Not all acne is the same. Every type of bump comes with its own personality—redness, puss-filled, blackheads, whiteheads—and each of them require a different anti-acne hero to tackle them. Dr Madhuri Agarwal, Mumbai-based dermatologist and founder and medical director, Yavana Aesthetics Clinic, gives us the complete lowdown on every skincare ingredient made to treat acne, what it best works for and what you should keep in mind when you use it.1. Salicylic acid
What it is: Salicylic acid is a type of beta-hydroxy acid (BHA) that comes with exfoliating properties to slough away dead cells and clear out clogged pores.
How it works for acne: The structure of the salicylic acid molecule makes it oil soluble, which helps to break down the oil collected in your pores and unclog the blockage. This makes it a good product to be used to treat early stages of acne, like whiteheads and blackheads for teenagers or for people who have generally oily (seborrheic) skin. In higher concentrations, it works as an anti-inflammatory to reduce pustules and red acne bumps to some extent. Salicylic acid is also a great keratolytic, or in simple terms, exfoliator. When dealing with acne-prone skin, the skin cells tend to stick together and clog the pores instead of getting shed off as they would in the case of normal, healthy skin. Salicylic acid acts by dissolving the glue that holds the sticky skin cells in the clogged pores
How to use it: A cleanser or gel preparation is preferred for salicylic acid to work. Look for salicylic acid in a 0.5-2 per cent concentration for OTC (over the counter) products for at-home use. It’s a good idea to combine it with a hydrator and an antioxidant for better tolerance. Do not apply it in large quantities or on large areas as it can get easily absorbed in the blood and lead to salicylate toxicity—just on the bumps when being used as a spot treatment.
Word of caution: It should be used with caution in people who have sensitive or dry skin as it can lead to irritation. Also, overuse at higher concentrations can again worsen the irritation. It should be avoided by pregnant and lactating females.2. Benzoyl peroxide
What it is: Benzoyl peroxide is an antibacterial ingredient that works by killing the bacteria that causes all forms of acne.
How it works for acne: Unlike salicylic acid, benzoyl peroxide has no impact on oil collection but works to neutralise the P.acnes (Propionibacterium acnes) bacteria that infects the clogged pores and triggers acne. It is effective against most forms of acne including whiteheads, blackheads, papules and pustules.
How to use it: Benzoyl peroxide is available as a cleanser or gel formulation. It is recommended to use an oily-skin-friendly moisturiser when you’re using this ingredient to treat acne. It is usually combined by a dermatologist with a retinoid as prescription medicine. OTC brands provide 2.5 per cent, 5 per cent and 10 per cent strength variations for home use.
Word of caution: It can cause excessive drying, burning and peeling of skin.3. Sulphur
What it is: Sulphur is a natural mineral that works as an exfoliator, antibacterial and anti-inflammatory ingredient.
How it works for acne: It is very effective in the initial grade of acne (whiteheads, blackheads and papules) and can be used in sensitive skin as well with care. It is a bacteriostatic agent, which enables it to prevent bacteria from multiplying. When topically applied, it removes the top layer of skin by drying it out and allowing it to easily peel off.
How to use it: Use it as a cleanser or short contact spot treatment to avoid skin irritation.
Word of caution: Avoid combining sulphur with anti-acne agents like salicylic acid or benzoyl peroxide as it can cause a severe allergic reaction.4. Tea tree oil
What it is: Tea tree oil is a known anti-inflammatory agent that is used to treat acne and excess oiliness.
How it works for acne: The concentration required according to a few studies should be around 5 per cent for it to be effective. The high concentration helps in initial grades of acne such as whiteheads and blackheads. It is not the most effective anti-acne choice if you have persistent acne.
How to use it: OTC products with tea tree oil as the main ingredient usually have a low concentration—less than 3 per cent—which is not sufficient for them to be effective. In case you want to use tea tree oil to treat your bumps, combine it with other anti-acne ingredients.
Word of caution: Consult with your dermatologist when combining it with another product to ensure you don’t dry out your skin or cause an unwanted reaction.5. Azelaic acid
What it is: Azelaic acid is a naturally occurring acid belonging to the family of dicarboxylic acid. It works as an exfoliant and has antibacterial and antioxidant properties, similar to benzoyl peroxide and salicylic acid.
How it works for acne: It loosens the acne-prone sticky skin cells, sloughing these dead cells off. It also targets P.acnes making them inactive and subsiding them. The additional benefit of azelaic acid is that it also reduces dark spots and blemishes caused by acne. It’s ideal for darker skin tones wherein there is a mixture of constant acne activity along with post-acne blemishes.
How to use it: Azelaic acid is available as a 10 per cent cream or even a serum. It is also a good solution for body acne in a foaming formulation. Use it in combination with a hydrator as it can sometimes lead to dryness. This ingredient can also safely be used by pregnant women.6. Retinol
What it is: Retinol is the gold standard for acne therapy, no matter your age or the type of acne you’re dealing with. It works from the inside out unlike other anti-acne agents.
How it works for acne: The retinoid binds to the skin’s nuclear receptors and triggers them to normalise the overall cell turnover cycle. As the normal skin turnover cycle comes in place, the pores are less blocked and enable other anti-acne products to work well.
How to use it: It is available as creams and gels in combination with benzoyl peroxide. Consult your dermatologist for the right retinol to be used based on your acne and skin type.
Word of caution: Retinol should be used with caution as it can cause dryness, increase sun sensitivity and can lead to an allergic reaction especially for those with combination skin. It is not advised to use if you're pregnant or lactating.Also read:
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