Acne Treatments 101: What You Need to Know

Let's be real—acne is a beast. Whether you're dealing with the occasional breakout or you're in a full-on battle with stubborn, inflamed skin, acne can mess with your confidence and make you feel like your skin is running the show. But here's the good news: you don't have to just sit back and let it. There are a ton of treatments out there, and when you understand how they work, you can take back control and start rocking the skin you're in.

Let’s break down the different types of acne treatments out there—from the ones that tackle hormonal imbalances to those that help reduce oil and increase skin cell turnover. By the end of this, you’ll know exactly what’s what, and more importantly, what might work for you.

1. Hormonal Regulation: A Balancing Act

First, if your acne is hormonal, no amount of scrubbing or topical creams will fully fix it. Hormonal acne is often triggered by an imbalance in hormones, particularly androgens like testosterone, which can increase oil production in your skin. This type of acne typically shows up along the jawline, chin, and lower face, which can be persistent and frustrating.

How to Treat It:

- Oral Contraceptives: Not my favorite option, but birth control pills can help regulate hormone levels and reduce the severity of hormonal acne. They work by lowering the levels of androgens in your body, reducing oil production. Unfortunately, this is often just a bandaid, and acne can reemerge once terminated. Plus it’s not an option for those hoping to get pregnant.

- Spironolactone: This is another prescription medication that blocks the effects of androgens. It's often used off-label to treat hormonal acne, especially in women. Because it is a diuretic it is very important to stay hydrated on this medication

- Diet and Lifestyle Changes: Sometimes, tweaking your diet or managing stress can help balance hormones naturally. Cutting back on dairy, sugar, and processed foods while increasing your protein and whole foods intake can make a major difference in hormonal acne. This is personally, my first and favorite approach when working with clients struggling with hormonal acne.

2. Oil Reduction: Cutting Down on the Shine

Excess oil is one of the main culprits behind acne, especially the kind that seems to pop up out of nowhere. Your skin naturally produces oil (sebum) to protect itself, but when it goes into overdrive, that oil can mix with dead skin cells and clog your pores, leading to breakouts.

How to Treat It:

- Topical Retinoids: These are vitamin A derivatives that help reduce oil production, unclog pores, and promote skin cell turnover. Retinoids can be found in both over-the-counter and prescription forms, with tretinoin being one of the most popular prescription options. Starting a retinoid can be a little rough which is why I often ease clients into using one by starting with a low percentage. I would not recommend retinoids for teens suffering from acne.

- Salicylic Acid: A classic for a reason, salicylic acid is a beta-hydroxy acid (BHA) that penetrates the pores and helps clear out excess oil and dead skin cells. It's gentle enough for daily use and can be found in cleansers, toners, and spot treatments. It is also a great option for younger acneic individuals.

- Benzoyl Peroxide: This powerful ingredient works by killing acne-causing bacteria and reducing oil production. It’s especially effective for inflammatory acne, like pustules and cysts.

3. Skin Cell Turnover: Out With the Old, In With the New

When your skin cells don’t shed properly, they can pile up and mix with oil, creating the perfect environment for acne to thrive. Boosting your skin’s cell turnover rate can help keep your pores clear and prevent breakouts from forming in the first place.

How to Treat It:

- Exfoliation: Regular exfoliation helps slough off dead skin cells and keeps your pores clear. Chemical exfoliants like alpha-hydroxy acids (AHAs) and beta-hydroxy acids (BHAs) are particularly effective. AHAs like glycolic acid work wonders on the surface of the skin, while BHAs like salicylic acid go deeper into the pores. If you have inflamed acne, steer clear of any scrubs as they can actually irritate your skin and make the acne worse.

- Chemical Peels: For a more intense treatment, chemical peels use stronger concentrations of acids to exfoliate the skin. These treatments can help with not only acne but also post-inflammatory hyperpigmentation (those pesky dark spots acne leaves behind).

- Retinoids (Again): Yep, retinoids are multi-taskers. In addition to reducing oil, they also speed up skin cell turnover, helping to prevent clogged pores and promote smoother, clearer skin. Really this topical can be amazing for those struggling with adult acne while also trying to stave off fine lines.

4. Combination Treatments: Sometimes, You Need a Little of Everything

Here’s the thing: acne is rarely caused by just one factor. It’s often a combination of hormones, oil production, and sluggish skin cell turnover. That’s why a multi-pronged approach can be the most effective.

How to Treat It:

- Skincare Routines: A well-rounded skincare routine might include a gentle cleanser, a chemical exfoliant, a retinoid, and a moisturizer that doesn’t clog pores (look for non-comedogenic on the label). Consistency is key, so stick with your routine and give it time to work.

- In-Office Treatments: If your at-home routine isn’t cutting it, consider in-office treatments like professional chemical peels, light therapy, or extractions. These can give your skin the extra boost it needs to clear up.

- Prescription Medications: Sometimes, over-the-counter treatments aren’t enough. If your acne is severe or resistant to other treatments, a dermatologist can prescribe stronger medications, such as oral antibiotics, stronger retinoids, or isotretinoin (formerly known as Accutane).

Final Thoughts: Taking Control of Your Skin

Acne can feel like a never-ending battle, but the right treatment plan can make a world of difference. It’s all about understanding your skin’s unique needs and finding the right combination of treatments to address them. Whether you’re balancing hormones, reducing oil, boosting skin cell turnover, or all of the above, there’s a path to clearer, healthier skin.

Remember, it's not just about treating the acne you have now—it's about giving you the confidence to rock the skin you're in, every single day. Keep at it, and don’t be afraid to ask for help if you need it. Your dream skin is within reach!