You Can’t Treat Acne
Over-the-counter spot remedies seem wonderful, claiming they get rid of acne in a matter of hours. It turns out that nothing works that way, and if you develop rashes all over your face, selectively treating multiple acne pimples would be a rather ineffective strategy at best.
The idea of spot treatment seems to be quite reliable: Get rid of acne, apply spot treatment at night and wake up the next morning without pimples and get ready to party. In fact, of course, everything is much more complicated. Acne is affected by everything from genetics to hormones and the types of skin care products you use, so I spoke with some professionals to help sort this out.
If you’re treating acne, it’s too late.
Cosmetics marketers love impressive statistics. Nowhere is this more evident than in acne marketing materials, almost all of which claim to reduce acne by an incredible percentage over a period of time – or both. Only a few bother to cite the results of their own ” clinical studies ” as evidence.
Unsurprisingly, these studies deliberately leave out much of the puzzle: Visible eels are already nearing the end of their life cycle. If your job is to “prove” that a product cures a lesion that has largely healed on its own, you can easily select data to support this claim, especially if you don’t have to do annoying things like rigorous experimental methodology or knowledge the difference between correlation and causality.
Not surprisingly, between misleading marketing jargon, conflicting anecdotes on the Internet, and high barriers to proper health care, many people have some inverse ideas about how acne treatments work. Here is what Dr. Ivy Lee , a board-certified dermatologist practicing in Pasadena, California, said when I asked her about common misconceptions about acupuncture:
The biggest misconception is that spot treatments can effectively treat acne on their own. Spot treatments are just … they heal the area you apply them to, and often [not] even effectively treat the stain. Spot treatments do not prevent acne from forming, so [they] do not offer effective long-term treatments.
Or, in the words of New Jersey dermatologist Dr. Rebecca Bakst , “By the time you need a topical treatment, your cat will be out of the bag, so to speak.”
That is, pinpoint procedures are a complete scam, right? Technically no. The ingredients in spot remedies have been proven to reduce inflammation and kill acne bacteria, but they take weeks and months of consistent application to the entire affected area to work wonders. A few hours in one small place will get you nowhere. You can play Whack-A-Zit with spot remedies if you like, but a product designed to be used consistently on a daily basis is more likely to actually prevent breakouts. Either way, they probably have the same active ingredients.
What is included in acupuncture treatment?
Most over-the-counter acne remedies, from ointments to creams and cleansers, are formulated to eliminate the clogging or bacterial component of acne. Their active ingredients generally fall into one of four categories:
- Exfoliators, such as salicylic, glycolic, or azelaic acid, which work by dissolving pore-clogging clumps of dead skin cells
- Antibacterial agents such as benzoyl peroxide and sulfur, which treat inflammation by killing acne bacteria
- Retinoids such as adapalene and retinol accelerate the healing process and unclog pores by increasing cell turnover;
- Steroids, such as hydrocortisone cream, reduce inflammation.
Certain ingredients serve multiple functions – sulfur and azelaic acid have antibacterial and exfoliating properties, but since acne develops from excess sebum, they are all likely drying out your skin. Just watch out for side effects: According to Dr. Bakst, five to ten percent of people are allergic to benzoyl peroxide. Slight redness and irritation is normal, but if you develop swelling, scarring, rashes or hives, stop using the product immediately.
Dermatologists I spoke with agreed that while all of the above ingredients are effective to some degree, exfoliants and / or retinoids work best on clogged pores and inflamed pimples respond best to benzoyl peroxide. Plus, whatever the ad text says, multiple active ingredients don’t make the formula more effective. As Dr. Lee says, “There is no conclusive evidence to support spot treatment combination products, [and] combination products may cause more irritation and dryness.” Orlando-based dermatologist Dr.Allison Arthur agrees, but notes one exception: A hydrocortisone ointment or cream can be applied over the topical spot as needed. All in all, though, you better not play mixologist or spend a ton of money on “double acting” products that combine active ingredients.
Bottom line: Spot treatments address the symptom, not the cause of the acne. Applying benzoyl peroxide gel can clear up an occasional blemish, but if you have recurring, widespread rashes, it’s best to see a dermatologist.