Acne

Managing Skin With Acne

Whatever the severity of acne, it is a condition which frequently requires medical care.  However there is still much that people with acne can do in terms of skin hygiene and skin care that will make the skin more comfortable and give it a better appearance. 

Skincare

The principal of skin cleaning for acne prone skin is to gently remove surface grime, dead skin cells and excess oils without either irritating or drying the skin.  It is important that cleansing is gentle as many clinical acne treatments are frequently accompanied by irritating effects.  Aggressive cleansing can also often aggravate acne.  Typically people who either have acne or a tendency for acne have higher levels of skin surface oil (sebum) than people who do not have the condition.  Sebum production cannot be reduced with any topical treatment, however surface oil is a prime concern to people with acne and removal of excess surface oil reduces the likelihood of “skin shine” either with or without make-up. 

Cleansing Products  


These include soaps, dermatological bars or cakes, liquid soaps in the form of antiseptic foaming solutions, antibacterial washes, cosmetic liquid soaps or gels, emulsions and rinsing products. 

Soaps 

Soaps are generally alkaline, mixing with water they liberate the free base from which they are formed and increase the skin surface pH which is normally between 5 and 6.  P.acnes the main bacterium associated with acne flourishes within in an alkaline environment.  While the skin will return to a more normal pH value in approximately half an hour after using soap, it is preferable to avoid creating a positive environment for this pathogen. 

People with acne should avoid strong soaps that may promote excess drying of the skin as well as producing a favourable p H environment for p.acnes.  Super-fatted soaps are preferable. These are usually rich in lanolin, to which many skins can have an allergic reaction, or sweet almond oil which is sometimes recommended by dermatologists for use on distressed skin.  These soaps may be used by people with acne who may have thickened, treatment resistant skin which is also very oily. 

Dermatological Cakes or Bars

These products resemble soaps but are chemically different.  They contain surface active ingredients, usually detergents, which have a variety of chemical modifications permitting easy and agreeable use.  They frequently have pH value close to that of normal skin and are therefore better tolerated than soaps.  Some dermatological bars contain active anti-acne ingredients, such as benzoyl peroxide, zinc sulphate and vitamin B6. 

Antibacterial Washes

A large number of washes for acne prone skin incorporate antibacterial agents, most of them have activity against surface bacteria but they do not penetrate the follicles which is where p.acnes flourishes.  These washes may prevent secondary infection in acne prone skin, but they have no real benefit on acne lesions.

More recently a group of washes containing benzoyl peroxide as the active ingredient has emerged.  Benzoyl peroxide is a potent oxidizing agent which is bactericidal for p.acnes when applied and left on the skin as a typical application can penetrate the follicles sufficiently to reduce the population of this bacterium.  While washes containing benzoyl peroxide do not achieve the same results as topically applied benzoyl peroxide, they tend to be less irritating and less drying.

Skin Cleansers

Skin Cleansers are one of the most traditional of cosmetic products which are used as part of the daily skincare routine and, or to remove makeup. They are formulated with oils and water to form an emulsification. In the case of Yin Yang Skin Cleanser, the formulation uses only plant oils with pure spring water as the base for the cleansing cream. This simple but thorough cleanser will leave the skin absolutely clean and the pH value of the skin will be undisturbed. 

Toners & Rinses

These can be tap water or astringent lotions.  Even when hard, tap water is well tolerated by oily skin, but Yin Yang would advise against unnecessarily raising the pH value of the skin as this is unhelpful to the healthy bacteria that are normally resident on human skin, but conversely much enjoyed by the acne bacterium.  Yin Yang Orange Flower Tonic is an ideal product for after cleansing hydration and toning: with a pH balanced to around 5.0, this gentle hydrating mist can be used to finish the cleansing process or simply to add moisture to the skin – especially if dry and tight as a consequence of using acne treatments.

People with acne should avoid all toners or rinsing products that contain alcohol as these can be irritating to acne prone skin. Other better tolerated astringents include witch hazel or extracts of cucumber, sage, comfrey and lemon.  Some of these contain camphor or allantoin, thought to have anti-inflammatory as well as astringent properties. 

Many cleansers, toners and astringents now contain alphahydroxy acids, usually glycolic acid, (Yin Yang products do not contain these ingredients). These are used for exfoliating activity, but excessive exfoliation can disrupt the skin surface and lead to secondary infection.  Shaving may be problematic in men.  In general, men with acne are advised not to shave too closely and not every day unless absolutely necessary. This is particularly important in people with multiple inflammatory lesions.  There are a variety of shaving foams and creams with antiseptic ingredients, including benzoyl peroxide. 

Moisturisers

People on acne medications may experience considerable skin dryness; in these circumstances a moisturizer that does not exacerbate acne will make the skin feel more comfortable and it will also improve the appearance of the skin.  In general moisturizers can be applied over the top of medications without ill effect. Light botanical oils are preferable to mineral oils or animal oils and moisturizers with a low oil to water ratio are to be preferred. Silicone derivatives are useful in moisturizers for acne skin because they are do not encourage acne, they are hypoallergenic and non greasy. 

Acne sufferers who may not have needed a facial moisturizer prior to using acne medications, may benefit from such a product in the lower sebum producing areas of the face such as the sides of the cheeks and along the jaw line. 

It is important to note that environmental conditions may also influence the oiliness or dryness of skin.  For people with acne and oily skin it may not be appropriate to use a moisturizer in humid conditions. 

Use of Cosmetics on Skin With Acne

Heavy older style makeup was often implicated in the development or increased severity of acne. More recently the cosmetic industry has paid much closer attention to the potential of products to worsen the condition of acne prone skins and a wide range of make-ups have been specifically designed for acne sufferers.  These are usually labeled “non comedogenic” or “non acnegenic”. 

In general make up specifically designed for oily skin is recommended.  These are usually oil and water emulsions which contain oil absorbing substances such as kaolin, talc or micronised polymide powders.  There are also acne treatment creams that are tinted (yellow) to provide cover for red lesions which some acne sufferers find helpful.  All make-up bases may be modified by a light application of face powder with a brush. 

Facial Foundations

People using acne medications may find it more difficult to achieve an even covering of foundation after beginning treatment.  Foundations containing silicone derivatives will allow the pigment to glide evenly over the skin to smooth scale induced by medications.  A small amount of silicone oil within a foundation will also aid in preventing the foundation from changing colour during the day.  Facial foundations can be used to camouflage complexion irregularities. 

Lip Cosmetics

Lip cosmetics are beneficial in people treated with oral isotretinoin to prevent and soothe cheilitis (lip cracking).  Most patients with acne however, may wish to avoid moisturizing lipsticks, lip creams and lip glosses.  These products often contain a high concentration of petrolatum, which can cause pimples.  Dull or matt finish lipsticks can generally be used without difficulty. 

Eye Cosmetics

In general dull or matt finished powdered eye shadows should be selected by the people with acne.  Eye shadows with a frosted, pearlescent or glittery appearance, may contain irritating particulate matter such as fish scale essence, bisthmus oxychloride, micro or ground metal  particles.  Powdered eye shadows are preferred because they do not contain irritating vehicles contained in liquid eye shadows or the oily substance found in cream eye shadows. 

Hair Cosmetics

Although topical acne medications are not applied to the scalp, irritation on the hairline is common and can create problems amongst people using volatile hair grooming products or who use hair dyeing or permanent waving.  Inevitably a small amount of the hairspray, mousse, dye or waving solution contacts the skin along the hairline.  This can cause burning or stinging of acne skin.  Stinging and increased irritation can be avoided by exercising care when applying hair grooming aids or by covering the face with a towel.  Barrier cream should be placed along the hairline beneath an absorbent cotton wick to aid decreased dye or waving solution skin contact.

Camouflaging Techniques

Several types of cosmetics are available for acne camouflaging, such as facial foundations, cover sticks, undercover products, blushers, facial stains and powders.

Facial Foundations

Any oil-free, water-based or low oil content facial foundation can be used to camouflage acne blemishes.  These products generally contain titanium dioxide, talc and pigment that can mask skin reddening [erythema].  Improved coverage can be obtained if the acne lesions are first dabbed with foundation, allowed to dry thoroughly and covered with a second layer of foundation.  The foundation can then be applied to the entire face if desired.  If the need for camouflaging the entire face in cases of severe acne arises, pancake style foundations can be used without worsening underlying acne.  Pancake foundations are wiped from a compact with a moistened sponge to form an emulsion and applied to the face.  These products are somewhat difficult to apply but provide excellent long wearing coverage with excellent oil control capabilities. 

Cover Sticks

Many people with acne will get post inflammatory pigmentation. Cover sticks are also available to dab over acne lesions.  Some are medicated containing salicylic acid or resorcinol and also contain increased amounts of titanium dioxide for superior coverage.  Most cover sticks have a high oil content that may cause pimples.

Undercover Products

Undercover products – also known as undercover primers – are designed to be worn under a facial foundation.  They are available in creams and liquids, in both oil free and oil containing formulations.  Undercover products based on the principle of complimentary colour blending, e.g.  red acne lesions can be covered with a complimentary yellow/green undercover cream to yield brown tone. 

Blushers

Blushers are pink, orange or red powders, liquids or creams applied to the upper cheeks to simulate the appearance of rosy cheeks.  For the people with acne on the cheeks, blush can be used to blend the underlying redness (erythema) into a more cosmetically acceptable appearance.  Powder blushes are often recommended.  The use of blush can be an effective camouflage alternative for a younger people with acne who do not use foundation makeup.

Facial Stains

Facial stains can be used to camouflage acne lesions in people who do not wish to wear a facial foundation.  These products are gels that contain water, alcohol, light esters and organic colours.  They are available as bronzing gels in shade of brown designed to simulate a tan and there are blushing gels in shades of red designed to simulate rosy cheeks.  These products impart transparent colour to the skin but provide no coverage only colour blending. 

Powders

Powders composed of pigmented talc can be used for several functions including blemish coverage and oil control.  They may be used alone or over a facial foundation. 

Acne and Sun

The Sun is a two edged sword for most people with acne.  While ultraviolet light may have a mild anti-inflammatory effect and tanning tends to hide acne lesions, ultraviolet light also may lead to development of pimples as sun exposure leads to increased thickness of the skin.  It is a well known observation in clinical dermatological practice that acne sufferers tend to get worse shortly after returning from summer vacation.   Sunscreen gels and oil-free lotions have been formulated over recent years for acne sufferers. 

Skincare Routine For Care of Acne Skin

Yin Yang Products For Care of Acne Skin

i.   Skin Cleanser
ii.  Kaolin Face Mask
iii. Orange Flower Tonic
iv. pH-Amino Gold Defence Lotion

,