In 2017, it’s far too easy to find solutions (or, what we think are solutions) to all of our problems on the Internet — and that includes beauty woes. When it comes to acne, there’s a massive wealth of information out there about what causes it, what works to clear it, and what doesn’t work at all. It can certainly be helpful in some ways, but it can also be overwhelming and, in some cases, ineffective. Here’s the thing: We can all read that ingredients like salicylic acid, benzoyl peroxide, sulfur, retinoids, and certain oils can do wonders when it comes to preventing and banishing breakouts. But, it’s possible to try all of those magic fixes and find that your skin isn’t getting any better — or even that it’s getting worse. Why, exactly, is that, though? We talked to experts to find out.
You’re using them too much.
When you’re faced with a breakout, it can be tempting to load on the acne products, but that could actually be counterproductive. Certain blemish-busting ingredients “tend to be drying, and the most common mistake people make is overusing them, either too often or too much,” NYC cosmetic dermatologist Sejal Shah, the founder of SmarterSkin Dermatology, tells Teen Vogue. “When they are overused they can overly dry or irritate the skin, leading to more breakouts.”
For example, salicylic acid, which works to unclog pores, is also a “mild chemical irritant,” meaning it also works as a drying agent and can cause skin redness and flaking if used too much, Kathleen Suozzi, a dermatologic surgeon at Yale School of Medicine, tells Teen Vogue. Other common acne-fighting ingredients, like benzoyl peroxide and sulfur, can have the same effect. If you go the benzoyl peroxide route, Dr. Suozzi recommends using it in the form of a “creamy wash, such as PanOxyl 4% Acne Creamy Wash or DCL B Prox 10 Anti-Blemish Wash,” because they’re less drying than other forms and not as likely to irritate your skin.
As for frequency, Dr. Shah suggests using leave-on products containing benzoyl peroxide, salicylic acids, and sulfur two to three times a week at first and gradually increasing until you’re using them once daily as your skin tolerates. For cleansing products that you rinse off, she says you can use them as often as twice a day every day (because they tend to be “more readily tolerated”), but if you have sensitive skin you you may want to try every other day at first. If you’re using masks, Dr. Shah says, start with once a week and don’t use them more frequently than three times a week, as they can be fairly drying.
You’re not using them enough.
On the flip side, if you’re using a retinoid, you may need some more time to see results. In fact, when you use this ingredient — which Dr. Suozzi says is the best for preventing and treating comedones, or clogged pores that result in blackheads and whiteheads — your acne may get worse before it gets better. “After starting a retinoid, some patients may experience a flare in their acne,” she says. “The acute expulsion of the comedones by topical retinoid can trigger a flare, but once the comedones are expelled and the retinoids have had a chance to normalize the turnover of skin cells in the follicle, the acne will improve.” The time frame varies from person to person, so it could be anywhere from days to weeks, but Dr. Suozzi stresses that it’s important to continue using the retinoids through that flare up. Eventually, it’ll resolve itself. “It is important that retinoids are used continuously,” she says. “Strict compliance is key for acne prevention. Retinoids are not to be used for spot treatment or to start during an acne flare, because…they prevent the first step of acne formation.”
Dr. Shah recommends starting your retinoid use with two to three nights per week and gradually increasing to nightly as your skin builds up a tolerance.
They’re not working well together.
Resist the urge to try anything and everything at the same time when you’re trying to prevent or treat acne. “In general, when initially using any of these ingredients, it’s best not to combine them so as to not overly dry and irritate your skin,” says Dr. Shah. “Doing so may cause more harm than benefit.” For example, she notes, acid ingredients could reduce the effectiveness of certain retinoids. “Instead, choose one or two and use them at different times during the day — for example, one in the morning and one at night.”
You’re allergic or sensitive to the ingredients.
Dr. Suozzi says it’s rare to be allergic to ingredients like retinoids and salicylic acid. But, it’s possible that your skin is sensitive to those ingredients, which could cause a reaction. “What is common is irritation to retinoids, which can cause what is called retinoid dermatitis…a red, dry, peeling rash that can develop in areas treated with retinoid,” she says. “This occurs if patients use retinoids incorrectly.” To avoid or limit the irritation, build up the use gradually (as previously recommended), and use a gentle moisturizer.
On the other hand, other acne-fighting ingredients can cause allergic reactions. Common culprits benzoyl peroxide and tea tree oil. If you’re using either of those and find yourself with itchy rashes, redness, or swelling, the ingredients may be the culprit. (In that case, discontinue use.)
And some ingredients just might not be right for your skin. For example, while tea tree oil may work wonders on some people’s breakouts, Dr. Suozzi points out that oils in general “can be comedogenic, mean[ing] pore clogging, which can trigger acne breakouts.” So if you’ve been using tea tree (or any other) oil and can’t seem to escape acne, that could be the case. “I also think it is difficult for patients to distinguish pore-clogging oils from those less likely to clog pores,” Dr. Suozzi says. “Typically, cosmetic formulation of skin oils can contain numerous ingredients, and it is hard for the consumer to be sure that whatever product they are choosing will not contain a pore-clogging oil.”
The concentration isn’t right.
Dr. Shah notes that the concentration of ingredients in your acne product doesn’t always affect how well they work, but it can. If you’re having continued issues with your skin, it’s possible the concentration of an ingredient like salicylic acid or benzoyl peroxide could be contributing. “I generally recommend starting with the lowest concentration available and increasing gradually as tolerated,” Dr. Shah says. “For example, some people think that a 10% benzoyl peroxide will be more effective than one that is 2.5%, but many 2.5% formulations are equally effective without the drying and irritation.”
As for topical retinoids, Dr. Suozzi says you can try an adapalene cream (one common brand is Differin), which is a synthetic retinoid available over the counter that may be less irritating than other retinoids. (That said, she does point out that it may be less effective in fighting your clogged pores.)
All that said, remember you don’t have to figure this all out on your own. If you’re trying different acne products or routines and nothing seems to be working, or you just want some advice before you start any new routine, you can always consult your primary care doctor or dermatologist.