Confession: I Lead A Clean Lifestyle But Don't Use A Completely 'Clean' Skincare Regimen
I'd like to think I lead a pretty clean lifestyle. I eat a plant-based diet, compost my food scraps, and recycle on the regular. Up until the end of 2019, I also had a clean skincare routine. I would even tell anyone who asked that my line-up of natural products was what cured my acne. And, I truly believed that...until I went off of my oral contraceptives for the first time in six years to look for a more natural alternative. About one month after going off the Pill, my skin started majorly changing and I realized that my birth control had played a role in keeping my skin clear.
Suddenly, the only thing that was consistent about my complexion was that it was inconsistent. The first thing to change was the texture—small, skin-toned bumps surfaced along my cheeks. Then, deep, painful, cystic pimples would pop up in random places on the regular. I kept going with my clean skincare routine, hoping that my face was just going through a phase. But after about a year, and what felt like a decade, of dealing with this and it not improving, I decided to see a dermatologist and bring in the big guns…prescriptions.
My dermatologist asked if she could put me on spironolactone, an oral medication used to lower blood pressure that has also been found to help control hormonal acne. I turned it down, as I didn’t want to be on yet another pill that was going to suppress the acne. While I didn’t love the idea of topical acne prescriptions—it didn't feel like the clean approach I was aiming for in the rest of my life–I was desperate. It felt like a little less intense of an alternative to ingesting something.
This is the regimen my dermatologist, Dr. Shari Marchbein, prescribed, along with what each product is used for.
I’ve been on this regimen for about three months now, and while it’s definitely doing its job at making my skin more consistently clear (🙌), I’ve been coping with the internal struggle of not using more clean ingredients. And honestly, I get embarrassed to tell people that I’m on prescription topicals. Clean beauty bullies are a real thing!
So, I went on a quest to see what the experts thought and asked dermatologists, as well as estheticians and Chinese medicine practitioners, for their thoughts on prescription topicals and what I could do to start to take a more natural approach again without causing a major acne flare up. Here’s what I learned.
This is how to safely make the switch to a cleaner routine without disrupting your acne.
Everything in moderation.
“My philosophy is that the right medicine at the right dosage at the right time is what creates healing,” says Sandra Lanshin Chiu, acupuncturist, herbalist, and founder of Lanshin in NYC. “If you need to get on prescription medications, do it. Sometimes you have to think about what’s best for your mental health at that moment and then figure out from there how to get to a routine that you feel even better about.”
Look for ingredients that have the same goal as your prescription products.
“I don’t believe prescription topicals work better than many over the counter products,” says Loretta Ciraldo, MD, a board-certified dermatologist and founder of Dr. Loretta Skincare based in Miami. “Dermatologists often rely on peer-reviewed studies of products, and these expensive studies are more commonly done on prescription products—hence why many derms rely on prescriptions to clear acne.”
She says you can typically find the ingredients used in prescriptions in over the counter products. While they may be a lower dosage, it’s a good alternative if you want to stick to clean ingredients beyond just the actives.
Switch out your prescription products for cleaner alternatives using caution.
Once you're ready to start looking for cleaner alternatives to incorporate into your routine, it's important to make sure you're still choosing ones that are right for your skin type. Luckily, there are many natural alternatives to common derm-approved ingredients like bakuchiol for retinol, willow bark for salicylic acid, and a sugarcane derived lactic acid.
“Don’t forget that your skin is still acne-prone,” cautions Dr. Ciraldo. “While your regimen may have you in the clear now, you always need to select products that won’t agitate your underlying acne-prone skin.” A few potentially irritating ingredients she suggests staying away from: artificial fragrances, sulfates, and ethyl alcohol, “which is very drying and can make your skin overproduce oils to compensate for the lack of moisture.”
Only swap in one new product at a time.
All of the experts I spoke with agreed that you should take it slow. “Even if you switch out your whole regimen with ingredients and products that are made specifically to treat acne, your skin will likely still freak out, as it’s just too much change all at once,” explains Brian Goodwin, an esthetician, herbalist, and international educator at Eminence Organic Skin Care.
Don’t ditch your prescriptions without a plan.
“For some, stopping the use of prescription topicals altogether can lead to the re-emergence of acne,” explains Lanshin. “Don’t panic—that just means that the prescription topical was suppressing the acne, but not actually healing it.” She suggests consulting with your dermatologist, esthetician, or naturopathic doctor to ensure that you have a plan of action to keep your acne under control while you're weaning yourself off of the topicals. That way, you don’t end up back at square one, desperate for acne relief.
Armed with this knowledge, I feel less guilty about my topical prescriptions—I won't be on them forever, and sometimes you’ve gotta do what you’ve gotta do. At the same time, I've started to incorporate some cleaner products into my routine. My biggest takeaway: Everyone is different, especially when it comes to skin, and the best answer is simply the one that you feel most comfortable with.
This article is part of Women's Health 2020 Acne Week. Click here for more.
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