Although acne is not life-threatening, the fact that it can persist into adulthood can be frustrating for some of us. That pesky recurring pimple on your cheek is enough to make you worried about erythema, hyper pigmentation concerns and subsequent scarring. In this article, we’ll discuss six of the best acne fighting ingredients and how these can help improve your acne.
Acne Fighting Ingredients:
The Ultimate Know It All Guide
While there are numerous options available for treating acne, the first-line of treatment that your dermatologist would most likely start you on, would include topical preparations. This stands true for the milder forms of acne, that presents with primary lesions only. On the other hand, severe acne refers to the presence of cysts, nodules and/or open lesions. The choice of treatment depends on patient’s age, acne sites, severity, as well as patients’ preference.
Look for acne fighting ingredients
Topical preparations such as lotions, solutions, creams and gels can be applied to the affected area directly. This not only gives them a therapeutic advantage via targeted release, but also reduces the systemic absorption of the drug molecule and minimizes side effects. However, since you’re applying it directly on to the skin surface, these products may cause some degree of skin irritation. One commonly used approach to overcome this is to start with the lowest concentration and increase gradually as tolerated. This is usually done over weeks time, or as directed by your dermatologist.
Trying too many products, one after the other, can stress your skin and worsen your acne.
Acne Fighting Ingredients
INGREDIENT CATEGORY: ANTIBACTERIAL, COMEDOLYTIC, KERATOLYTIC
Derms swear by a few ingredients and benzoyl peroxide is one of them. For those not au fait, benzoyl peroxide has both mild sebostatic (meaning, it reduces sebum and skin oils) and keratolytic effects. Kertolytic agents work by dissolving the keratin in the outer horny layer of the epidermis.
Benzoyl peroxide is a popular choice due to its ability to markedly reduce
Propionibacterium acnes— (the bacteria associated with inflammatory acne lesions). Additionally, it also works as an anti-inflammatory that soothes redness and swelling. All in all, from a clinical perspective, it has everything you need. Its not surprising that benzoyl peroxide is one of the few ingredients you’ll see in the label of nearly every acne-fighting product.
Benzoyl peroxide is available as both over-the-counter and in certain prescription formulations in concentrations of 2.5%, 5% and 10%. Generally speaking, concentrations above 5% have a tendency to cause more skin irritation, photo-sensitivity and in some cases, a severe skin reaction. Therefore, I recommend you consult your dermatologist before using it. Meanwhile there’s evidence that 2.5%, 5% and 10% are equally effective at reducing inflammation associated with acne. So there’s no reason you should increase the dose, if your skin is responding to 2.5% or 5%.
Does benzoyl peroxide cause purging, or acne-flare ups?
Benzoyl peroxide speeds up the skin cell turnover rate, meaning it increases the rate at which existing microcomedones turn into acne.
This in turn might cause ‘purging’ or a sudden rush of breakouts on your face. This phase typically lasts for 4-6 weeks and is restricted to the standard break-out areas on your face. Purging is when the acne you’re treating worsens initially after introducing a new product or active ingredient into your skincare routine.
Benzoyl peroxide is not just available at the chemist’s, but has also found its way in mainstream cosmetic brands. Many brands have now developed their own bezoyl peroxide formulations and have cleverly incorporated this ingredient into their range of products. From cleansers, to lotions, gels to acne spot treatments, its nearly available in every formula.
INGREDIENT CATEGORY: KERATOLYTIC, COMEDOLYTIC, ANTI-INFLAMMATORY
Aside from its effectiveness in promoting collagen synthesis and fading pigmentation, retinoids also act as comedolytic agents (meaning they work by unclogging blocked pores). They work synergistically with topical antibiotics to allow them to enter the pore and eradicate the underlying bacteria causing the acne. This synergistic effect is very beneficial in the treatment of acne. On the downside however, retinoids can cause dryness and irritation. This explains why their use should be built up gradually over the span of weeks.
Retionoids are available both over-the-counter and on prescription (e.g. Differin, Tretinoin), but it doesn’t stop there. Even skincare brands have formulated their own versions with varying concentrations of retinol in them. So if you can not tolerate a prescription strength retinoid, then you can start with retinols instead. How do they differ? To understand better, read our article on retinoids vs. retinols here. Though retinols are weaker in strength and potency, it has lesser risk of skin irritation. However, as a general guide, always make sure that your retinol product contains a minimum concentration of 0.1%.
Side effects include skin irritation, which can manifest as skin dryness, itching, redness and flaking of the skin. Most importantly, always use a sunscreen with a minimum SPF 30 over all the retinoid-treated areas. This is because retinoids can make your skin more sensitive to UV rays. If you’re pregnant, always consult your doctor before using it. Although topical retinoids does not appear to cause any birth defects due to its rapid metabolism by the skin; however, few reports of fetal defects have been reported.
Remember, with acne treatments, consistency is the key. On average, it takes 4-6 weeks for you to notice changes in your skin.
INGREDIENT CATEGORY: KERATOLYTIC, COMEDOLYTIC, ANTI-INFLAMMATORY
Salicylic acid is a beta-hydroxy acid (BHA), a type of oil-soluble molecule that can penetrate into the pores. What makes this acne-busting ingredient so popular is that apart from its keratolytic and comedolytic properties, it also decreases secretion of sebum (skin oil) in patients with acne.
The reason why it works in acne is via its dual action on clearing up the clogged pores and breaking apart the debris inside it that would otherwise cause acne. Additionally, it eases signs of inflammation on skin and can be used synergestically with benzoyl peroxide for better results. The concentration that dermatologists recommend for salicylic acid is between 0.5% up to 2%. All in all, salicylic acid is great add-on for acne.
INGREDIENT CATEGORY: ANTISEPTIC, KERATOLYTIC, COMEDOLYTIC, ANTI-OXIDANT
Azelaic acid (also called Finacea®; Skinoren®) is a naturally occurring dicarboxylic acid found in whole grain cereals such as wheat, rye and barley. It not only prevents, but soothes and treats acne, making it a great addition to your skincare routine. Despite copius research, azelaic acid, in practice, is not as popular as BHAs, AHAs or benxoyl peroxide. I’m sure for some of you, this might even be the first time you’re hearing about it.
But how does it fare in clinical setting? Well, there’s evidence that this multi-functional ingredient works via different mechanisms to help you achieve the clear complexion you want. In fact, not only does it double up as an antioxidant, anti-inflammatory and anti-comedonal— but also improves overall skin texture.
In a nutshell, aside from the acne-busting property, it also has the added value of improving skin tone, clear your pores and fade old blemishes. This should be a great addition for those who are struggling with post-inflammatory hyper pigmentation and acne scars.
This can be used either on its own or mixed together with your favorite moisturizer. Also make sure your skin is completely dry post-cleansing before you apply it. This is because moisture can make skincare products absorb faster and this also increase their potency, which in turn can lead to irritation. And just as we discussed earlier, you might experience an initial ‘purging’ effect, so don’t get disheartened, this is just temporary.
Tea Tree Oil
INGREDIENT CATEGORY: ANTISEPTIC, ANTI-FUNGAL, ANTI-INFLAMMATORY
While benzoyl peroxide, salicylic acid and retinoids are considered key players in treating acne, tea tree oil is a natural alternative that is slowly garnering unsolicited attention. Derived from Melaleuca alternifolia, a tiny tree native to Australia, tea tree oil contains several compounds including terpinene-4-ol.
Tea tree oil works via different cascades and functions as an antiseptic, anti-fungal and anti-inflammatory agent.
This helps with acne, especially to the soothe inflammation and reduce the number of active papules and pustules. However, given that the researchers have mainly studied the effects of 5% tea tree oil, it is difficult to extrapolate this finding into what is being sold in the current market. Most of the brands are not listing this information on their product labels.
It is difficult to identify the concentration and purity of tea tree oil in over-the-counter products. In fact, many brands don’t even share this information on their label.
Another caveat to keep in mind is, since this is an essential oil, it is most likely diluted with a carrier oil. This means the formula that you’re finding in the stores is way below the 5% that was trialed. However, if you have sensitive skin, it is best that you avoid using it and consider other options. A second approach would be to add a few drops of the oil in your moisturizer and apply it on your face at night time. As with every essential oil, NEVER use them directly without diluting. You can read more about this here.
INGREDIENT CATEGORY: PHOTO-PROTECTIVE, ANTI-INFLAMMATORY, SEBOSTATIC, LIGHTENING
Niacinamide is a naturally occurring water-soluble form of vitamin B3. Having a neutral pH makes it less likely to cause skin irritation and reaction. Additionally, it is also known for its ability to brighten the skin, fade pigmentation marks, improve skin texture and sebum regulation. And unlike the other ingredients we’ve discussed above, it’s generally well tolerated by all skin types (and yes, that includes sensitive skin).
Research has shown that for best results, you should use 4% niacinamide. On the other hand, some smaller scale studies have also reported benefits seen at 2% concentration.
Can you combine salicylic acid with niacinamide?
Last week during our open Q&A session, one of our Instagram readers shared this question with us, which I think is very relevant and should be addressed. So here’s the thing: both offer similar benefits but work via different pathways. In fact, research has found that combining both ingredients together gives you a synergistic advantage with regards to acne management.
But if skin irritation is your concern, then I would recommend using niacinamide as part of your morning skincare routine and keep acidic ingredients such as salicylic acid for night time. Another approach would be to apply them 30 minutes apart. This means you can apply niacinamide all over your face and use salicylic acid more like a spot-treatment.
While niacinamide use is generally tolerated, some people have reported skin sensitivity reactions while using it. This could be due to an allergic reaction to the ingredient, or using a product with high concentration of niacinamide. Regardless of the cause, if you develop any redness, burning, or stinging sensation, you should immediately remove the product from the skin and avoid using it further.
Acne treatments can make your skin dry, especially if you’re using retinoids. So for best results, I’d recommend you use a non-comedogenic moisturizer, like these moisturizers for acne-prone skin.
For best advice, always consult your dermatologist. They will gather your medical history to determine whether you’re genetically predisposed to acne, or identify if there’s an underlying condition, such as PCOS, or if you are overweight, allergic, etc.