For women all over the world, acne is a skin concern that's likely reared its head on several occasions throughout life. From breakouts in our teen years to surprising smatterings in adulthood, we can hardly remember a time when we weren't reaching for products to help nip zits fast.
Treating acne can be frustrating and complicated, so we turned to one of the best dermatologists in Los Angeles, Nancy Samolitis, MD, co-founder and medical director of Facile, to help break down the root causes, and the best treatment approach. First and foremost, she'll cover the leading acne-causing culprits to help us better understand what we're up against. Then, continue on to check out Samolitis's expertly curated skincare routine for banishing breakouts, once and for all.
What Causes Acne?
Culprit #1: Genetics
Despite our best efforts to care for our skin, sometimes acne and its contributors are just written into our genetic code. "The biggest contributor to acne is genetics," Samolitis says. "Some people are just programmed to have larger pores, more oil production, inflammatory skin, etc." That's not great news, but genetic or not, there are always solutions to help manage skin concerns like acne.
Culprit #2: Hormones
Hormones help to regulate everything from reproduction to stress, and according to Samolitis, they can also have quite a bit to do with acne. "Hormonal stimulation of oil production is also an important factor. This is obviously a factor in teens, where their hormones are just starting to rise, but is also very common in adult women—often for unknown reasons," she explains. "Certain hormonal medications such as the progesterone component of birth control pills, IUDs, and bioidentical hormone supplements can trigger acne."
Culprit #3: Diet
It's no surprise that what we put into our bodies has an effect on our skin. After all, just about every fad diet out there claims to be a road to clearer skin. Samolitis believes that there are specific foods to watch out for while actively treating acne, "in particular, foods that spike insulin levels like sugary or processed foods, " she says. "The hormones in meat and dairy that are given to farm animals may also play a significant role in acne, but this is poorly understood."
Culprit #4: Products
"Finally, use (or lack thereof) of certain skincare products can trigger breakouts as well." With the ever-growing selection of products available now, we have to be more cautious than ever when trying new things, as to not upset the skin's delicate pH balance. "This day and age, there are not as many comedogenic (pore-clogging) products and makeup as there used to be, but products that contain thick creams or ointments may lead to clogged pores and worsening of acne," says Samolitis.
With so many different factors that could potentially be contributing to acne, it might feel like an impossible feat to figure out the best steps to take. And the truth is, there's no better place to start than by consulting a trusted physician to nail down a treatment plan. "If you have acne that is severe, cystic, scarring, and is resistant to skincare and treatments, it's important to seek treatment by a board-certified dermatologist who can assess and work up the acne, ruling out underlying medical causes," Samolitis implores. "There are many prescription treatments that are safe when used under proper supervision and can treat severe acne before scarring occurs."
In the meantime, our trusty expert has mocked up a skincare routine that will help anyone who would like to treat their acne.
Samolitis recommends starting the day with a clean slate by using a cleanser with salicylic acid. "Exfoliating acids, in particular, oil-busting salicylic acid, help to remove excess oil that is leading to clogged pores in the first place," she says.
After the skin is freshly cleansed, it's the perfect time to go in with a highly active ingredient–based serum. This one by Versed uses willow bark extract and a powerful zinc blend to clear out excess pore-clogging sebum.
"Niacinamide is a more newly recognized anti-inflammatory ingredient that works particularly well for adult female acne and also has anti-aging benefits as a bonus," Samolitis explains. She carries this niacinamide and antioxidant-rich treatment in her own practice and recommends it to clients struggling with a multitude of inflammatory skin conditions.
As mentioned above, Samolitis cautions against oil-based, heavy creams for those dealing with acne. The pore-clogging that could ensue just isn't worth the risk. That's why this lightweight, gel-cream moisturizer is the perfect alternative for achieving deep hydration without running the risk of breakouts.
In the evenings, Samolitis again recommends cleansing to keep the skin free and clear of acne-causing dirt and debris. Rose, mint, and apple amino acids make this one a super-gentle option that doesn't sacrifice efficacy.
"Vitamin A derivatives (like retinol and adapalene, the active ingredient in over-the-counter Differin gel) help to normalize skin cell turnover and keep skin cells from sticking in the pores. They can also stimulate healthy collagen growth, improving acne scars," Samolitis advises.
Samolitis emphasizes how important it is to replenish moisture in the skin to fight any possible redness or dryness that might arise while using a retinoid treatment. This Versed booster deploys two different kinds of hydrolyzed hyaluronic acid into the skin.
"When all is dry and soaked in, use benzoyl peroxide as needed. Naturally antibacterial, benzoyl peroxide detoxifies the bacterial overgrowth that occurs in inflammatory acne," Samolitis says. She recommends this leave-on mask by Neutrogena.