Help! I’m Breaking Out!
Dr. Sejal K. Shah’s tips for treating and preventing acne.
With Valentine’s Day just a few days away, the last thing anyone wants to be dealing with is a break out. The good news is you can clear up your complexion — whether you’ve got a few weeks or even just a few days — with these tips from Manhattan based dermatologist Dr. Sejal K. Shah. We asked to explain exactly what triggers acne and how to deal with it before date night rolls around.
What causes acne?
Contrary to popular belief, acne is not an infection. “There is overgrowth of a natural bacteria that lives in the hair follicles, but it is not an actual infection,” says Shah. “Four things happen in the creation of acne: Oil production, shedding of skin cells, overgrowth of bacteria, and inflammation.”
Essentially, your oil glands start producing more oil and this combines with shedding skin cells to form a plug in the pores or hair follicles. When this happens, the P. acnes bacteria (Propionibacterium acnes) that live in our pores overgrows and this stimulates inflammation in the skin.
Treatment
“Treatment plans really depend on how much time you have,” says Shah. If you are noticing breakouts a few weeks before an event like your prom, schedule an appointment with your dermatologist to see if prescription medication is an option for your acne. Shah offers a combination of a low-dose oral steroid and an antibiotic to patients that have a little more time to clear up their skin.
If you just have one big bump, a steroid injection is a great option. “These typically take 24-72 hours to work,” says Shah. “Occasionally people see improvement on the same day, so this is something you can do up to the day of your event.” Steroid injections should be done by your dermatologist and are usually best for a really big, red bump, like a cystic bump. With an injection, there is always a risk of skin atrophy or discoloration in the area.
If you have a few days, at home spot treatments are a great option. “Look for something with benzoyl peroxide, salicylic acid, or a sulfur,” says Shah. “All of these work as anti-inflammatories.” Shah recommends benzoyl peroxide for a bigger bump due to the anti-bacterial properties. Salicylic acid helps to exfoliate the skin and is great for white heads or black heads. She also recommends doing your spot treatments at night, as they can be drying for the skin. If you notice a spot pop up the morning of your big day, you can use ice to reduce inflammation or an over-the-counter hydrocortisone.
If you’re faced with a whitehead, Shah stressed the importance of not popping it. “The safest thing to do is to see your dermatologist, or if you have a very good esthetician, and have them extract it for you. If you pop things at home, you are potentially worsening the situation.”
Prevention
“The biggest mistake people with acne prone skin make, is thinking if they wash their face more or scrub their face more, it will help their acne,” says Shah. It turns out that overwashing your face or using harsh scrubs can actually make your situation worse. “Your skin dries out and it responds by producing more oil, which can potentially worsen the acne.” Shah recommends washing your face twice a day at most and, if you are acne prone, incorporating an acne face wash into your routine a few times a week. If you’ve got more sensitive skin, she recommends products that use tea tree oil. “Overall, you don’t want to be too abrasive with your skin,” says Shah.
Another key to preventing breakouts is finding out if there is something in your lifestyle that is a trigger for acne. “There are the four factors that cause acne, but some people have triggers that stimulate these factors — either in your diet or your lifestyle,” she says. Common triggers include dairy and high glycemic foods that can cause hormonal surges leading to excess oil production.
Looking for a spot treatment? Dr. Shah recommends Neutrogena On-the-Spot Acne Treatment ($6), Mario Badescu Drying Lotion ($17), and Glamglow Supermud Clearing Treatment ($), Aztec Secret Indian Healing Clay ($13) and The Body Shop Tea Tree Oil Clearing Lotion ($15)
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