What The Dermatologist Didn't Tell You About Acne
Acne is a genetic condition where the pores create too much dead skin and that dead skin sticks in your pores – it’s called retention hyperkeratosis. That dead skin, combined with oil in your pores, clogs the follicles and then forms impactions – which are the starting point of all pimples from simple blackheads to painful, inflamed cystic lesions.
Acne is often thought of as a pubescent problem to see a dermatologist for, but this is changing as many aren’t getting the clear skin thought to be so easily prescribed by the doctor and post-puberty breakouts can continue for decades due to hormone shifts, lifestyle choices, and stress waves. As we get older, we must work to balance not only acne, but acne scarring, hyperpigmentation, aging skin, and overall skin health.
We’re weighing in with our stance on the most common dermatologist treatments and why they don’t always work. But don’t worry, we bring solutions along with our constructive criticism! ;) And yes, we wish we would have known this when we were younger too – but, trust us, it’s never too late!
Prescription Antibiotics:
The Upside: The P. acne bacteria (formally known as Propionibacterium acnes) loves to feed on our own skin’s oil and oily and waxy ingredients in skincare products and cosmetics. Taking an oral antibiotic or using a topical gel like Clindamycin can reduce the bacteria and sometimes bring down painful inflammation.
The Downside: Antibiotics (oral or topical) should never be a long-term treatment strategy and in our opinion is irresponsible of doctors. When used long-term, it risks bacteria resistance and other serious side effects too like wreaking havoc on gut health. The use of antibiotics must be brief and need to be combined with a holistic lifestyle and skincare approach to work. Otherwise, once the antibiotics are stopped – the acne is back. Additionally, topical antibiotic creams and oral antibiotics don’t do anything for scarring, aging, pigmentation, or overall skin health.
The Skin MPLS Way: Bacteria is only one contributing factor to acne – it’s not the main cause. But, in a complete approach to managing certain types of acne, we include Dr. Fulton’s bacteria-killing Benzoyl Peroxide formulations in conjunction with avoiding other lifestyle triggers to help curb acne. Without managing the other factors in acne, you just won’t see full results – at least not for long. Read our secret acne triggers to avoid to ensure you have all your bases covered.
Hormonal Birth Control:
The Upside: During the last half of women’s monthly cycles, estrogen levels begin to decline, which increases acne breakout potential – some birth controls boost estrogen and help regulate this. Many women choose to be on birth control for pregnancy protection anyway so it can be a bonus to find one that helps with acne.
The Downside: If you are using birth control for acne, that is again only one piece of the puzzle, so you’ll still want to work with us to treat acne-prone skin topically as well. While you may think your acne is strictly hormonal, it’s rarely that simple – because we all know hormones are never simple! Besides, some birth control can actually spike acne. Eek!
The Skin MPLS Way: If you are thinking about starting or changing your birth control, please check with us to confirm your birth control is on our approved list, and then breathe a sigh of relief. If you are currently trying to get off birth control, we can work with you through the process to bring your skin to a natural and stable place. Just like your doctor helps find the right birth control for you, let your aesthetician find the right skincare to sustain clear skin through your adult life.
Tretinoin:
The Upside: Tretinoin (formerly known as Retin-A) was originally co-formulated by Dr. Fulton, the founder of Vivant Skincare and a true acne pioneer. It is a prescription-grade gel with vitamin A in the form of Retinoic Acid. This has a peeling effect on the skin and inside the pore to regenerate cell growth which clears acne and helps treat scarring and skin aging. Remind yourself What the F is Vitamin A? by re-reading our blog.
The Downside: The original formulation of Tretinoin was only the gel version, unfortunately somewhere along the way, the pharmaceutical companies lost their way and developed a cream version as well. Unfortunately, Tretinoin cream contains the pore-clogging fatty acid Isopropyl Myristate which literally feeds acne and ends up clogging pores – and yet dermatologists continue to prescribe it to acne patients. We’re just as perplexed by it as you are – and to add to it, check out these other commonly used acne-fighting products that contain pore-clogging ingredients that you’ll also want to be sure to avoid.
The other downside of prescription Tretinoin is that we are often guilty of thinking stronger is better – but pure retinoic acid almost always irritates the skin. This makes it impossible to stay consistent and actually use the product. Your pores can’t get cleared out if you’re not able to use the product regularly. Tretinoin can also interfere with getting necessary skin-boosting treatments like dermaplaning, chemical peels, and microdermabrasion.
The Skin MPLS Way: We love to battle acne from all angles when it comes to lifestyle and products. So we recommend an effective vitamin A like Exfol-A Serum used in conjunction with other actives (check out some of our other favorite ingredients here). When using vitamin A, we only recommend it in serum form to give the ultimate results.
Spironolactone:
The Upside: Spironolactone has become very popular in dermatological acne treatment. It helps lower testosterone production which can lower oil and acne production. It can be beneficial in treating some people’s acne.
The Downside: Again, we stress there are many contributors to acne – so you may get prescribed Spironolactone, which takes a few months to work, and then see no results. Also, we find it surprising to prescribe a prescription to lower testosterone production without first testing the blood to know if testosterone levels are even high. Spironolactone is a blood pressure stabilizer and a diuretic. It can come with side effects like nausea, diarrhea, headaches, and dizziness. It can also interfere with other medications, and you may need to up the potency to keep results.
The Skin MPLS Way: We want to treat and manage your acne, not Band-Aid it. We are still happy to work with clients that want to stay on Spironolactone though to get them even more results and also and meet other skin goals that medication cannot treat! Book a virtual consultation with our in-studio acne experts to find more sustainable options that will bring results in your overall skin health without even needing a treatment.
Accutane / Isotretinoin:
The Upside: Isotretinoin (formerly known as Accutane) should be the last stop in acne treatment. It is an extremely high dosage of oral vitamin A which stops ALL oil production of the skin and in turn, completely stops acne production (temporarily). It can be the best option for extremely resistant and severe acne after all other measures to manage acne have been tried.
The Downside: It’s a controversial medication with quite a list of side effects (including depression). It is often given out to patients too quickly who haven’t tried a topical approach and aren’t doing anything else to treat their skin. We find that it’s oftentimes over prescribed – especially for simple, non-inflamed acne.
Isotretinoin takes about 6-9 months, comes with excessive drying, and acne can likely come back. Many of the acne clients that we’ve successfully treated came to us after having tried Isotretinoin more than once. When not properly informed about acne and its true causes, the use of Isotretinoin can be another Band-Aid approach. The daily act of taking a pill to treat your acne doesn’t teach you anything about your skin and pores and once you go off it, there’s a high probability that the acne will just return.
The Skin MPLS Way: We pride ourselves on honesty and will be transparent if we believe Isotretinoin may be your best option. Learning about your skin and the way it functions is a process but so rewarding in the end.
Acne is beyond frustrating, but today we are lucky to have Dr. Fulton’s approach plus Vivant Skincare products instead of the one-size-fits-all approach that many dermatologists oftentimes take. While the internet has helped people learn more about acne, it has also bred mass confusion. What works for someone may not work for others. Our true passion will always be eradicating acne and we love seeing the confidence in our clients grow as their skin glows.