Skincare Routine for Acne-Prone Skin

Medically reviewed by Anna H Chacon, M.D. FAAD
Skincare Routine for Acne-Prone Skin

Acne is an age-old human problem. Even Aristotle and Hippocrates wrote about it nearly 2500 years ago. By now, you’d think we’d have figured out how to get rid of it once and for all. 


There are so many factors involved with this multifaceted condition, including age, hormones, and the skincare you use. That’s why the best acne treatments are also multi-faceted. Instead of one simple cure-all, humans have developed different treatments and approaches to manage acne, from skincare to medication.


The main job of a skincare routine for acne-prone skin is to support your skin’s baseline health. It should be part of your acne treatment plan but it’s also an important tool in preventing new breakouts in the future. 


In this post, we’ll cover exactly what an acne skincare routine should look like, including the key acne-fighting ingredients to look for and how to find suitable products. 


Guide at a glance:

What causes acne?

There are four main things that usually occur as part of an acne breakout: 


  • First of all, the skin overproduces sebum, which is the oil excreted by the sebaceous glands. 
  • Then, the dead skin cells that line the pore fail to shed correctly, in part because of the excess oil making the inside of the follicle “stickier. This leads to a comedo (i.e., a clogged pore such as a blackhead or whitehead). 
  • Finally, the Cutibacterium acnes bacteria, which is very commonly present on human skin as part of its microbiome, infects the clogged hair follicle, leading to the formation of a pimple. 
  • The skin responds to the infection with inflammation, which results in redness, swelling, pain, or pus that is frequently associated with different types of pimples. 

These are the underlying factors behind pimples and breakouts, but there are plenty of other physiological factors that can play a role. Hormones have a massive influence over how much oil the human skin produces, while skincare may play a part in how much C. acnes bacteria is present on the surface of the skin. 


That’s why the best acne treatments work by targeting all four factors in different ways, often in combination with attempts to address other 

Active ingredients for acne-prone skin

The perfect skincare routine for acne-prone skin should always include some active ingredients, which can show up in cleansers, serums, spot treatments, or moisturizers.  


The majority of active ingredients fight breakouts by encouraging healthier shedding of dead skin cells, mitigating irritation and swelling, and inhibiting the acne bacteria: 

Retinoids

Retinoids (molecules related to vitamin A) are major staples in acne care. There are many different types of retinoids that work by triggering receptors in the skin to improve the differentiation, growth, and shedding of skin cells. This triple-action is incredibly useful for unclogging pores, fading blemishes, and even helping to fade or prevent post-acne marks. 


Retinoids are also popular in anti-aging skincare since they enhance collagen production to visibly reduce wrinkles. They come in cosmetic forms like retinol and retinaldehyde, over-the-counter forms like adapalene, and prescription-only forms like tretinoin and tazarotene. 


The key ingredient in our Enzyme-Active Retinol Serum is 0.1% retinaldehyde, which is the most powerful cosmetic retinoid. Unlike retinol, which has to go through two conversion steps before it can impact the skin, retinaldehyde only undergoes one conversion that leaves it about 20 times more potent. This makes it phenomenal if you want to simultaneously fade breakouts while also treating signs of aging. 

Salicylic acid/BHA

Also known as beta hydroxy acid or BHA, this is an oil-soluble chemical exfoliant with soothing effects. It's considered a first line of defense against breakouts and closed comedones because it can penetrate oil-clogged pores. 


It's normally used at a 0.5% to 2% concentration in all sorts of products from cleansers to creams. It's sometimes combined with other ingredients such as AHA or azelaic acid, since they all work well at similar pH levels, and provide slightly different effects. It’s fairly mild but it pairs well with a lot of other excellent actives. We find that the most optimal way to use it is in cleansers, which allows you to use other treatments in leave-on products. 

Azelaic acid 

Azelaic acid can be found in both acne and rosacea treatments, thanks to its ability to minimize the redness associated with both conditions. It's a soothing ingredient with antimicrobial properties and a very mild pore-unclogging effect. 


It’s a gentle treatment option that’s worth trying if other treatments haven’t worked for you. That said, it does have the potential to cause some side effects such as itchiness or irritation.  

Benzoyl peroxide

This antibacterial ingredient has mild exfoliating and soothing effects. It’s also very well-researched as a single treatment or in combination with prescription treatments. It doesn’t cause bacterial resistance, which is why it’s often recommended in conjunction with antibiotics. 


It’s likelier to dry out the skin compared to salicylic acid, which is why many people with acne-prone skin find that it’s too harsh and irritating for them. To add it to your routine successfully, it’s important to have a very healthy skin barrier.   

Sulfur 

This stinky acne treatment isn’t as popular as it once was, perhaps because of the smell. It’s antimicrobial and keratolytic, which is why it's quite effective. However, it can also be quite harsh and drying. Paired with the unpleasant usage experience, it’s not surprising that it’s not in common use today. 

Glycolic acid/AHA

A type of alpha hydroxy acid (AHA) that removes dead skin to facilitate renewal. It stimulates the natural shedding of the outermost layer of rough, dead skin, so it’s excellent for supporting the action of other ingredients for acne-prone skin. 


It also has hydrating, brightening, and anti-aging effects, so it’s an excellent option if you have multiple skin concerns to address at once. That’s why it’s the key ingredient in our gentle, soothing Double AHA Cleanser.  

How to introduce new products safely 

When you have acne-prone skin, it makes sense to worry that new products might break you out. Certain ingredients can trigger skin purging, which is a temporary breakout that occurs as the skin cell turnover rate speeds up. 


 With that in mind, we have tips for introducing new skincare products: 


  • Only add one new product at a time, especially when looking at products with active ingredients. This will allow you to judge products accurately and be able to pinpoint the specific effect each new product has on your skin. 
  • Patch testing new products can help if you’re concerned with comedogenicity or irritation. Apply the product to a small patch of skin for a few days in a row to judge its impact. 
  • When introducing products with active ingredients, use them just 2-4 times a week to start, and gradually increase frequency. 
  • Pay attention to signs of irritation, such as redness, flakiness, or pain/stinging. 
  • If you experience these, take a break from the product responsible. Identify ways to limit irritation, such as by using it less often or by applying it over a moisturizer.  

Choosing skincare products for acne-prone skin

So what products are a must in a skincare routine for acne-prone skin? Here’s what we’d recommend to keep your skin in excellent shape while preventing breakouts. 

Cleansers for acne-prone skin 

Regular cleansing helps to clear away excess sebum, bacteria, and pore-clogging sunscreen or makeup residue. Research shows that cleansing once or twice a day is quite important for acne-prone skin, but any more than that can worsen breakouts. 


The best face washes for acne-prone skin will have low pH which will maintain the skin’s natural acidity level, to keep it less hospitable to the acne bacteria while still allowing beneficial microbes to hang out. 


If your skin is oil and acne-prone, you might prefer a gel cleanser with stronger cleansing abilities, but for dry acne-prone skin, it’s best to choose a slightly creamier cleanser. Either way, your cleanser should leave your skin feeling fresh - not tight or stripped of oils. 


Some cleansers can reduce breakouts all on their own, especially if they contain active ingredients like BHA, AHA, or benzoyl peroxide. 


Using a treatment cleanser is a good solution if you have sensitive skin that cannot tolerate active leave-on products, or if you want to use several active ingredients in your routine without having to layer on too many steps. 

Leave-on treatments with active ingredients 

Most acne treatments feature specific active ingredients like the ones we mentioned above, that work as either chemical exfoliants, antibacterial agents, or both. They normally go on the skin after you’ve cleansed, although some can be applied after moisturizing to slow down their rate of penetration. 


They treat acne directly by unclogging pores and speeding the skin renewal process while also inhibiting the growth of acne bacteria. They’re incredibly useful whether you’re trying to get rid of pimples or prevent new ones from forming. 


It’s generally best to use acne treatments at night, after cleansing, and before moisturizing. That said, if you’re combining several acne treatments in one routine, it’s important to know about interactions. The pH level of a leave-on salicylic acid product, for example, might compromise the effectiveness of a retinoid. Using too many products at once can also damage your skin barrier, which will make it harder for breakouts to heal. 


This means that if you’re using several acne treatments at once, you may want to alternate use (e.g., using benzoyl peroxide one night, and a retinoid the following night), or use one in the morning and another at night (e.g., salicylic acid in the morning and benzoyl peroxide at night). 


Layering different treatments together can be complicated, especially if you’re also using retinoids. Check out our advanced skincare layering guide for some suggestions for combining products. 

Moisturizers for acne

Just because you’re breaking out doesn’t mean you need to give up on moisturizer. In fact, moisturizers are essential for keeping your skin strong, resilient, and quick to heal. They also prevent the extreme flakiness and dehydration that come with many acne treatments.


Breaking out is very individual, and some moisturizers can worsen a breakout. Finding the right one for you might require some trial and error. Generally, lightweight gel or lotion moisturizers will work best since they’re usually formulated with the potential for breakouts in mind. 


Our very own Water Lock is an excellent option. It was designed with a blend of non-comedogenic, water-binding ingredients that seal moisture into the skin without feeling greasy, which makes it the ideal moisturizer for acne-prone skin, whether dry or oily.  

Sunscreen for acne 

The sun is one of the most damaging external forces that impact the skin. UV exposure has a pro-inflammatory effect that has been found to make acne worse. It also increases the risk that healed pimples will turn into dark spots. 


A great sunscreen for acne-prone skin will protect your skin from the sun’s rays without breaking you out. Unfortunately, as with moisturizers, certain sunscreen ingredients can be comedogenic for some. 


Sunscreens advertised specifically for the face or as matte, oil-free, or non-comedogenic are more likely to be compatible with your skin. Check out our lab’s top sunscreen recommendations for some product suggestions. 


As a rule, you’ll want to apply at least a 1/4 teaspoon of sunscreen to your face, neck, and ears before exposing your skin to sunshine. 

Example routine for acne-prone skin

So how do you put everything together? This is what your skincare routine for acne-prone skin could look like: 

 

AM

  • Splash your skin with water, or cleanse if you feel oily or are using a treatment cleanser. 
  • Optionally, apply any active serums or spot treatments to your skin. 
  • If your skin feels dry, apply a thin layer of moisturizer and let it sink in completely. 
  • Finally, apply at least a ¼ teaspoon of sunscreen to the face and neck. If your sunscreen is rich or moisturizing, you can skip moisturizer. 


PM

  • Cleanse your skin with a mild cleanser, or use a treatment cleanser as needed. Leave your skin damp. 
  • Apply your active treatment or serum to address breakouts - nighttime is ideal for retinoids.
  • If possible, wait for your first treatment serum to sink in completely before applying any additional leave-on products.  
  • Apply your moisturizer of choice. 
  • In areas where your skin is feeling dry, apply a light layer of a richer cream or ointment. 

When to see a doctor for acne treatment

In cases of moderate to severe acne, it’s best to speak to your doctor rather than self-treat. Because acne can have so many underlying causes, sometimes it’s better to treat those directly, such as by addressing hormonal imbalance, or oil production. 


Many highly effective acne treatments are only available by prescription, from topical creams to oral medications. 


There are also a lot of ways to combine a skincare routine for acne-prone skin with medical treatment, so it doesn’t have to be one or the other. For example, your doctor may prescribe hormonal medication to treat the underlying cause of your breakouts, while still recommending the use of skincare and OTC treatments. 

What to avoid if you have acne-prone skin

When you have acne-prone skin, it’s important to avoid comedogenic ingredients. Comedogenicity is a rating given to ingredients or products based on how likely they are to clog pores. 


Most brands advertising to those with acne-prone skin have phased out ingredients that score high on the comedogenicity scale, like cocoa butter, wheat germ oil, isopropyl myristate, or algae extract. There are some exceptions, of course, especially amongst clean or natural beauty brands.


Whether you’ll break out or not also depends on the concentration of comedogenic ingredients in a formula, and how it’s used. For instance, a small amount of petrolatum in a moisturizer might be safe (albeit a little greasy), but full-strength petrolatum may contribute to bacterial proliferation by occluding the skin too much


If your skin is already compromised, breakouts are likely no matter what, and it can seem like new skincare products are the trigger. However, once acne is mostly dealt with, the skin can become more tolerant of certain ingredients. 

Other tips for caring for acne-prone skin

The ideal routine for acne-prone skin can help keep your breakouts under control while seeing a doctor will help you treat the condition directly. That said, it’s important to remember that because this condition is so tied to hormonal health, other lifestyle factors can also come into play: 


  • Diet: While there are no overwhelming correlations between specific foods and breakouts, an unhealthy diet can have a negative impact on hormonal balance or inflammation, potentially leading to increased breakouts. Low-glycemic index diets are generally regarded as the best option, while for some avoiding dairy can help. 
  • Stress and sleep management: The impact of stress and lack of sleep on the entire body is hard to overstate. They can disrupt hormones significantly, which can worsen acne. Finding ways to limit stress and get restful sleep is definitely important for effective acne treatment. 
  • Hygiene: For the most part, people with acne-prone skin have perfectly good hygiene. It’s not a primary or secondary reason for breakouts. That said, some objects should be washed regularly because they come in contact with the skin, like pillowcases, makeup brushes, or headphones. 
  • Over-cleansing: Never washing your face could make your acne worse, but so can washing too much. Research shows that cleansing once or twice a day is likely ideal, but more than that and you run the risk of damaging your skin barrier. 
  • Scrubbing: In the same way that over-cleansing can be irritating, scrubbing is another major thing to avoid. Physical exfoliation is very irritating - it can worsen your inflammation or break the skin, potentially leading to angrier breakouts. 

The bottom line on acne 

Introducing new skincare when you have acne-prone skin can be scary. Every new product is another chance for a breakout, and figuring out all of those treatments together can be confusing. 


We hope our advice clarifies which products you should look for, which you should avoid, and how you can put together a comprehensive skincare routine for acne-prone skin. It’s a complex condition, so while finding your perfect regimen may take some trial and error, having clear, resilient skin at the end is worth it!

Medically reviewed by Anna H Chacon, M.D. FAAD

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