Acne is something that most people will struggle with at some point in their life. There’s no escaping it! In fact, an estimated 80 percent of people between ages 11 and 30 have acne outbreaks at some point. Because it is so common, the skincare market is oversaturated with various creams and spot treatments that promise to heal your skin overnight. It can be overwhelming to navigate and figure out what works best for you without doing more damage to your skin.
So I reached out to dermatologist Joshua Zeichner, to get the lowdown on what acne treatments are the most effective. He also provided some insight into what the newest acne treatments are, and what mistakes people make when trying to clear their skin.
Dr. Zeichner is the Director of Cosmetic & Clinical Research in Dermatology at Mount Sinai Hospital in New York City. In 2015, he was awarded a prestigious Elle Magazine Skin Genius Award for his innovative approaches in treating aging skin and his work has been published in top Dermatology journals. Dr. Zeichner was voted by his peers to New York Magazine’s Best Doctors in 2018 and is consistently selected to the New York Metro Area’s Top Doctors list by Castle Connolly. So if there is anyone you should listen to when it comes to treating acne, it’s him!
What do you tell patients to look for when they’re trying to treat acne topically – any key ingredients or formulations?
Over the counter, there are four main ingredients available to treat acne. These include benzoyl peroxide, salicylic acid, sulfur, and adapalene. Benzoyl peroxide should be your go-to if you have red, angry pimples. It lowers levels of acne-causing bacteria and helps reduce inflammation in the skin. Salicylic acid is a beta hydroxy acid that removes excess oil and exfoliates dead cells from the surface of the skin. It is useful for all types of acne. Sulfur is anti-microbial and anti-inflammatory. It is a great option if you have sensitive skin. Adapalene is a topical retinoid that prevents skin cells from sticking together and blocking the pores. It is particularly useful if you suffer from blackheads and whiteheads. If you suffer from acne, it is important to treat the entire area that tends to break out rather than just spot treating. You want to get rid of pimples that you currently have and prevent new ones from developing in the future.
What do you feel are the most common mistakes people make when they’re trying to treat acne?
Spot treating will address an individual pimple, but does not address the underlying issue and will not prevent future breakouts. Over scrubbing can lead to more harm than good. By just drafting the outer skin layer, it can lead to dryness and irritation, making it more difficult to treat acne. Another mistake is not giving your treatment enough time to work. It takes several weeks for medications to exert their full effect, and not seeing an immediate improvement does not mean the treatment will not work for you. More is not better. Higher concentrations of active ingredients like benzoyl peroxide may not necessarily work any better but may lead to more irritation. In fact, 2.5% benzoyl peroxide has been shown to be as effective as 5 or even 10% in treating red, angry pimples.
What do you feel are the best cosmetics for men and women struggling with acne?
If you suffer from acne and have red or brown marks on your face, there’s nothing more valuable than a cosmetic concealer to camouflage the spots. Look for an oil-free foundation, preferably one that is mineral-based to give full coverage. There are some liquid foundations that contain a low concentration of salicylic acid as well that are a great option for people with acne.
Are there any new treatments or products on the market right now that you’re excited about? What do you think will be the next big thing?
Two new prescription medications just hit the market. The first is an antibiotic pill called Seysara. This medication is a sister to doxycycline, but it is specifically approved only for the treatment of acne. Patients tend to improve quicker, with significant benefits within three weeks. When I prescribe antibiotics for my acne patients, it is always in combination with a topical treatment and always limited to 3 to 4 months. After the patient’s face improves, I stop the oral antibiotic and continue with the topical medication for maintenance. A new topical retinoid called Altreno lotion just hit the market. It is the only FDA approved Tretinoin lotion on the market. It has the proven effectiveness of Tretinoin, but, because it’s a unique vehicle, it tends to be much less irritating on the skin.
What inspired you to pursue a career in dermatology?
Dermatology is a field based on pattern recognition and physical diagnosis. Being a visual person, it came naturally to me. Dermatology gives me the opportunity to make meaningful improvements in my patients’ lives as skin conditions certainly run more than skin deep and have a significant impact on self-esteem. My practice is a split between medical dermatology and cosmetic and surgical procedures, so it allowed my artistic side to come out as well.
Do you have any advice for aspiring dermatologists?
Remember that dermatology is much more than just Botox and before and after photos on Instagram. Make sure you appreciate the field for what it truly is rather than the smoke and mirrors you see on the Internet. Study hard, get good scores on your exams and good grades in school, and be prepared to take some time off to do research if you need to.