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I am a board-certified dermatologist with a large practice devoted to skincare and how to treat acne. One of the main questions I hear in my practice is, “Is it better to wash my face 1, 2, 3 or more times a day to help with my acne skincare?”
This is an important question I address with my patients when discussing how to treat acne, and the answer to this question might surprise you. Cleansing twice daily with a gentle acne wash or acne cleanser is sufficient to remove oil and debris that can clog pores and make your acne worse. Once in the morning and once at night, for most individuals, should be an adequate regimen for your acne skincare. If you wash or cleanse your face too frequently, even using a gentle acne wash or the best acne products, your acne can become irritated; and you could worsen your skin’s appearance. You can’t scrub off acne. Your skin needs to heal. That’s right…if you wash your face too frequently, even with the best acne products, you can worsen you skin’s appearance.
If you are involved in activities that cause you to sweat a lot, such as working out or playing sports, it is very important to wash your face as soon as possible after your activity to remove the oil, debris, and bacteria. Keeping your skin free of these three troublemakers should be the emphasis behind your acne skincare program.
When you're a teenager and you're just figuring out who you are, and you are super concerned with the way you look everyday, you get acne and it's not your fault. Androgens are being stimulated by puberty, hormonal changes that everyone's going to go through, boys and girls. Genetics have a huge role, so you have to look at your parents, you have to look at your siblings, you have to look even at aunts and uncles, grandparents. And the way that they went through their teenage years will have an impact on you. The four things that cause teen acne are medications, cosmetics, hormones and stress. Stress won't give you acne, but it will certainly make any existing acne that you have worse. A lot of the over-the-counter products are good.
Salicylic acid, benzoyl peroxide, retinol — they are all very helpful, but they have to be done in the correct manner. Teenagers end up buying 5 or 6 over-the-counter acne products and then using all of them and scrubbing their faces twice a day, and using an exfoliant twice a day. And they end up causing skin irritation, which is redness and flaking and dryness. If you dry the skin out too much, then the oil glands kick in to overload, and they try to produce more oil to fix the dry skin. Picking is horrible.
I know teenagers say, "it's right on the surface, i couldn't possibly leave it alone, I can't go to school like that," but you run the risk of pushing half the bacteria out and half the bacteria deeper in the skin. The medicines that we use will help with the acne and will help with the scarring from the very beginning. The other thing that makes scarring more permanent in my teenagers is that they like the sun. They say, when I get a tan, it looks better. Well, it temporarily dries you out and it may give you a little tan, which may help hide the redness, but ultimately, you're cementing your scars. We know that sun exposure causes skin cancer. That's really not a safe way to try to fix your acne.
I would like teenagers and parents to understand that if you can't control your acne with an over-the-counter line of products relatively easily, then is the time to come in and see a healthcare provider with a specialty in dermatology. There weren't that many options when your parents were growing up, and there are a ton of options now. And they're available and they're affordable and they're safe. We can't cure acne, but what we can do is manage it to the point that it looks like it's not there while you finish going through puberty.
So there are many lasers now that are used to treat acne. Some of them target the sebaceous gland or the oil gland and the way they work is by shrinking the gland and making it less active. An example of that is the smooth beam laser. Some lasers also use broadband light to try to kill the bacteria that causes acne which is called P. acnes. And one machine called the Isolaz uses broadband light to kill bacteria while also using a suction device to try to clean out pores.
To me the main pro of using laser therapy to treat acne is that it's very safe. You can even do it when you're pregnant. The cons are really two. One is that it's not covered by insurance and it can get costly. The second is that we don't have long-term studies that show that laser treatments are gonna put you in a remission so it may be something that you have to continue doing every once in awhile to keep your acne under control. Personally, I think photodynamic therapy with blue or red light is better than laser therapy for acne and that's why I do that in my office. But to me, the more weapons we have to treat acne the better.
The most evolving treatment, also the most revolutionary of treatments available nowadays for acne, is photodynamic therapy. I feel very strongly about photodynamic therapy. In my opinion, it can in many instances replace the need for oral antibiotics, that are unnecessarily given for long periods of time. It is very, very similar in results to isotretinoin or Accutane without the need to exposure of chemicals that some people may be very fearful of.
Photodynamic therapy works by incorporating a medicine, a substance called levulinic acid into our oil glands. It is then activated by red light and blue light, and that particular activation causes destruction of the oil glands - not of all oil glands at the same time, but of a number of oil glands. Often times it results perhaps in shrinkage of some oil glands first before it can completely eradicate that oil gland, but that turns off the acne. And don't worry, we have plenty of oil glands on our face and we really don't need all of them.
So, we apply this medicine on a cleansed face. We then let it sit on the skin to be able to move it into the oil glands for approximately an hour or two, sometimes longer than that sometimes less than that, it depends a little bit on the characteristics of your skin. And then we'll expose your skin to the light source after that. And the light source that the aminolevulinic acid is most receptive to is blue light. However, red light seems to also have quite some activation power, and so often times we combine it with red light as well. At the end of the treatment, you leave the office covered with sunscreen and often times even a sun-protective hat if it was performed on the face. The sun protection has to consist of either zinc oxide or titanium dioxide.
It is crucial to avoid the exposure to visible light for 42 hours after the treatment and that is to avoid that there's further activation of the medicine that still remains in your oil glands. What you can expect of the next few days, and that may already start on the day of the treatment, is redness and swelling. By about day three, the skin will feel very, very tight, and by about day four that tight skin will start shedding off.
There are some people who get more pronounced reaction and may have some redness, to a certain degree, for up to ten days in their skin. Some may even get very pronounced swelling. That is a subset of our patients, it certainly doesn't effect everybody and most of the time it goes very, very straightforward.
It is oftentimes a series of four to six that are spaced anywhere between two to four weeks apart that gives the best possible results. And those results can, in the majority of all patients treated, results in complete eradication of the acne. So what's the success rate? About 75 percent of people who are treated with 4 to 6 treatments of photodynamic therapy will be rid of their acne by completion of the treatment.
If you noticed, I broke down and used heat on my hair today. My hair just was not cooperating with me today. It didn't like me today. Well I tried to flatiron my hair and it's still frizzy. Whenever I wear it curly for like weeks at a time, and then I try to flatiron it, it's like no. A lot of people have been asking me to do a do it yourself, you know, mask or treatment for acne, body acne, face acne.
This one is by far my favorite. So before I got into the other ones, I wanted to put this one out there first because I really want everyone to try this. There are so many people that have tried this all over the world and they had nothing but good experiences to share. If you try this and you do not like it, then discontinue it. But, I promise your skin is not gonna melt off if it doesn't work for you. You don't need a bunch of ingredients. You don't need a bunch of tools. All you need is one thing, salt. Okay, so have you ever noticed that after swimming in the ocean or you know, some kind of body of water that has salt in it, your skin looks amazing? Because salt is actually really good for your skin you guys.
Okay, it can reduce the size of your pores, get rid of blackheads. You know, relieve oily skin if you have oily skin. It just naturally helps heal wounds faster. And that's why salt is so good for your skin. Now, for the fun part, I'm gonna show you a few different ways to actually use salt to treat your acne, blackheads, etcetera.
So, put you hair up first, it's gonna get messy. So, the first method is actually steaming your face with the sea salt. Now, not only is this good for your skin but it's really good for your respiratory system as well. So, all that you do is you take the salt, pour it into a pot of water, let it boil, or let it get hot enough to where it's producing a lot of steam, rest your head over it, and let it do its magic. Open up your pores, get all the toxins out. If it gets too hot, just take your nose up, breathe some fresh air, and then go back in for more. Do this one to two times a week and you'll notice an improvement usually. The next way, I have this creepy looking rag right here.
I actually cut the eyes out, and a little slit for my nose, for when I wanna soak my face. This one's really easy. All you need to do is mix some sea salt with some warm water. Dip the rag in and let it sit on your face. You don't have to make a creepy rag like this. You can just make put regular rags on your face and so, okay, for like 10 minutes, 15, or even longer if you want to. You can do this as much as you want to, but remember that too much salt will dry out your face. Make sure you use a moisturizer. The next method is a honey sea salt scrub, my favorite. You can use it one your body, your face, it doesn't really matter. Honey is really good for your face. It has antioxidants in it and the sea salt is really good for healing wounds. So just go ahead and mix it in a bowl, apply it to your face and let it sit for 10, 20 minutes or so. And you can repeat a few times a week if you want to, it's up to you. One of the only cons is that sometimes when you apply salt to your face. Especially if you have open wounds, it sometimes can sting a little bit, don't worry about it, your face isn't falling off, it's just the salt working its magic, but if it's too unbearable, obviously, wash it off, the stinging should go away.
This next one is for if you're wanting to get rid of acne, or blackheads on your body, just go ahead and fill the bath full of warm water, stir in some salt, sit in it for about 30 minutes. Do this one to two times a week and some people have noticed actually improvements within three days of doing this. And the last method I'm gonna include in this video is a salt water toner. All you do is just mix some salt water in a bottle, if you have an extra bottle lying around perfect, use it. And spritz it on your face before you go to bed at night. This is gonna be nasty but one girl actually said this popped her zits for her, just spraying her face at night. So it's all happy today but there is tons of recipes you can look at up online and tons of success stories also that you can read online.
