Dr. Mona Foad expands upon the insights she shared in her recent Woman’s World feature: How To Get Rid of Adult Acne, Plus Doctors Pinpoint Why Women Over 40 Deal with Breakouts

What causes skin to be acne-prone?

A combination of genetic, hormonal, and environmental factors can cause acne-prone skin. One factor is excess sebum production by the sebaceous glands in the skin, which can clog pores. Hormonal changes, particularly androgens, can also increase sebum production. This is why acne is common during puberty, menstruation, pregnancy, and in conditions like polycystic ovary syndrome (PCOS). Another factor is clogged pores, whereby dead skin cells that do not shed properly can mix with sebum and clog hair follicles, forming comedones (whiteheads and blackheads). Bacterial growth in clogged pores and inflammation caused by this bacterium in the pores also play a crucial role in acne development, leading to redness, swelling, and pus. 

Additionally,  genetics can determine how much sebum your skin produces, how your skin cells shed, and your body’s inflammatory response, all of which can make you more prone to acne. Some studies also suggest that diets high in refined sugars and dairy products may exacerbate acne. Stress is another factor that can cause acne since it increases hormone levels that stimulate sebum production. Frequent touching of the face, wearing tight clothing, or using items like helmets and backpacks can cause further friction and pressure on the skin, leading to acne mechanica.

What is a good skin care regimen for someone with acne-prone skin?

A good skincare regimen for someone with acne-prone skin should focus on keeping the skin clean, reducing excess oil, and minimizing pore blockage without causing irritation. I always recommend a morning and evening skincare routine for my patients.

For a morning routine, start by using a gentle, non-comedogenic cleanser such as La Roche-Posay Effaclar Gel Facial Wash to remove excess oil and impurities. Using a toner is optional, but if you choose to do so, opt for one that is alcohol-free and contains soothing ingredients like witch hazel or glycolic acid to help exfoliate and remove any leftover impurities.

Next, apply a serum with active ingredients like salicylic acid, niacinamide, or tea tree oil to target acne. Niacinamide can also help reduce inflammation and control oil production. I like to recommend SkinCeuticals Silymarin CF to my patients. Use a lightweight, non-comedogenic moisturizer to hydrate the skin without clogging pores. Elta MD Moisture Seal is a moisturizer I typically recommend to my patients. Finally, apply a broad-spectrum sunscreen with at least SPF 30. Sunscreen is crucial to protect the skin from UV damage, which can worsen acne and cause hyperpigmentation. EltaMD UV Facial SPF 30+ Dry is a great sunscreen product I highly recommend. 

For an evening routine, start with cleansing the skin to remove makeup, sunscreen, and daily grime. Next, apply targeted acne treatments that can be stronger, like retinoids, which can promote cell turnover and prevent clogged pores. Finally, make sure to use a non-comedogenic moisturizer (same as your morning routine) to keep the skin hydrated. It’s essential even for oily skin to maintain the moisture barrier.

What ingredients should they look for?

Certain ingredients can help manage and prevent breakouts for acne-prone skin while keeping the skin balanced and healthy. Some ingredients to look for include salicylic acid, a beta hydroxy acid (BHA)  that penetrates pores to exfoliate and reduce sebum production, and glycolic acid, an alpha hydroxy acid (AHA) that exfoliates the skin’s surface to remove dead skin cells. For serums, look for niacinamide to reduce inflammation, retinoids to promote cell turnover, unclog pores, and reduce the appearance of acne and fine lines, and zinc to help control sebum production.

When it comes to moisturizers, look for hyaluronic acid to hydrate the skin without clogging pores, ceramides to restore and maintain the skin barrier, and aloe vera to soothe and hydrate the skin. For sunscreens, opt for non-comedogenic formulations specifically designed not to clog pores, as well as mineral sunscreens with zinc oxide and titanium dioxide that provide broad-spectrum protection with less risk of irritation. If you like to use mask treatments, look for products that include charcoal to draw out impurities and help detoxify the skin and clay, which helps to absorb excess oil and unclog pores. 

What ingredients should they avoid?

Avoiding certain ingredients that can exacerbate breakouts or cause irritation is crucial for someone with acne-prone skin. Avoid comedogenic ingredients like heavy oils and butters, waxes, and silicones that clog pores and contribute to acne formation. Additionally, steer clear of irritating ingredients such as alcohol and both synthetic and natural fragrances. You’ll also want to avoid harsh exfoliants like apricot and walnut shell powder. All of these ingredients can cause inflammation, irritation, and worsen acne. 

Product recommendations for acne-prone skin

For acne-prone skin, using products that help keep the skin clear without causing further irritation or breakouts is essential. The cleanser I typically recommend is the La Roche-Posay Effaclar Medicated Gel Cleanser. I like that it contains 2% salicylic acid to target acne and clear pores. For a serum, I like La Roche-Posay Effaclar Serum. For a moisturizer, CeraVe PM Facial Moisturizing Lotion is a non-comedogenic, oil-free moisturizer with niacinamide and hyaluronic acid. These ingredients will help to control oil. EltaMD UV Clear Broad-Spectrum SPF 46 is a lightweight sunscreen that protects against UVA and UVB rays. It is also formulated with niacinamide to help calm the skin. Differin Gel is an over-the-counter retinoid that helps prevent and treat acne by promoting cell turnover.

Dr. Mona Foad expands upon the insights she shared in her recent Cosmopolitan feature: The Best Acne Light Therapy Devices Are Worth Adding to Your Routine, Stat

What is light therapy?

LED light therapy is also known as light-emitting diode therapy. This is a non-invasive skincare treatment that uses specific wavelengths of light to stimulate various cellular processes in the skin. It’s a popular treatment because it can help decrease inflammation in the skin. It can also treat a variety of skin conditions, including acne, fine lines, and eczema.

LED light therapy is a versatile treatment, with different colors of light offering a range of benefits for the skin. For instance, red light stimulates collagen production, reducing wrinkles and enhancing skin texture. It also aids in controlling inflammation and promoting wound healing. Blue light, on the other hand, targets acne-causing bacteria, effectively reducing breakouts. It’s a popular choice for mild to moderate acne treatment. Green light works to even out pigmentation and enhance skin tone while also providing a soothing effect. Lastly, yellow light promotes lymphatic flow, improving overall skin health and reducing redness and irritation.

What light kills acne bacteria?

Blue light therapy is the type of light commonly used to kill acne-causing bacteria. Specific wavelengths of blue light, typically in the range of 405 to 420 nanometers, are used to target and destroy the bacteria known as Propionibacterium acnes (P. acnes), which is a major contributor to acne.

Blue light therapy penetrates the skin and reaches the sebaceous glands where P. acnes bacteria reside. When exposed to blue light, the bacteria produce molecules called porphyrins, which then generate free radicals that ultimately destroy the bacteria. This process helps reduce inflammation and prevent new acne breakouts from forming.

Blue light therapy is often used as a non-invasive and drug-free treatment option for mild to moderate cases of acne. It can be administered on its own or in combination with other acne treatments. Depending on the severity of your acne and other individual factors, your provider may recommend other acne treatments. These can include over-the-counter skin care, prescription topical medications, oral antibiotics, birth control pills or isotretinoin.

Dr. Mona’s favorite devices  

When recommending LED devices to patients, I take into consideration individual preferences, skin types, and specific needs. Belowa are some of the more notable options I like to recommend to my patients:

• LightStim for Acne LED Light Therapy Device uses blue light to destroy acne-causing bacteria, and red light reduces redness to help soothe and calm the skin. LightStim has advanced NASA’s LED technology to simultaneously emit multiple wavelengths (colors) of light that work together to help clear existing breakouts and give your skin a more radiant and clear complexion. This device is great for adults and teenagers and is maintenance-free with no cartridges, LEDs or battery replacement costs.
  • For an even more effective treatment, we offer the LightStim Professional LED Treatment here in our office!
• The Neutrogena Light Therapy Acne Mask is an over-the-counter mask that uses blue light to target acne-causing bacteria and red light to reduce inflammation. It’s a convenient and accessible option for at-home use and is suitable for mild to moderate acne.
• Foreo ESPADA is a handheld device that emits blue light and low-frequency pulsations to target acne bacteria and stimulate faster healing, thereby promoting clearer skin. It’s portable, rechargeable, and suitable for treating individual acne spots. This device uses a smart skin sensor that only turns on the blue light when it is in contact with your skin. I like this feature because it protects your eyes from any harmful LED light exposure.
• Dr. Dennis Gross DRx SpectraLite FaceWare Pro is a wearable LED mask that combines red and blue light therapy. By offering both light options, this device can target acne and promote skin healing. It’s designed to be worn for just a few minutes daily and is suitable for all skin types.
• The Environ Omnilux Contour FACE  is also a handheld LED device that emits blue and red light therapy for acne treatment. It’s portable, easy to use, and suitable for spot treatments or larger areas of the face and body.

How to choose the best acne light therapy device for you? 

Choosing the best acne light therapy device involves considering several factors to ensure it meets your specific needs and preferences.

Determine Light Type

First, determine whether you prefer blue light therapy, red light therapy, or a combination of both.

• Blue light targets acne-causing bacteria
• Red light reduces inflammation and promotes healing.

Some devices offer both types of light for comprehensive acne treatment. If possible, I would recommend getting a device that has both red and blue light to target both the acne and the inflammation that can cause hyperpigmentation.

Determine Design That’s Right For You

Consider the size and design of the device and whether it’s suitable for treating the areas of your skin affected by acne. Some devices are designed for spot treatments, while others cover larger areas like the entire face or back.

Next, check the intensity and wavelength of the light emitted by the device. Higher intensity and specific wavelengths are often more effective but may also increase the risk of side effects. Look for devices with adjustable settings to customize treatment intensity according to your skin’s sensitivity and the severity of your acne. 

Determine Desired Features

Additionally, opt for a user-friendly and convenient device to incorporate into your skincare routine. Consider factors such as portability, ease of setup, and whether the device is rechargeable or requires disposable batteries. To guarantee its safety and effectiveness, ensure that the device is FDA-cleared or CE-marked for acne treatment. Avoid purchasing unregulated or uncertified devices, as they may not provide reliable results and could pose risks to your skin. Make sure to research customer reviews and recommendations from reputable sources to learn about the experiences of other users with the device. Look for feedback on effectiveness, ease of use, durability, and customer service. Finally, compare the prices of different devices and consider the overall value they offer in terms of features, effectiveness, and long-term benefits. While investing in a high-quality device may require a larger upfront cost, it can provide better results and durability over time.

Ensure Eye Protection

It is very important to protect your eyes while using an LED treatment. If used incorrectly, LED light therapy has been shown to damage your eyes. At-home use can be safe if you follow the appropriate guidelines. Make sure to use a high-quality, reputable device that meets all safety standards, and be sure to read and follow the instructions and guidelines included. Some devices, as mentioned, only turn on when in contact with your skin, some are made to be used around the eyes with a lower intensity of light and have built-in safety features, while others may require eye protection. Make sure to research the right device for you.