For years, the prevailing method for treating acne was to attack, attack, attack. Drying lotions, antibiotics, and harsh exfoliants were—and still are— typical parts of a clear-skin strategy. The only problem? A lot of these old-school treatments might actually be making your skin more aggravated. Despite having more treatment options than ever before, adult acne is actually on the rise, especially in women. Here’s why some of the traditional “solutions” are now being second-guessed—and in some cases, may actually be encouraging breakouts.
Why the Drugs Stop Working
Take antibiotics, for instance. Decades ago, dermatologists began prescribing oral and topical antibiotics to treat P.acnes, the bacteria strain that causes acne. The concept was simple: Destroy the acne bacteria, end the breakouts. But as experts learn more about the delicate balance of the microbiome, a.k.a the living world of bacteria both harmful and beneficial, it turns out that antibiotics aren’t the quick fix they were thought to be.
Among some derms, using oral antibiotics is actually passé. “That’s an old-school methodology,” says board-certified dermatologist Rita Linkner, M.D., of Spring Street Dermatology in New York City. “You won’t see board-certified dermatologists who have been trained in the last decade depend upon [them].” That’s because while they do indeed wipe out the acne-causing bugs, they do the same for other bacterial strains—the equivalent of using a wrecking ball, not a scalpel, to address the issue.
In addition, there’s ample evidence that acne bacteria are developing antibiotic resistance to topical and oral treatments, which poses its own problems. When antibiotics lose effectiveness, acne bacteria can run amok, which leads to—you guessed it—more breakouts. Worst-case, the resistance extends to other, more harmful bacteria that can cause serious health issues.
Benzoyl Peroxide Can Backfire
Many dermatologists recommend topical benzoyl peroxide, a topical cream that bleaches your pillowcases and towels while going after your pimples. It’s true that BP is antimicrobial, which means it reduces the amount of acne-causing bacteria without risking resistance. But (and you knew there was a ‘but’ coming, didn’t you?) there’s growing concern that it, too, may disrupt the balance of the skin’s microbiome. While researchers continue to explore a possible BP-microbiome link, some of the treatment’s side effects are already known. Benzoyl peroxide, especially in higher concentrations, can cause dryness, redness, and flaking—which can cause your skin to overcompensate by producing more sebum, which can then clog your pores, which can then cause acne.
Resist the Urge to Strip Your Skin
So if harsh treatments aren’t the answer, what is? Maintaining clear skin requires a skincare regimen—one that’s gentler than you might expect. Start by swearing off alcohol-heavy toners and spot treatments. They may temporarily dry out a pimple, but Dr. Linknew says that they often irritate your skin further, which triggers inflammation. (“And that can make a patient break out even more,” she notes.) Instead of trying to dry out your skin, think more holistically about keeping skin hydrated. For example, Clear Nutrient Toner helps balance even the oiliest complexions, while the Clear Pure Radiance Oil adds moisture without the pore-clogging concerns of lotions.
Enough with the Scrubs
And before you reach for that tube of walnut-scrub exfoliant, think again. Such harsh physical exfoliants can create microscopic tears in skin, irritate existing blemishes, and spread P.acnes bacteria around. A better, more modern option is a chemical exfoliant. Dr. Linknew sings the praises of exfoliating with an alpha- or beta-hydroxy acid, which usher pore-clogging dead skin cells away in minutes. We’re partial to the Resurfacing Moisture Mask, which uses lactic acid to reveal fresher skin and keep pores clear, plus astaxanthin to boost repair.
In short, many of us have been labeling adult acne as our skin’s enemy, when acne is actually just our (troubled, needing-TLC, sensitive) skin. We can pummel and punish it and make breakouts worse… or approach it with attention, care, and patience to help it become its better, more-balanced self.