I’ve had problems with acne my entire life. I also have extremely sensitive skin. I tried everything, from over-the-counter toners and fancy face washes to topical antibiotics, Retin-A, and even Accutane. Nothing actually kept my breakouts away. And most of the stuff I tried made my skin hurt even if it did kind of work.
Then, at the age of 29, my brother’s awesome fiance directed me towards my very first useful consumer-directed resources about skincare. I discovered that “I tried everything” wasn’t as true as I thought it was: the stuff I’d tried had been poorly formulated, and/or I hadn’t had enough instruction about how to use it. Since I got the opportunity to learn more, I use a lot fewer products than I did, my routine is less complicated, nothing hurts to put on, and my acne is gone. (Except around periods. But even then, my hormonal breakouts are significantly better.)
The product I’ve used that’s made the most difference is a properly formulated salicylic acid exfoliant. Which is amazing, considering that salicylic acid was one of the first ingredients I tried and dismissed.
Salicylic Acid, aka BHA (Beta Hydroxy Acids)
Salicylic acid is one of the best, and one of the most commonly misused, ingredients in acne treatments. It tackles acne from pretty much every angle: it’s an anti-inflammatory, it’s anti-microbial, and it unblocks clogged pores.
If you’re like me, though, you probably think you’ve tried it and it didn’t work for you. Why should that be?
It works best at a pH between 3 and 4.
Most products have the wrong pH– generally too high to be effective, but a few even have a pH that’s so low as to be irritating. Since most skincare products don’t list pH, probably your best bet is to check Beautypedia for any products you’re thinking of using. Or, if you’re a giant nerd, get pH test strips and test your products yourself, but that’ll probably cost you a lot of money and run you through a lot of substandard products before you find a good one.
Salicylic acid works best in leave-on products.
A lot of face washes contain salicylic acid. There’s no real reason for that, since salicylic acid needs to actually work its way into your pores, and only about 1-2% of the salicylic acid in wash-off products stays on your skin. Beyond that, face washes are usually at a pH level between 5.0 and 6.0, which, as mentioned above, makes salicylic acid ineffective!
It works best in concentrations between 1% and 2%.
And it won’t do anything at all unless it’s 0.5% or higher.
A lot of the time, it’s combined with damaging ingredients.
In particular, it gets mixed a lot with alcohol denat./SD alcohol/isopropyl alcohol (which is terrible for your skin, unlike fatty alcohols like cetyl, stearyl, and cetearyl alcohol), menthol, damaging fragrance ingredients like lavender, and witch hazel. Generally, try to avoid superfluous fragrance ingredients.
There are a couple of other things you should know about salicylic acid:
If you’re allergic to NSAIDs (ibuprofen, aspirin), patch-test salicylic acid products before use.
A lot of people who are allergic to NSAIDs are also allergic to salicylic acid. Luckily for me, I am not, but I’m the exception.
Breakouts might get worse for a couple of weeks if you’re using a good salicylic acid exfoliant for the first time.
Don’t give up! Skin actually can go through a ‘purging’ stage with BHA exfoliants. I definitely found myself breaking out heavily for the first two weeks. Ever since then, my skin’s been great.
Experiment to see how often you need to use it / at what dose.
For some people, that’s once a week; for some people, that’s twice a day. (I’m still working on this one: I think I might overuse it.)
You need to use it consistently to see results.
You probably won’t see much change after a single day’s treatment. If you’re looking for a spot treatment, benzoyl peroxide is probably a better bet.