those with a high alcohol content. You’ll also want to avoid astringents (which I tend to avoid in all my patients). If you have dry skin and acne, you need to be careful. Whenever your skin senses that it is too dry, it will respond by increasing your sebum production. Increased sebum production means increased acne. After you wash you face, you will need to moisturize twice a day. It’s non-optional for you. You’ll want to look for a creamy cleanser. For oily skin, foams may work well for you. You’ll also want to make sure that your cleanser is pH balanced. Cleansing gels can be used as well. In most instances, because I am treating patients with acne medications, I recommend a simple gentle cleanser. However, this is particularly important if you consider yourself to be someone with sensitive skin.
So now that I have taken you through how to pick the right facial cleanser, let’s close by reviewing how to wash you face. Yep, there is a right and wrong way to wash your face!! Proper face washing is almost as important as a proper face cleanser.
When washing your face, it is important to remember a few things:
- Use lukewarm water. If the water is too hot or too cold you might end up with broken capillaries on your face, which will leave your face red.
- Make sure your hands are clean. A clean face starts with clean hands.
- Wash twice a day, no more. If you over wash and strip your skin of natural oils your body will start producing more oil and pores will be more likely to become clogged. If you have excessively dry skin, you may need to wash only once a day. I would recommend washing at night and then splashing lukewarm water on your face in the morning.
- Avoid abrasive face towels, and keep clarisonic brushes to a minimum. Over exfoliating, will cause skin irritation, which will cause your skin to break out. I would limit the use of these brushes to three times a week max.
- Don’t rush. After a long day I know how tempting it can be to rush through your evening routine. Your face requires gentle action and you should take time to work in the product and to rinse well. When you have finished with a thorough cleanse and rinse, pat dry with a soft towel.
Do you have a favorite cleanser? I’d love to hear about it in the comments below. Also, be sure to enter your email address below if you would like to be notified when I publish the next post in the series.