SKIN SERIES | The Deal with Dry Skin & Acne
There are a lot of murmurings in the esthetician community that having dry skin and acne is not possible - that you have simply dried your skin out with harsh anti-acne products. Additionally, when searching for skincare products you may have noticed the constant coupling of oily and acne prone. All of which can leave you frustrated when you swear that your skin is dry AND congested. What gives?
Let's back up and talk about sebum because it's really at the heart of everything (well inflammation is, but for the purpose of this post, let's focus on sebum!) While those with oily skin may disagree, sebum is good. It moisturizes the skin and keeps it looking youthful. The problem arises when sebum production goes haywire. Androgens play a big role here, as does stress and insulin resistance. When we are younger, this hormonal pattern typically takes on the classic form of oily skin. And a lot of skincare formulators/practitioners become married to this idea of excess sebum production = oily skin = acne!
But more savvy estheticians/skincare formulators are noticing that adult acne doesn't quite look the same as teenage acne - that it involves a lot more inflammation and perhaps dryness and dehydration. So if your skin feels dry, but acne involves excess sebum production and clogged pores then what is going on? Meet linoleic acid deficiency, aka sticky sebum. Sebum that is deficient in linoleic acid is hard, sticky, and lacking in anti-inflammatory properties with a tendency to get stuck in the pore. So you really can be dealing with excess sebum production and surface dryness!
Both dissolving congested matter within the pore and keeping sebum flowing freely become really important here. This involves strategic exfoliation and adequate topical hydration with oils rich in linoleic acid (if your skin tolerates oils).
In terms of exfoliation, I recommend chemical over physical. Inflamed, acneic skin tends to be very sensitive and tender. In addition, physical exfoliation can actually spread bacteria. (That being said if it's working for you, keep on keeping on.) Chemical exfoliants come in the form of cleansers, toners, serums, and even overnight masks. Please don't use all of them at once. Cleansers are the exception because they are only left on the skin for a short period of time. You can typically combine an AHA/BHA cleanser with another exfoliating product. Finding the perfect amount of exfoliation for your skin involves a lot of trial and error. If your skin is shiny and tight, then you have now entered the land of dehydration and need to back off. If your skin is still really congested, you might need to step it up (and don't be afraid to simply exfoliate the congested area and leave the rest of your face alone). Some of my favorite exfoliating products include:
Acure Incredibly Clear Cleansing Stick (cleanser)
Allies of Skin Clay & Manuka Cleanser (cleanser)
Allies of Skin Bright Future Sleeping Facial (overnight mask)
Retinol can also be really helpful for normalizing cell turnover. That being said, I have yet to find an over-the-counter retinol that is actually helpful for acne. Most are going to be limited to anti-aging benefits. Truth Treatments 5% Retinol Gel is the best over-the-counter retinol I've found for acne, but be forewarned that it is just as irritating as a prescription strength retinoid. Essentially I'm telling you that you are going to need something prescription strength if you are hoping to see some of retinol's keratolytic properties. (A product containing retinaldehyde, like this one, would be a close second because it has been shown to exhibit significant antibacterial activity when applied topically making it a fantastic choice for treating acne.)
Addressing linoleic acid deficiency with oils rich in linoleic acid is wonderful, but I also want you to think about incorporating a water-based serum as well. I'm not asking you to buy a zillion products - think water-based serum + lipid-based moisturizer (and SPF for the day). There are even SPF products that contain an array of linoleic-rich oils allowing you to skip the moisturizer step (Josh Rosebrook Tinted Day Cream is a good example of this). A few of my favorite hydrators for dry, acne prone skin include:
Heart of Gold Resonant Frequency (also contains a healthy dose of niacinamide, which helps to brighten and regulate sebum production)
It is 100% possible to address acne and surface dryness/dehydration at the same time. It's simply a matter of being strategic with your skincare. Treating your skin as though it's dry will likely lead to increased congestion and treating your skin as though it's oily will likely leave you inflamed and irritated. A little exfoliation and lightweight hydration will go a long way towards addressing the incredibly frustrating dry, acne prone skin situation!
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