Acne is something that’s quite personal to me. You see, I don’t recall suffering much acne in my teenage years and early 20s like many of my peers, but it has really affected me in my 30s.
A combination of poor diet and lifestyle, stressful job (Emergency Medicine), and varying shift work (primarily night shift), led to consistent, moderate to severe acne breakouts. I would go 3-4 weeks with relatively good skin, but invariably it would flare up, leading me to want to go into hiding for a couple weeks. I tried antibiotics, different “acne” skin products, even resorting to cover up make-up to hide the worst of it. Colleagues and friends would ask “What’s happened to your face?” Even as a Doctor I found this embarrassing, and to some extent, I still do.
For the past 3 years I have been using the ZO products that we sell at Inject Skin. The man behind them (Dr. Zein Obagi) is a world renowned Dermatologist, who’s primary interest lies in pigmentation and acne. It is at this point I started to understand a bit more about the pathology of acne and basic steps to improve and prevent.
The causes of acne are not completely understood, but these 4 factors provide the basic concept:
- Sebaceous glands and hair follicles
- Keratinocytes (top layer of skin cells waiting to be sloughed away)
Very simply: Sebum binds together keratinocytes (or other debris) to block pores. Trapped material oxidizes (turns black causing blackheads). Bacteria produce “pus”, causing whiteheads. This combined with background inflammation, leads to red, angry, inflamed appearing breakouts.
Acne can be helped by taking a variety of measures, including:
- Decreasing sebum production
- Increasing keratinocyte turnover, and getting them off the skin
- Decrease inflammation
- Decrease bacteria load
What I see in practice is generally 1 of 2 things:
- Antibiotics are prescribed to decrease bacterial load
- Isotretinoin is prescribed to decrease sebum production
We’re generally missing 3 key factors:
- Increasing keratinocyte turnover
- Decreasing inflammation
- Unblocking pores
The steps I’ve taken on myself are the following:
Completely cleanse the face morning and night.
Sebum is pro-inflammatory (as is make-up). You need wash this off.
This is found in the ZO TE pads (2% salicylic) as well as the Vitascrub. Salicylic acid dissolves keratin plugs which is blocking the pores. It is also an anti-inflammatory agent
Amongst other things, retinol increases cell turnover, which leads to fewer keratinocytes sitting on your skin waiting to block pores. Retinol is found in most of the ZO products, but I would start with the Daily Power Defense
Anti-bacterial, benzoyl peroxide
Low percentage benzoyl peroxide (2.5%) is effective on your skin to kill the bacteria which contribute to acne. I don’t require this much anymore, but during severe breakouts I would use it at night for up to a week at a time.
Decrease pro-inflammatory foods
A quick google search will tell you which foods can be considered pro-inflammatory. The usual suspect (sugars, saturated fats, caffeine) are all there. Summed up, if it tastes good it’s not helping your skin.
When I first started this routine, I’ll admit things got worse before they got better. It took a good 3-4 months before I started seeing improvements. These days I continue to get the odd pimple or 2 (or 10). But they heal faster, and are less inflamed. The debilitating breakouts have ceased (fingers crossed they don’t return).