Our skin is a remarkable example of how incredibly versatile the human body actually is. It’s our first line of defence, it plays a significant role in regulating body temperature and can adapt to new environments over time. Despite these unique qualities, for some people it can also be the source of much frustration, be it general sensitivity and irritation, or persistent acne.

The appearance of our skin has an unmatched influence over how we feel. This is especially true when it comes to our face, and for many people, persistent acne is an issue that requires multiple approaches before the one that works best for you can be found. This period of trial and error can span several months or even years. Although it creates a feeling that treating your acne almost becomes part of your lifestyle, your acne does not define you and it can be treated.

Whilst the science and ongoing research uncovers more knowledge around the topic of persistent acne, one thing is for sure; it’s a frustrating experience to find a solution, or even a starting point.

Here are five suggested starting points for treating persistent acne. 

1. Your Skin is On Your Side 

Your skin is a remarkable organ, but it also needs some help from you. Many people react to persistent acne with an enhanced cleansing regimen believing this will improve skin health and reduce breakouts. Whilst cleansing and good skin hygiene are always important, the treatment of persistent acne isn’t helped by what can become ‘overcleansing’. 

In an attempt to protect itself from the outside world, our skin produces an oil known as sebum that forms part of our natural barrier. We produce this throughout the day but it can be washed away with cleanser, make-up remover and mild soap. Sebum serves an important role in protecting your skin barrier, so when it is stripped more quickly than it can be replaced, your skin’s natural defences become compromised. This can cause additional irritation and redness, compounding the damage already being suffered from acne. 

This isn’t to say that you shouldn’t wash your face, but rather that excessive cleansing should be avoided. Daily cleansing is advised to maintain a healthy balance of good skin hygiene. Alongside this, an awareness of all the products used on your skin can help you understand what is helping, and what isn’t when it comes to treating persistent acne.

2. Sebum Composition is key: Linoleic vs Oleic Acid -  Rebalance Your Skin 

Typically, those suffering from persistent acne may have an imbalance of linoleic and oleic acids, two natural components of your skin’s protective oil (sebum). These fatty acids each have very different textures; oleic acid is thick and greasy, whereas linoleic acid is light and fast-absorbing. 

Research shows that if you have acne-prone skin, your sebum is likely to be deficient in linoleic acid. This means your sebum has a thicker consistency, leading to clogged pores and breakouts. In fact, The amount of linoleic acid in sebum is inversely proportional to the rate of sebum production [British Nutrition Foundation], i.e. the less linoleic acid in your sebum, the more sebum your skin produces - causing breakouts.

Addressing this balance is key to ensuring you’re giving your skin the tools it needs to restore itself and reduce the appearance of persistent acne. One way in which you can supplement your levels of linoleic acid and replenish your depleted stores is by using facial oils which are rich in linoleic acid. Some natural plant oils high in linoleic acid include; Kalahari Melon Oil, Rosehip Oil and Prickly Pear Oil. 

Supplementing levels of linoleic acid calls for a product that carefully addresses the fine balance in your sebum but also doesn’t give rise to new issues or imbalances. 

3. Face Mask Hygiene & Physical Contact with Your Skin

One thing the coronavirus pandemic brought into our lives overnight is the widespread use of face masks, which introduced a new factor to consider for those looking to treat persistent acne.

The environment behind a face mask is one where we see a great deal of friction between the inner mask layer and your skin. With talking and breathing through your mouth and nose creating a moist, enclosed space, the skin in that area is faced with a brand new challenge. Further to this, the glands responsible for producing the protective skin barrier oil, sebum, are concentrated in an area known as your T-zone, a part of which sits squarely underneath a typical face mask design.

With this in mind, the treatment of persistent acne requires an awareness of face mask hygiene and even the most straightforward measures are potentially advantageous such as:

• Wearing a clean face mask at all times
• Removing a face mask when permitted and whilst outdoors 
• Ensure your face mask fits appropriately to avoid touching your face and moving the mask around 
• If you’re planning to wear a mask for a long period of time try to go make-up free 

4. Taking something away can be better than adding something new

Some people believe sunscreen causes breakouts, but more often than not, it’s because they forget to remove the transparent film from their face, before going to sleep. Acne, at the most basic level, is caused by the clogging of pores after all.

Brands that produce makeup products have known for some years that makeup needs to work alongside the natural composition of the skin and the biological processes that the skin goes through, and this is reassuring. However, it doesn’t mean we’re free to ignore what our skin is telling us when using a product that seems to exacerbate the presentation of persistent acne. 

At the end of each day, take some time to remove all sunscreen and makeup (the earlier the better). This doesn’t mean acne will clear up overnight, but eventually, by introducing some makeup-free time, you can give your skin time to work to its full potential. 

5. Maintaining a strong skin barrier

Most acne treatments consist of strong active ingredients, such as retinol, benzoyl peroxide and salicylic acid. These acne-fighting ingredients help to treat persistent acne in different ways, such as increasing skin cell turnover and/or reducing acne-causing bacteria, known as c.acnes. However, they can come with side effects. Frequent use of harsh acne ingredients at high concentrations can lead to skin barrier damage. This can result in your skin becoming dehydrated, sensitive and irritated, which may worsen the effects of acne. 

Maintain a strong skin barrier by:

• Moisturising daily using a cream or facial oil, rich in skin-repairing ingredients such as ceramides and linoleic acid
• Don’t complicate your skin routine. Avoid using too many actives at once, instead limit the number of steps in your regime 
• Applying moisturiser before using strong actives, to act as a buffer. It may slow the time it takes to see results, but it will reduce the risk of side effects.
  

Be Led by The Science, Listen to Your Body

In the treatment of persistent acne, above all else is patience. Acne certainly doesn’t go away overnight and it’s wise to give yourself four weeks to see improvements before moving to another approach. 

In the first instance, learning more about the science behind acne can help inform your decision making and give you an insight into what you’re trying to achieve. Specialist medical professionals are in a position to advise and this is certainly an option to consider, but bear in mind it doesn’t guarantee a quicker outcome. 

The causes of acne are multifactorial which means there could be more than one underlying reason for you to consider and address simultaneously. The outcome of your actions will be seen on the surface but treatment must look deeper to ensure a long-term solution is found.