Acne is one of the most common skin conditions, and with the right information, you can learn how to prevent acne scars and treat acne. We have interviewed doctors and experts in the field about the best ways to treat acne and prevent acne scars.
How to Properly Wash Your Face and Prevent Acne
As Dr. Carol Ann Goodman from Bella Vi Spa and Aesthetics says, “Acne treatment regimens should be custom for each individual as everyone’s skin and acne are a bit different.” While acne is catalyzed by overactive sebaceous glands, the exact cause of acne is unknown, often explained by multiple factors that include genetics, hormones, and environmental factors such as diet.1 This can result in different types of acne that require different forms of treatment.
“The acne regimen is usually very individual and depends on the type of acne one has,” says Dr. Susan Bard, a board-certified dermatologist from Manhattan Dermatology Specialists.
Although acne treatments can vary among individuals, a proper face cleansing method can be adopted among everyone for healthier skin.
How Often Should You Wash Your Face
It is recommended to wash your face twice a day (once in the morning and once at night) and anytime after excessive sweating.
The Doctor's Skincare Routine
Along with a good face cleansing routine, an effective skincare regimen is also necessary to prevent acne breakouts.
Dr. Goodman suggested a simple regimen of cleansing, toning, and moisturizing twice a day, and many of the other doctors we spoke to suggested similar steps. Dr. Fayne Frey, a dermatologist of over 25 years from Fry Face, suggested that for a morning regimen, it is best to cleanse twice daily with a soap free cleanser, apply a moisturizer containing non-comedogenic ingredients, and finish with sunscreen, liberally and often.
Jane Nassar, a beautician of 30 years who trained in France, offered a specific night ritual:
- Wash the face with a special acne foam cleanser with active ingredients that reduces blemishes by killing bacteria.
- Dry the face using a tissue not towel (for sterilization).
- Use astringent toner, which helps to remove excess oil.
- Use acne cream lotion to minimize the secretions of sebum and moisturize balance the oil/water in the skin.
Dr. Tsippora Shainhouse from Rapaport Dermatology of Beverley Hills broke down acne regimens for both morning and night.
Morning acne prevention regimen:
- Gentle facewash to help remove excess surface oils. If you tend to be greasy or clogged, try a cleanser containing salicylic acid.
- Topical acne medication (prescription or benzoyl peroxide over the counter)
- A broad-spectrum SPF 30+ sunscreen lotion that says “non-comedogenic.” It will minimize UV-induced skin inflammation and prevent darkening of acne marks and scars.
- Makeup can be applied as the final step
Evening acne prevention regimen:
- Wash your face with a gentle cleanser to remove makeup, pollution, excess oils.
- Exfoliation can be helpful for some acne-prone skin types, but choose a gentle product that won’t damage the skin. Look for fruit acid/enzyme-based gel masks or sugar scrubs that melt easily. Twice a week is usually sufficient.
- Acne medication (prescription or retinol over the counter)
- If your skin is dry, moisturizers are fine to use. Look for oil-free, non-comedogenic products that will hydrate the skin surface. In fact, if the skin senses that it is dry, it will produce more oil to moisturize the skin, which, in turn, can trigger new acne flares. Lighter formulations are well-tolerated, but super dry skin or Accutane patients will prefer thicker creams.
The general consensus emphasizes a simple daily morning and night routine consisting of 3 parts:
- Cleanse - Cleansing helps to remove bacteria, sweat, toxins, and other irritants that could contribute to inflammation and breakouts while cutting down excess oil.2
- Apply moisturizer- Moisturizer helps to prevent dryness while balancing and regulating overall oil production.3
- Apply acne treatments - Topical acne treatments target the main factors contributing to your acne.
During the morning routine you can also apply sunscreen/makeup. Dr. Bryan Tran of DrFormulas emphasizes the importance of sunscreen: “sunscreen is important because acne treatments, particularly retinoids, cause the skin to be more fragile and sensitive to UV damage.”
Treating Existing Acne
What are the best topical treatments for acne?
Treatments for acne range from prescription acne cream to over-the-counter topical creams. According to Dr. Shainhouse, three of the most common acne medication ingredients include:
- Salicylic acid – This is a hydroxy-acid that helps exfoliate skin and remove dead skin cells, leaving skin smoother and less clogged. It also helps remove surface oils, so skin is less greasy and pores appear smaller. Look for washes that contains this ingredient. On-the-Spot treatments can dry up new inflamed pimples.
- Benzoyl peroxide – This ingredient literally oxidizes bacteria and kills it. It also helps reduce inflammation. Use it as a daily facewash to keep acne bacteria at bay. Use an on-the-spot treatment to calm new, red, inflamed pimples.
- Retinols – Retinoids help skin cells mature, rise to the skin surface and slough off. They help unclog pores and help lighten pink or dark acne scars. While over the counter retinols are not as strong as prescription versions, applying a thin layer at bedtime will start to yield results in a few months. Retinol is available over the counter at strengths up to 1.5%.
Like acne regimens, the type of treatment that works best for you may not be as effective with someone else. Much of that comes down to the type of acne that you have. Dr. Bard breaks it down into four different types of acne:
- Comedonal acne, also known as clogged pores (blackheads and whiteheads), which is best treated with retinoids. Recently, the mildest retinoid, Differin 0.1 % gel was made available over the counter. Chemical peels and acne facials help with clogged pores as well.
- Inflammatory acne, characterized by pustules and pink bumps, is best treated with benzoyl peroxide, which is available over the counter, and topical or oral antibiotics, depending on severity, for which you need a prescription from your physician.
- Nodulocystic acne, comprising deep painful bumps under the skin that often leave behind scars. Isotretinoin, a vitamin A derivative oral prescription medication, is the treatment of choice as it can lead to permanent improvement and prevent scarring.
- Hormonal acne, which most often affects women and is usually cystic in nature. Hormonal acne can be constant or flare at certain times in the menstruation cycle (i.e. during ovulation, prior to menstruation). This is best treated with certain birth control pills or a prescription oral medication called spironolactone. Avoidance of dairy may be helpful as well.
Dr. Erin Murphy from Restore SD Plastic Surgery also recommends glycolic and lactic acids to prevent clogged pores.
Whichever you choose, it’s important to limit your acne treatment to just one. Applying too many different acne treatments at once can overload sensitive skin and cause irritation and inflammation.4
Should a person with acne exfoliate?
Exfoliation refers to the removal of dead skin cells, accomplished through both physical and chemical methods. Many consider exfoliation a necessary step. “Exfoliation is key,” says Dr. Murphy, “This is going to remove the excess layers of dead skin cells that would otherwise clog the skin and create more pimples. The less debris there is on the skin, the less there is to get trapped deep in the pores.”
Dr. Goodman agreed, saying, “Everyone, including those with acne, need to occasionally exfoliate to keep skin sloughing to avoid pore clogging build up.”
However, according to Dr. Fayne Frey, exfoliating is not for everyone with acne. “Under the supervision of a dermatologist, exfoliation may be suggested. In general, exfoliation removes the superficial layers of skin that maintain adequate water hydration. Exfoliation can be irritating. This is not always beneficial for acne patients.”
Is chemical or physical exfoliation better?
Physical exfoliation involves using a scrub, sponge, or brush to physical remove dead skin cells from your top layer of skin. Chemical exfoliators use chemicals, commonly alpha and beta hydroxy acids (AHA and BHA), to dissolve dead skin cells. Both are effective, but it often depends on your skin type and the type of acne you have.
“If the acne is mild, mostly white heads or black heads, then usually a physical exfoliator like a scrub will do the trick,” says Dr. Murphy, “These use tiny beads made of oils or minerals to physically remove debris from the surface of the skin. A chemical exfoliator is better suited for someone with tolerant skin, and maybe a more severe case of acne. Ingredients like Glycolic, Salycilic, or Retinol/RetinA are used to remove the dead skin cells. These can be performed as peels, or as part of a daily routine.”
Dr. Goodman recommends chemical exfoliators over physical exfoliation. Chemical exfoliation is “product controlled,” while physical exfoliation makes it far too easy to over-exfoliate, which can leave the skin irritated and potentially damaged.
DeeLisa Sacco from Palm Beach Wax Studio and Skincare prefers chemical over physical if she only had to choose one. However, she also suggests combining both for better results. “First, a microdermabrasion and then a chemical peel with the combination of salicylic, glycolic, and lactic acid is my go-to dual treatment.”
Face masks also offer effective exfoliation. Nassar recommends peeling and clay masks twice per night. “The exfoliation is pore cleansing and softening for the skin,” she says, “The clay mask draws impurities to the surface of the skin and absorbs sebum with healing and antiseptic properties.”
Consult your dermatologist for more information to determine the best regimen and treatments to keep your acne under control.