[4,27] If you’re concerned that the emollient texture of your sun-protection products might cause breakouts, look for lightweight options. See the end of Chapter 9, Managing Oily Skin, for a list of some of our favorite lightweight, matte-finish sunscreens.
We realize that this is a lot of information to digest all at once, but preventing (or at least reducing) acne once you know what to use and what not to use can be surprisingly simple. We hope the information in this book will make your decision process far easier.
Acne Myths: A Reality Check
Regarding acne, there’s no shortage of advice and there are all sorts of theories as to what works and why. Among them are the following myths that turn up all the time, no matter how many times they’ve been debunked.
MYTH: You can dry up blemishes. Water is the only thing you can “dry up,” and a pimple has nothing to do with skin being wet. Drying up the water and other moisture-binding substances in skin actually hurts its ability to heal and fight inflammation, which encourages bacterial proliferation. [3,4,53] Absorbing oil that’s on the skin’s surface or in the pore is radically different from “drying up” skin with harsh ingredients such as SD or denatured alcohol, sulfur, camphor, and witch hazel.
MYTH: Acne is caused by not cleaning your skin well enough. This mistaken belief often leads to over-cleaning or scrubbing of the face with soaps and strong detergent cleansers, which only increases the risk of irritation, inflammation, and dryness, while doing nothing to prevent pimples. [53]
MYTH: You can spot-treat acne. Although you can greatly reduce the redness and swelling of a breakout with a salicylic acid (BHA)–based product or with a benzoyl peroxide disinfectant (both explained below), that doesn’t help prevent other breakouts from popping up on other parts of your face. Dealing with only the pimples and pustules you see means you’re ignoring those that are in the process of forming. [27,34]
As you may have guessed, spot-treating leads to a never-ending cycle of chasing acne around your face. Spot-treating tends to be most useful for those whose breakouts are consistently infrequent and localized (for example, always on the chin, nowhere else), rather than for those who experience them more frequently and/or randomly all over the face.
MYTH: If it tingles or feels cooling, it must be working. Ingredients that make your skin tingle, such as menthol, peppermint, eucalyptus, and lemon, show up in countless anti-acne products, yet there’s no research showing they have any benefit for acne or oily skin.
In fact, these ingredients irritate and inflame skin, only making matters worse! Irritating skin triggers stress-sensing nerve endings at the base of the pore, which in turn stimulate oil production. [4] That cooling sensation, however nice, has no ability to reduce acne.
MTYH: Eating chocolate or greasy food causes acne. Although it’s absolutely true that eating healthy food and an overall anti-inflammatory diet is good for your skin and your overall well-being, specifically eating chocolate or greasy food isn’t going to give you acne. [53] If that were true, then everyone who ate either of these things would have acne, and that’s simply not the case! On the other hand, diets high in sugar, dairy products, gluten, nuts, and fish may worsen acne for some people. [59,60,61,62,63]
MYTH: You can scrub acne, whiteheads, and blackheads away. It can help to use a gentle scrub as an extra cleansing step, but it won’t change acne conditions in skin. None of these problems are about skin being dirty or needing a “deep” cleansing.
In terms of blackheads, gentle scrubbing can remove only the top portion of the problem, kind of like mowing over a weed rather than pulling it out of the soil, roots and all. That’s why, within a day, if not within hours, of scrubbing blackheads, the dark dots are again lining your nose and cheeks. [64] The same concept applies to blackhead-removing pore strips, and the adhesives on these strips can be quite irritating. Depending on the scrub and how you use it, you most likely will be inflaming your skin, making matters worse!
MYTH: “Non-comedogenic” products won’t cause breakouts. You’ve no doubt seen the term “non-comedogenic” dozens of times—you may even look for it when shopping for makeup, in the belief that a product with this claim won’t clog pores or cause acne. Unfortunately, non-comedogenic is a totally unhelpful claim; the term was coined under test conditions that are not even remotely applicable to how you, or anyone else for that matter, use beauty products.
How did the non-comedogenic myth get started? It stems from a 1979 study published in the British Journal of Dermatology. [65] This study examined the potential of various ingredients (cocoa butter, for example) to clog pores and lead to the formation of comedones (a fancy word for blackheads and whiteheads). This potential was determined by applying a pure amount of an ingredient to the skin on a rabbit’s ear.
Here’s the kicker: Each ingredient was layered five times per application over a period of two weeks, without cleansing the skin at any time. [65] Can you imagine? This methodology easily dispels the entire notion of these tests relating in any way to how skincare products or makeup are actually formulated (it’s the rare skincare product that contains only one ingredient) and to how people really use them.
What really determines whether an ingredient in a makeup (or skincare) product is likely to trigger a breakout is how much of an ingredient is present in the formula. A tiny amount of an ingredient, even mineral oil or a thickening agent, in your moisturizer, blush, foundation, or concealer is not going to cause or exacerbate a breakout. By the way, the researcher largely credited for developing the concept of comedogenic, Albert Kligman, said as much in his 1972 study, “Acne Cosmetica”:
“It is not necessary to exclude constituents which might be comedogenic in a pure state. The concentration of such substances is exceedingly important. To exile such materials as lanolin, petroleum hydrocarbons, fatty alcohols, and vegetable oils from cosmetics would be irrational. What is ultimately important is the comedogenicity of the finished product.” [66]
Like most of the beauty advice from the 1970s (for example, when we used baby oil to increase the effects of the sun to get a deeper tan while sunbathing), it’s time to retire the whole concept of “non-comedogenic.” It’s just not helpful, and how many of us have bought products claiming they won’t cause breakouts—yet we broke out anyway?
What to Avoid
OK, so we know that no one can say with certainty whether or not a product will or won’t exacerbate a breakout if you’re already prone to acne. What we can do is make your search easier by helping you identify the biggest culprits—namely irritating ingredients and products with thick, waxy textures. If you start experimenting by eliminating these from your skincare routine, we’re sure you’ll see important changes for the better.
Avoiding products that contain irritating ingredients is critical for everyone, but especially for those who have oily, acne-prone skin, because inflammation can worsen breakouts and oiliness.
The tricky part about irritation is that research has demonstrated that you don’t always need to see or feel irritation or inflammation for your skin to suffer damage.[2] Just because you don’t see redness on the surface doesn’t mean that damage isn’t taking place underneath the surface, silently hurting the skin in a variety of different ways. This fact explains why some people can use irritant-laden, anti-acne products, yet not suffer obvious signs of irritation.
It’s also important to understand that the effect of inflammation on skin is cumulative, and repeated exposure to irritants contributes to a weakened skin barrier, slower healing (including of red marks from acne), and a dull, uneven complexion. [67]
If that weren’t enough, inflammation in the skin plays a major role in increased
