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Acne may be the most common skin condition in America, but that doesn’t mean you have to suffer its slings and arrows—blemishes, blackheads, and the emotional agony they often cause. “Today, virtually all acne can be treated, and—with the right routine—you can even keep breakouts at bay,” says David Bank, MD, a dermatologist in Mount Kisco, New York. Here’s the scoop on common practices that help keep your skin in the clear.
Retinoids, a form of vitamin A, aren’t just the gold standard of acne treatment—they’re the perfect way to prevent pimples before they even start, says Dr. Bank. “When you have acne, cells lining your pores clump together and form a plug that blocks the pores below the skin’s surface,” he explains. “Retinoids get down there and normalize the cells so they don’t stick together.” There are many types of retinoids, including prescription and over-the-counter versions. If you have sensitive skin or are trying retinoids for the first time, an OTC retinol—which minimizes the dryness and irritation that usually accompany these “A” agents—is a good choice.
Acne sufferers tend to think moisturizing is the last thing their frequently oily skin needs, but since many acne treatments can leave skin dry and irritated, well-hydrated may be just the ticket to managing the condition. For one thing, using a moisturizer allows your skin to better tolerate acne-fighting medications like retinoids and benzoyl peroxide, which helps keep the bacteria that causes acne in check, says Arielle Kauvar, MD, director of New York Laser & Skin Care and clinical professor of dermatology at New York University School of Medicine. Moisturizer also prevents “rebound” oil production that can result when skin becomes too dry. To be sure your moisturizer does more harm than good, the American Academy of Dermatology advises choosing a product that’s oil-free and non-comedogenic, which means it won’t clog pores. For best results, apply moisturizer after cleansing skin to trap much-needed water in your skin.
When it comes to skin cleansing, it’s always important to be gentle. But overzealous washing when you have acne can be particularly problematic. “Stripping the skin leads to increased oil production and inflammation, which can trigger a breakout or worsen an existing one,” says Dr. Kauvar. The key to proper cleansing is to use mild cleansers (skip often-harsh “teen” products if you’re over age 40, for instance, to avoid overdrying skin), never scrub, and only wash when necessary. Key times for washing your face are in the morning, before bedtime (even non-comedogenic makeup can cause acne if you sleep in it), and after sweating. “The buildup of sweat, skin oils, makeup, and hair products can clog your pores and aggravate acne,” explains Dr. Kauvar. Derms advise washing with your fingertips and rinsing with warm—not hot—water.
Contrary to popular belief, sun exposure makes pimples worse, not better, says Dr. Bank. “The initial, temporary drying effect—and the blemish-concealing tan—may fool you, but UV rays actually stimulate oil production,” he explains. “At the same time, they thicken the outer layer of your skin, which blocks your pores and leads to breakouts.” To help keep acne—and wrinkles, brown spots, and other signs of aging—at bay, be sure to use a broad-spectrum sunscreen with an SPF 30 or higher on a daily basis. Here’s more info on picking the right sunscreen for your skin type.
Women who ate fruits and vegetables or fresh fish on fewer than four days of the week were more than twice as likely to have acne in one study, compared to those who ate such healthy fare more often. (Check out this advice for eating more fruits and vegetables every day.) Other research shows a connection between breakouts and eating foods with a high glycemic index (think refined sugars and white carbs), which could explain the link. Dairy also appears to be linked with acne severity, with skim milk showing the strongest effect, says Dr. Kauvar. Dermatologists aren’t sure exactly how milk and acne are associated, but they suspect that hormones and growth factors in milk might play a role. One way to know if your diet is impacting your skin is to keep a food diary and note which foods cause acne flare-ups. If you're trying to cut back on dairy, consider eating more of these plant-based sources of calcium.
“I’ve seen a surprising number of patients whose acne failed to improve until they actually started washing their brushes and sponges,” reports Debra Jaliman, MD, a dermatologist in New York City and author of Skin Rules. The applicator-acne connection: Bacteria that can cause or aggravate acne build up quickly on any surface, particularly one that comes into contact with your skin.
“People with acne can’t use heavy foundations and oily concealers, period,” says Dr. Jaliman. “I’ve had several celebrity clients whose acne didn’t clear up until I personally spoke to their makeup artist—all that heavy TV makeup was ruining my carefully prescribed skin-care regimen.” Look for makeup that’s oil-free and non-comedogenic. If your skin is oily, mineral-based foundations may keep it matte longer.
#Beautysleep: It’s real. Too little sleep can increase levels of the hormone cortisol, which in turn boosts oil production and raises your risk for clogged pores and pimples, says Dr. Kauvar. Aim to slumber for at least seven hours a night, which the American Academy of Sleep Medicine recommends for optimal health. Try one of these 11 tips from sleep doctors to nod off faster.
If you’ve ever broken out while stressed about studying for test, say, or during a rough patch at work, here’s why. Stress aggravates acne, and the more stress you’re under, the worse your acne may be, research shows. In one recent study, women who reported the highest stress levels had a threefold greater risk of acne than those who were less stressed. It’s impossible to avoid any stress in your life, so finding ways to manage it is key. One excellent way is with exercise: Besides taking your mind off stress, physical activity releases endorphins, the body’s natural mood elevators, which makes you feel better. Exercise also improves sleep, so it’s a win-win all around.
Some forms of birth control have the welcome side effect of also helping to prevent or manage acne. For instance, some types of birth control pills, such as Yaz, Ortho Tri-Cyclen, and Estrostep, contain forms of the hormone progestin that may help control acne, Dr. Kauvar reports. However, other forms of oral contraceptives, as well as some injections, implants, and IUDs, may actually worsen acne—in part because the progestin they contain or release can stimulate testosterone, a hormone that cranks up oil production. The effects of these contraceptives on acne can vary from person to person, so discuss your skin-care issues with your doctor to be sure you’re getting the right treatment for you.
A hands-off approach is best when it comes to keeping skin clear. “Picking and squeezing can spread bacteria and lead to inflammation, persistent blemishes, and scarring,” says Kauvar. Avoid resting your face in your hands or on any non-breathable surface (like your cell phone) for prolonged periods as well: The pressure against the oil glands can trigger them to produce more oil leading to breakouts. And please, please, please: Don’t pop pimples. It could lead to scarring or spread bacteria around and make acne worse.
“[Your phone] is a good breeder for bacteria and grime,” says Dr. Bank, who advises swabbing your cell with alcohol daily. Another way to dial down breakouts is to consider using a headset. Besides limiting skin’s contact to the gunk on your phone, it may also keep your complexion looking youthful by curbing exposure to the light emitted by cell phones. According to one recent study, this light can lead to brown spots, which research shows make your skin look even older than wrinkles do.