by Dr. Rob Ayoup, ND
1550 Bayly Street
Pickering, Ontario L1W 1Y7
905 674 0100
Cleansers, toners, AM moisturizers, PM moisturizers, sunscreens, serums, gels, and ointments… With infomercials showcasing amazing before-and-after effects, and the daunting number of products lining cosmetics store shelves, acne can be challenging to manage. Is a regimen using a multitude of products necessary? What ingredients should be looked for if they are needed? The answer is that everyone is unique. One person may control acne through a course of various prescription and over-the-counter topicals, while for the next person, simply reducing animal meats and dairy in the diet while obtaining acupuncture from their naturopath will do the trick! Working with both your dermatologist and local naturopathic doctor is a great way to cover all your bases. Having said that, active ingredient–containing cosmetics, also known as cosmeceuticals, can play a beneficial role in acne management for most. This is especially true when looking to strengthen our skins’ natural barrier, a key part of care for acne. This article will review some of the key cosmeceutical ingredients to look for in various cleansers, toners, and moisturizers used for acne. The information reviewed can then be discussed with your local (skin) health-care provider to confirm its appropriateness in your case.
Let’s Start with What’s Most Essential
Before diving into the various product formulations, there is one discussion we must have first and foremost. Acne—and many other skin concerns as well—can be worsened when our skin barrier is compromised. Recent research has shown how impairment to the skin barrier integrity and function can itself trigger an increased inflammatory response to Propionibacterium acnes, the bacteria implicated in acne development. It also may be involved in the process that leads to the development of both open and closed comedones (aka “blackheads” and “whiteheads”). Various factors can impact the skin barrier, including hormone stimulation of the glands producing sebum (a common cause in teenagers), hot water (such as shower or while washing the face), using the wrong type of face/body cleanser, friction from clothing, UV-light exposure, pollution, air conditioning, and even inadequate intake of essential fats from the diet.
The skin barrier needs regular maintenance. Much like the bricks and mortar protecting the outer layer of a house, it is comprised of nondividing cells called corneocytes (the bricks), and a lipid matrix helping to bind the corneocytes together (the mortar). This matrix is made up of ceramides, fatty acids, and cholesterol. Research is starting to show how lower levels of ceramides are found in acne. What better way to repair the barrier than by “restocking” it with these very raw materials themselves? Enter the world of ceramide-containing skin-care products. Now found in more than just moisturizers, ceramides are now featured across a variety of skin-care products, including cleansing bars, liquid cleansers for body and face, and even make-up–removing liquids and wipes. Given this wide array of ceramide-containing products now on the market, it would be beneficial to consider such options for the product categories we discuss next.
What Ingredients to Look for in a Cleanser?
Type of Cleanser: Before jumping into the key ingredient to look for, it is important to first review the type of cleanser being used. Cleansers fall into various categories, with soaps, synthetic detergents (“syndets”), and lipid-free cleansers being among the more common. The goal of all cleansers is to efficiently remove sweat, sebum, bacteria, and other secretions from the skin surface. Unfortunately, while latching onto and removing the oil-rich debris, the beneficial lipid matrix of the skin barrier can get stripped away as well! Traditional soaps will be the harshest in this effect, as they generally contain less moisturizers and are more alkaline, which can further damage the skin barrier. By contrast, syndet cleansers contain ingredients that are milder in their cleansing properties; contain more moisturizers to help replenish and protect the upper layer of skin; and are neutral/acidic, which further supports skin-barrier maintenance. As such, syndet cleansers often leave the skin feeling softer and less dry or irritated compared to soaps. Oil-free cleansers are also now popular, and are among the gentlest on skin. Like syndets, they are neutral/acidic in pH; leave behind a thin moisturizing layer; and are typically formulated with little to no fragrances, dyes, or irritating preservatives. Although ingredients will vary across manufacturers, the ingredients within traditional soaps include sodium tallowate, sodium cocoate, palm kernelate, sodium palmitate, water, PEG 6 methyl ether, palm acid or tallow acid, fragrance, glycerine, sorbitol, sodium chloride, pentasodium pentetate, tetrasodium etidronate, butylated hydroxytoluene (BHT), and titanium dioxide. By contrast, those often found in syndet cleansers include sodium cocoyl isethionate, stearic acid, sodium stearate, cocamidopropyl betaine, polyethylene glycol (PEG), sodium isethionate, coconut fatty acid, natural oils, salts, sequestrants, and titanium dioxide.
In addition to the ceramides we discussed above, a helpful ingredient to look for in your cleansing product, especially if dealing with oily skin, is salicylic acid. Originally derived from the bark of the willow tree, salicylic acid acts as a deep-penetrating exfoliant, owing to it ability to dissolve in oil-rich areas on the skin and in follicles where acne develops. This exfoliation helps to reduce the degree of pore clogging and acne development. Since salicylic acids can be irritating in some, like with most topicals, testing small areas of the skin first is typically recommended.
What Ingredients to Look for in a Toner?
The benefit of a toner product is the potential for additional removal of sebum, especially from the T zone (the oil-rich areas of the face encompassing the forehead, between eyebrows, and nose), that may have been missed by the cleanser. This can be particularly helpful if one finds certain areas of the face are oily (such as T zone), whereas other areas are drier. Applying toner in the oily areas will help to ensure sebum removal in those areas, while preserving the skin barrier over dryer skin since it’s not being subject to further additional, and unnecessary, cleansing. Witch hazel is a common herb which, due to its tannin content, acts as an effective astringent to gently tighten and contract cells of the skin. It also has the added benefit of reducing sebum levels from the skin. Antiacne toners will also sometimes contain acne-managing ingredients such as tea tree oil, eucalyptus, and alpha hydroxy acids (such as glycolic acid and lactic acid).
What Ingredients to Look for in a Moisturizer?
As described earlier, when looking to manage acne, repairing or fortifying our skin barrier is a paramount importance. In addition to a diet rich in the healthy fats the skin uses to construct the skin barrier, moisturizers are another easy and effective way to achieve this goal. Ceramide-containing moisturizers fit perfectly here given their role in replenishing the barriers’ lipid matrix contents of ceramides, cholesterol, and fatty acids. A second ingredient to consider is that of niacinamide, a form of vitamin B3. Niacinamide has been studied for a wide variety of properties that make it valuable in the management of acne. Owing to its ability to reduce sebum production, it can have a direct antiacne effect, as well as a potential reduction in the size of dilated pores and improved skin texture. Niacinamide research also seems to demonstrate anti-inflammatory properties, which may further help quell the inflammatory process characteristic of acne. Further studies indicate that niacinamide may also stimulate the production of the very components of the skin barriers’ lipid matrix. Another ingredient that may be included in a moisturizer focused for acne care is green tea. Like niacinamide, green tea may help manage acne on several levels. As a rich source of polyphenol antioxidants, epigallocatechin-3 gallate (EGCG) in particular, early research indicates that it may help in controlling inflammation, sebum production, and bacterial growth (including the acne-causing P. acnes discussed earlier).
Acne-Product Tip of the Day
Claims of “noncomedogenic” (nonacne/pimple forming) can be based either on the safety information of the individual ingredients in a product (which can be a less accurate assumption of the effects of the final product), or testing of the final product itself on animal or human skin (which is the most ideal and accurate an assessment of potential for acne formation). Before use, consider contacting the cosmetic company to confirm with them if their final product, in and of itself, was tested for acne formation, or if the noncomedogenic claim was assumed based on the individual ingredient profiles.
Disclaimer: The information presented in this article is for general information purposes only and does not constitute medical advice. Please first review with your personal health-care provider what therapeutic approaches and products would be best for your case.