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What is the best skincare routine for acne? How do you choose the ideal regimen to prevent acne breakouts? Join me in this masterclass as we dive deep into the science of acne and the art of skincare routine for acne.
Eucerin’s ProACNE Solution is a dermatologist recommended holistic approach addressing the underlying causes of acne from the outside-in.
The science of acne
Blackheads, whiteheads and acne bumps are commonly attributable to pimples, known medically as the condition acne vulgaris. There are a few subtypes to be aware of, namely:
- Acne vulgaris
- Physiologic acne
- Adult acne
- Hormonal acne
- Drug-induced/steroid acne
- Occlusion acne i.e. maskne
Let’s go through each of these so you have a better idea of what they are about.
Acne vulgaris
While all types of acne are classified under the umbrella term acne vulgaris, dermatologists tend to distinguish between different severities of acne this way
- Mild (less than 3-5 pimples per month, if afflicting teens, known as physiologic)
- Moderate (up to 10-20 lesions)
- Severe (more than 20 and/or presence of cysts)
This term encompasses various forms of acne, namely: whiteheads, blackheads, papules, pustules and cysts. Whiteheads and blackheads are what we know as open and closed comedones respectively.
At this juncture, it’s helpful for us to elucidate the exact process that explains how acne bumps come about.
How acne bumps come about?
At about 2-4 weeks prior to an acne bump appearing, the process begins in the deeper layers of skin. Microcomedones are mini comedones which form at this time. These invisible bumps, driven by genetics that influence inflammatory processes make their way to the surface of the skin. When it rears its head—that’s when it’s officially regarded as a comedone. A closed one, also referred to as a ‘blind pimple’ is readily recognisable as it is without a ‘head’. This contrasts with open comedones, which appear to the naked eye as little pores within which are black dots of ‘dirt’. Now here’s a fun fact: blackheads don’t contain dirt. Rather, it is the oxidation of sebum that leads to this blackish tip appearance. This accounts for its common name ‘blackhead’.
From the time a comedone becomes visible on the skin surface, it also becomes vulnerable to infection. Most commonly, surface bacteria lead to the formation of an inflamed acne bump known as a papule—one that is red and painful—as comedones get infected with bacteria. A certain type of bacteria known as Gram-negative bacteria is also fairly opportunistic. It is at this juncture that comedones and/or papules can get secondarily infected. This leads to a type of skin condition known as Gram-negative folliculitis. And this is the origin of what dermatologists term as a pustule—a type of pimple characterised by pus at its tip.
Cystic acne
Cysts go even deeper—typically arising from one of the above types of lesions, infection and inflammation cause a deeper lesion to form. They tend to be persistent, lasting several days or even weeks and can complicate by abscess formation (when pus collects within a cyst cavity). Cysts are also likely to lead to deeper acne scars.
The following relate to descriptive terms attached to acne vulgaris. They are important for understanding how acne affects certain age groups differently.
Physiologic acne
Physiologic acne is linked to the onset of puberty. We consider it as a natural process, one of the body adjusting to the release of sex hormones at puberty. It tends to be mild and self-resolving.
Adult/hormonal acne
Adult acne is a very broad term and is sometimes used interchangeably with ‘hormonal acne’, one which dermatologists have argued is quite redundant—for all acne must be regarded as hormonal in nature. On this note, it is helpful to point out that a specific type of hormonal acne is directly linkable to hormonal dysregulation in adult females. Polycystic Ovarian Disease, also known as PCOS for short, can present with adult onset acne, excess facial hair growth and irregular periods in females. Treatment is typically in the form of oral contraceptive pills and co-management with a gynaecologist is usually the recommendation.
The other types of acne are perhaps considered rarer subtypes. Use of oral and topical steroids can lead to a form of acne known as steroid acne; occlusion of skin via face mask wear/headgear can lead to occlusion acne.
Moderate and severe types of acne require treatment with prescription oral medications, which is beyond the scope of discussion here. However, we must address all types of acne with at least a consistent skincare routine for acne that targets various factors such as:
- Excess sebum production
- Inflammation
- Infection
- Oxidative stress that worsens inflammation
- Acne marks (post-inflammatory hyperpigmentation)
- Acne scars (deeper dermal scars)
With this in mind, we will turn our attention to a minimalist 3-step skincare routine for acne that can address all of the above contributing causes, in order to holistically treat acne, acne marks and scars, while preventing flare-ups.
Step 1 Cleansing in Skincare Routine for Acne
The ideal cleanser for acne prone skin is one dermatologists recommend for sensitive skin types as well. Many times, prescription acne treatment causes skin dryness and sensitivity. This is the reason why dermatologists often recommend gentle cleansers to accompany acne treatment. However, such a cleanser must also fulfil the function of stabilising the skin microbiome. A dysregulated microbiome is in fact one of the underlying causes of acne. Cutibacterium acnes has been identified as the causative bacteria in acne, but it is also one that naturally exists on the surface of healthy skin. So the real question is, why do some individuals get acne and others don’t? Acne isn’t caused by dirty skin but it can be worsened by poor hygiene. This is where cleansers that respect the skin moisture balance, at the same time removing excess oil, dirt and grime are regarded as ideal for acne prone skin types.
The Eucerin ProACNE Solution Cleansing Gel is a soap-free and fragrance-free gentle acne cleanser that removes excess sebum, with a gentle exfoliating action that regulates cell turnover hence reducing pore clogging.
Step 2 Serum in Skincare Routine for Acne
Apply Eucerin ProACNE Solution Triple Effect Serum with Patented Thiamidol + Salicylic Acid
Serums are the ideal vehicle to deliver high doses of concentrates, which is not as efficiently formulated in a cream or lotion vehicle, for instance. Serums that contain ingredient pairings such as Thiamidol plus salicylic acid are particularly effective. When tested on acne patients, such a product resulted in reduction of acne, acne marks and an overall brighter skin tone in as little as 2 weeks of use.
Patented Thiamidol reduces acne marks at its root, which is the production of melanin
Eucerin’s ProACNE Solution Triple Effect Serum contains patented Thiamidol which effectively reduces acne marks and scars at its root. Post-inflammatory hyperpigmentation occurs quickly after an acne bump resolves, a result of excess melanin production. Thiamidol targets this by removing excess pigmentation, hence addressing the problem at its root. Salicylic acid, on the other hand is a Beta Hydroxy Acid. BHAs unclog pores and also gently exfoliates, hence supporting the skin cell renewal process. Salicylic acid in particular is known to reduce and prevent acne marks as well as future breakouts.
The Thiamidol and Salicylic acid ingredient pairing makes for an excellent holistic approach to acne-prone skin—with more than 95% of study participants reporting anti-acne, skin brightening effects and also anti-shine, skin mattifying benefits. The serum is to be applied on the whole face.
Step 3 Treatment in Skincare Routine for Acne
Treat with Eucerin ProACNE Solution A.I. Clearing Treatment: 10% Hydroxy Complex + Licochalcone A
An effective acne skincare regimen is one that also prevents flare-ups. One of the greatest frustrations of acne sufferers is the recalcitrant nature of the condition—before skin has a chance to clear up, a new pimple emerges. This brings us back to what we have discussed earlier. Before whiteheads and blackheads even show up on skin, they have been brewing in the deeper layers for at least 2-4 weeks prior. What this means is that we can institute a regimen that actively targets these invisible microcomedones—when used regularly, this will reduce the number of whiteheads and blackheads.
The ProACNE Solution A.I. Clearing Treatment is also designed for full-face application. Featuring 10% Hydroxy Complex, a highly effective combination of Salicylic Acid, Glycolic Acid & Polyhydroxy Acid, the last step of this regimen can visibly reduce acne and prevent re-appearance. This proprietary mixture has been shown to be highly effective—with 81% of participants describing a significant anti-blemish effect, particularly so for inflamed acne bumps, 86% reporting effectiveness in prevention of flare-ups and appearance of new blemishes, 84% attributing a skin-soothing effect. Lichochalcone A in particular is incorporated as an anti-inflammatory ingredient that helps to soothe irritation in as little as 7 days.
This podcast episode is sponsored by Eucerin Singapore as a joint collaboration to create scientific educational content relevant to skincare and dermatology. Images produced as part of editorial collaboration consistent with site policy.