Defense Against the Dark Arts

Acne. Bane of our existence.

Why does it happen? Well, skin has little glands, which produce natural oils that keep our hair and skin looking nice.

When a pore (the opening of a gland out onto the surface of your skin) gets clogged with dead skin, the gland gets irritated — either by bacteria that’s trapped inside, or by continuing to produce its natural oils, which now cannot get out.

It gets inflamed (making the red bump). The body’s defense system will wall off the gland to isolate the problem, and eventually the skin on top of it thins and breaks open, getting the gunk out of your body. Whiteheads, blackheads, and pimples are actually just different life-stages of the same issue.

Now the important question: what can you do about it? There are three topical drugs for acne and they all work the same way. They break down the proteins that help your skin cells stick together, which means skin cells slough off more easily, thinning the skin. This speeds up the process of getting the zit up to the surface and out.

Every over-the-counter acne treatment — whether you buy it in Sephora or Walgreens — will have one of two active ingredients: benzoyl peroxide or salicylic acid (which is similar but not the same as aspirin). Since the active ingredient is what’s important, you can buy an equally effective treatment at either Sephora or Walgreens. I’m liking Neutrogena Rapid Clear Acne Eliminating Spot Gel, a clear gel with a 2% salicylic acid concentration (~$8-9 at Walgreens).

The third drug is a retinoid (like tretinoin, the active ingredient in Retin-A) — these are similar but not the same as vitamin A. Retinoids are prescription-only because they can cause major birth defects.

Because all these drugs thin the skin, they usually carry a warning about increased risk of sunburn. Going overboard (applying too strong a concentration, applying too often), can result in peely, flaky skin. Chemical peels work by the same mechanism, but more of it, which is why you don’t do them at home — you could end up going too far and scarring yourself. I hate pimples as much as anyone, but time and patience are also necessary to cure them without hurting your skin. If what you’re doing hurts, stop doing it.

One more note: some people have constant acne that just won’t go away. It’s okay to see a dermatologist about this. IF (and only if) your acne is caused by bacteria, your doctor may put you on a class of antibiotics called tetracyclins to kill the bacteria. If your acne is not caused by bacteria, the antibiotics will be completely ineffective. Don’t self-prescribe antibiotics, and if you are prescribed them by a doctor, please for the love of God, follow the dosing instructions and take the full course.

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8 Responses to “Defense Against the Dark Arts”

  • Joy says:

    >Hey Karla,

    This is recommended by as well! Good job!

    Joy (gingitsune on MUA)

  • tina_mbc says:

    >Well said! Great post! I was suffering from acne in my teens, and this sums up my experience excellently!

  • innerchild says:

    >Thanks for this entry on acne, Karla! I’m one of those people that had to see a derm and use prescription meds, otc products weren’t doing well for me.

    I’ve started on a retinoid the past few months, and while it causes me to purge, I’m being a trooper about it cos the results will show in the end! :) I had used Retin-A Micro last year, I stopped cos I ran out of samples and it costed too much for the full-size. This time around, I bit the bullet and purchased Atralin (the baby sister of Retin-A, made by the same manufacturers of Retin-A and Retin-A Micro). Atralin is more gentle cos it contains moisturizing ingredients, it’s fairly new, and I’m very grateful that my parents were willing to pay for this for me.

    Anyway, to treat acne, it takes patience, I firmly believe this. Sorry for rambling, my thoughts just wander…

  • Agne says:

    >Hi Karka,

    I am suffering w/ this plague that is acne…jaw line acne.
    I’m on meds (antibiotics)…its been only 1 week and I can see no results yet.
    My question to u is: do you have any reviews about products that won’t hurt even more yr skin? like acne-friendly products?

    Thx =D


  • Jessica says:

    >For those that are looking for acne control for the body, Clinique makes a salisylic acid spray that’s great for hard to reach areas like the back.

    Also, retinol can be found in over the counter products, just in lower concentrations than what a doctor could provide. ROC, Estee Lauder, Philosophy and Peter Thomas Roth are a few companies that make products that contain this ingredient. Be careful though- even over the counter concentrations can cause severe sensitivity- start out using the product once a week and increase over time (or follow the directions on the package insert.)

    For those that have sensitive skin, look for products that contain glycolic acid. It works much in the same way salicylic acid does but tends to be a bit gentler.

    BTW Agne:
    This may sound silly, but make sure you clean your phone regularly with alcohol- it’s actually possible that could be contributing to your jaw-line acne (do you have a job that has you on the phone a lot?) Also, keep an eye on your habits to see if lean your head on your hand a lot. The oil, dirt and bacteria could be spreading that way too!

  • delirious says:

    >Love the brown bag pic, LOL!

  • Jess says:

    I know this is a very dangerous drug, but if you are serious about getting rid of oily severely broken-out skin, you should really try Accutane (isotretinoin).

    It really, really works…it’s a miracle.

  • Mia says:

    I have a theory about all this. There is a bacteria that can cause breakouts, P. Acnes, to me, the real acne is caused by this bacteria. When the skin is not infected by it, breakouts happen for other reasons, that’s just a plain breakout and not acne. Therefore, each should be treated differently. And how it’s possible that products to get rid of such problems are still skin-damaging?! I personally would never use any of the products recommended to oily/acneic skin. I’m investigating myself safer ways to cure those problems.

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