Being someone who started to fight against acne since teenage year, I have been wanting to talk about skincare for a while, but hesitated because I felt the lack of warranty — I am not a dermatologist, not a professional in skincare / health industry, not someone with degree in pharmaceutical, cosmetic science or chemistry, not even someone with skin condition that will impress others. That made me question if what I share are factually correct, and even if they are, whether people will believe me.
This mindset recently changed for a few reasons:
- Being someone who practices “strong opinions weakly held”, I should not feel scared to be wrong. In fact, I should be happy that by sharing it, I get the opportunity to be pointed out where I misunderstood, and the earlier it happens, the better.
- No matter what I say and how I say it, there will be people that do not believe me, and that is fine. I am writing to be a giver, and I should never have the expectation that what I give is the silver bullet that everyone needs and will appreciate — cuz when I was on the other side of the table, I choose to not believe things I read either. At the end of the day, people choose what they want to read, whether they want to think, and how they want to interpret it. It’s always possible to wake someone from sleep, but no amount of noise will wake someone who is pretending to be asleep.
- Don’t let the lack of labels be the reason of not doing something, create them if needed. I have seen so many people on social media like YouTube, Bilibili and TikTok where they started off as an enthusiast in field X, and gradually they built the personal branding that associates them with that field. Should they not start this journey because they feel they do not have the permission to create, they won’t have made all these great contents.
- Or…do labels even matter? To some degree, yes, but at the end of the day, it is the quality of content that differentiates my work from others. So stop falling into the bias of “appealing to authority” and focus on producing things that are high quality.
Alright, enough of why I finally have the guts to write this article, and here we go on a few things I have learnt about skincare :)
My skin condition
I have acne-prone skin. Acne becomes my main skin concern since I was around 17. Looking at photos taken in the last 6 years, I have always had a mix of a few large angry pimples on my face, and some smaller acnes around my jawline / mouth area, blackheads and whiteheads on my forehead and nose, and post inflammatory erythema (PIE) / post inflammatory hyperpigmentation (PIH) here and there. I would consider my acne situation as mild to medium — not severe enough that I need immediate dermatologist attention (I did end up seeking professional help though, more in details later; if your skin condition is severe, reach out to a dermatologist for help!). My goal from skincare is to 1) reduce the frequency and severity of acnes on my face, 2) help fade PIE and PIH, and 3) even my skin texture and tone, with ideally some brightening.
Few things I tried but stopped
Using wrong skincare product, or using the right product in a wrong way
I started off by buying skincare products that are branded as “For oily skin” or “For deeper hydration”. Few examples I can remember include L’Oréal charcoal cleanser for men, Kiehl’s calendula toner and midnight recovery concentrate, SK II’s facial treatment essence, as well as the black tea instant perfecting mask from Fresh. Back then, I simply went for brands that have a shop located nearby my dorm and picked up their top seller products for oily skin type, without any ideas what’s in it. Looking back, they may still be good product (not for me to judge), but they are not the products I will use myself, or recommend to other people.
At the same time, I actually was fortunate to have access to some good products, that can indeed help me — such as Neutrogena’s oil free acne wash, Paula’s choice 2% BHA liquid exfoliant, or SkinCeuticals’s Phyto Corrective gel. However, I didn’t really know how to use them, so I made the mistake of following the instruction too literally, using a 2% BHA exfoliant twice a day, plus a face wash with active ingredient, layered with other products that may or may not be comedogenic. Because of my wrong usage, my “more is better” mindset, and my unrealistic expectation (“that I should see improvements in less than a month”), those good products ended up not staying on my shelf long enough to show an effect on my skin.
Peeling, and oral antibiotics
I have also been to skincare clinics to seek some help. I did a chemical peel once in the clinic. The peeling stage was fairly scary — there were around 10 days that my face was having a heavy peeling and I basically couldn’t go out. After that, the new skin does look and feel smoother but it ended up not solving the acne problem — I was still having breakouts more than I wanted.
I have also taken oral antibiotics for around a month back when I was around 18. Not helping as much. Also it was quite expensive getting prescribed medication so I stopped.
Solve it like a puzzle
The unsuccess of fighting against my acne motivated me to use my problem solving skills and deal with it systematically. I started to realize this is not something I can just resolve by trying a few random solutions and getting lucky, it will be a year-long journey that requires correct and open mindset, science-backed knowledge and consistent efforts.
Correct my mindset
There are a few key mindset shifts that I think really helped me stay focused and not feel anxious:
- I will NOT get flawless skin, no matter how hard I try. Acne is a complex skin issue. It’s part of my DNA. So many things can trigger acne — stress, lack of sleep, eating oily / sugary food, not enough cleanse, too much cleanse, etc. No topical skincare products + occasional clinical treatment can 100% solve it. My best bet might be oral retinoids + antibiotics, but it comes with side effects and the gain may not be worth it.
- It takes time for skincare products to kick in and help. When I accept the fact that I am in a marathon, not a sprint, I stop the urge of checking in progress every day or every week. I care more about whether I am on average improving my skin condition or no in 3 months, 6 months or even a year. Consistency is key.
- Keep it simple, less is more. I stopped believing that expensive products are better, or more products mean faster or better result. I am lucky that the skin issue I have been struggling with are actually well studied, with very affordable and accessible solutions. With simpler routine, I do not have to worry about active ingredients affecting each other, or too much irritations to my skin. Plus, if the routine is as simple as possible, it helps me stick to the plan and not feel I need to pour in a lot of efforts / do a lot of thinking around it!
Knowledge
It turns out that I only need four things: cleanser, sunscreen, acne treatment and moisturizer.
Disclaimer: I will mention quite a few brands, products and YouTube channels down below. I am not affiliated with any of them and they are not paid promotion. If you see the same brand appear again and again, it is because I trust them and they have done a great job making awesome products!
Cleanser
I opt for gentle cleansers in my routine. The purpose of cleanser is simple: remove excess oil, dirts, etc. from my face. I don’t wear makeup, so a simple amino-acid based cleanser works pretty well for me. Some of my favourite products are Kanebo Freeplus Gentle Cleansing Cream, Cetaphil’s gentle skin cleanser, CeraVe foaming facial cleanser.
I am not a big fun of using physical scrub on face (I do use Dove’s exfoliating body scrub), and I don’t currently use any face wash that has active acne treatment ingredients (like salicylic acid or benzoyl peroxide), but those are the things I may consider having as a backup cleanser when my acne was super out of control, or rotate with my chemical leave-on exfoliants.
Sunscreen
Sunscreen is important. If there is only one takeaway from reading this piece, I want you to take this message to heart. It is the single most effective thing you can do to protect your skin, not only from photoaging but also from any irritations you may get from UVA and UVB that can worsen your acne or acne mark.
My rule for finding day-to-day sunscreen (not for beach / full day sweaty outdoor sports!) is simple:
- SPA 30+
- Broad spectrum / PA+++ above
- Non-comedogenic
Above that, I would prefer something that is lightweight, fragrance-free, not leaving a white cast, and reef-safe. I do not have a strong preference over mineral or chemical sunscreen.
I am still in the exploration phase for sunscreen — haven’t found one that I really really like and want to continue to use. Several that I so far enjoy are:
Murad’s City Skin Age Defense SPF 50 | PA ++++
Coola Organic Mineral Sun Silk Creme SPF 30 Broad Spectrum
Etude Sunprise Mild Airy Finish Sun Milk SPF 50 PA +++
Elta MD UV Clear Broad Spectrum SPF 46
Shiseido Urban Environment UV Protection Cream Plus SPF50
A few I do not particular like were The Ordinary’s mineral UV filters SPF 30 with antioxidants (left a purple-ish cast on my face), Skinceuticals ultra facial UV defense SPF 50+ (tint too dark for me, plus it felt a bit oily).
I tore between whether I should absolutely use sunscreen everyday or not. Right now I do not — I only use sunscreen when I am going outdoor, or when the UV index is above 2 (even if I stay in).
Acne treatment
Okay here comes the meat: I have watched so many YouTube videos around this, and read so many articles from different sources about this area, to a point that I really want to summarize everything I’ve known. I am a believer of science-backed ingredients, so I have high confidence that everything I mentioned below should work with research and experiments prove. I will also mention at the end of the article resources that I base off to form my opinions. Feel free to comment / reach out to me if you think I made a mistake, and I am happy to discuss!
Salicylic Acid (BHA)
What it is? A chemical exfoliant that concentrates around oil glands on your face that helps acne by clearing up the clogged pore and quickly remove dead skin cells.
What it helps with? BHA is generally helpful to fix bumps, blemishes and white/black heads. I use BHA on areas that have little bumps or some pimples that are not badly inflamed yet.
Products I recommend My go to product is Paula’s choice 2% BHA liquid exfoliant. I recently started to experiment different vehicle and their gel format works well on me too. I have also heard good things about COSRX One Step Original Clear Pad and STRI-DEX Daily Care Acne Pads. I also own a Drunk Elephant T.L.C Babyfacial Mask which I use when I feel I have a thick horny layer of skin that I want to exfoliate off. I use it twice every month.
How to use them? I recommend starting slow, such as once or twice per week (rather than following the product’s instruction, which usually tells you to use the product twice a day). Think of it as adding condiment to your dish — start little by little, and don’t ruin the dish / skin by overusing it.
Benzoyl Peroxide
What it is? Antibacterial ingredient that kills P-acne (or cutibacterium acnes, the bacteria that caused breakouts). It does not cause bacterial resistance, which is awesome. It has a bleaching effect so be careful with your pillow case, etc. when using it.
What it helps with? I like to use benzoyl peroxide on those angry, inflamed red zits. It doesn’t help much on noninflammatory acnes like whiteheads and blackheads.
Products I recommend I always keep a Paula’s Choice Regular Strength Daily Skin Clearing Treatment with 2.5% Benzoyl Peroxide with me. I have also used one from Acne.org, and heard good things about La Roche-Posay Effaclar Duo Acne Treatment with Benzoyl Peroxide which has a stronger (5.5%) percentage.
How to use them? Acne.org recommends using benzoyl peroxide all over the face. While some people may do that, I find it too drying and prefer to use benzoyl peroxide as spot treatment option. I use them only when needed (when there are large inflammatory pimples) and once per day.
Azelaic Acid
What it is? Azelaic acid works by getting rid of dead skin and killing bacteria. It is generally considered as milder (in terms of side effects) than benzoyl peroxide or retinoid (which we will discuss below).
What it helps with? I consider Azelaic Acid as a very well-rounded ingredient. It acts as a gentle exfoliant, can refine skin’s surface, has anti-inflammatory benefits and can also brighten up skin and reveal more even skin tone (so it helps with PIC/PIH too!).
Products I recommend Percentage strength is really the key here for Azelaic Acid. Over-the-counter product (aka products you can buy without a doctor’s prescription) is usually of 10% maximum strength (Australia does have 15% Azelaic acid OTC), which can yield some benefits but most of the research are based on higher concentration between 15% to 20%. I am a fan of The Ordinary’s Azelaic Acid Suspension 10% which is affordable and really easy to use. I also like Paula’s Choice 10% Azelaic Acid Booster (ignore the name, just use it as an acne treatment serum). Right now I am using Finacea (15% Azelaic Acid) under prescription.
How to use them? I use Azelaic Acid once a day as part of my morning routine. I use it all over my face. Azelaic Acid is a great ingredient to use during maintenance mode (I do not have regular active breakout anymore) because it’s less irritated and can help with fading acne marks.
Retinoid (Retinoic Acid and Retinol)
What it is? Let’s get the terms right first:
Retinoid is an umbrella terms for vitamin-A derivatives. Below you will have retinol, retinaldehyde and retinoic acid.
Retinoic Acid is the strongest in terms of efficacy. They usually appear in medication. There are different generations of retinoic acids. The older the generation is, the more studies people have done on them. The newer the generation is, the more changes scientists have made on top of them to make them less irritating. The 1st generation retinoic acid includes tretinoin (brand name Retin-A). The 3rd generation includes adapalene (brand name Differin).
Patent around Retinaldehyde was owned by Avène so you may have heard it less than retinol. But essentially it is a derivative that takes one step of conversion to become retinoic acid and take effect on skin.
Retinol is the weakest (and mildest) among the three (theoretically, the final result largely depends on how you deliver the product + percentage as well). It takes two steps of conversion at a high level to become retinoic acid.
Note that retinoid (retinoic acid) is not pregnant safe (Oral retinoic acid definitively not safe, topical use also highly discouraged. Consult your doctor about it please)
What it helps with? Retinoic acid is one of the most well studied acne treatment. It helps with acne by working on skin cells’ receptors and change the skin turnover rate. It may look like an exfoliant but it is not getting rid of dead skin by itself but rather instruct the skin cells to turn over faster. It also has amazing anti-aging effect because it can increase collagen production.
Products I recommend I am getting tretinoin through prescription from Curology, which I highly recommend. I think this is one of the most convenient (well, maybe not the cheapest) way to get access to tretinoin. I have also tried OTC differin gel myself, but switched to Curology because I like the idea of having a personalized formula that contains tretinoin + other ingredients. I am currently at 0.025% strength of tretinoin. It is generally agreed that the percentage doesn’t matter that much if you use tretinoin for an extended period of time; the higher strength just delivers the result faster, but with the risk of more irritation.
If you are looking for retinoid, here are some brands you may want to look into. I categorize them roughly based on the strength of the product. Note that I have NOT personally used any of them:
Introductory:
- Olay
- Neutrogena
- RoC
- CeraVe
Intermediate:
- Murad
- Avène
- Obagi
Advanced:
- Skinceuticals
- Paula’s Choice
- Drunk Elephant
- ZO
How to use them? I use my retinoic acid at night. I use a pea size amount and dab them on dry, clean face and rub them in gently.
It is worth discussing the side effect of retinoic acid (and retinoids in general). I have personally gone through purging phase for both adapalene and tretinoin. It was hard — I remembered there were around 2 weeks that my mouth area + chin were just full of pimples (10+). But knowing that this is temporary and expected really helped. Do not be scared and stop! Just keep going and using a bit more moisturizer. After the skin can handle retinoids it becomes much easier to tolerate. Right now I just got some dryness and flakiness from time to time but nothing is unbearable and cannot be solved by using some moisturizing lotion or cream.
I will credit the improvement of my skin condition mostly to retinoic acid. I started using it since mid 2019 and it has been almost 2 years. Even I am only in my 20s, I have seen visible improvements on some forehead dynamic wrinkles I had (take my word here with a grain of salt; dynamic wrinkles are hard to be improved with topical treatment; it may be because I am still young and I don’t have deep wrinkles so tretinoin helped; or it may not help at all and I just got that feeling because of the improved collagen production). Given its benefit on acne treatment AND anti-aging, I can see myself keep using tretinoin / adapalene for rest of life time (why not?)
Moisturizer
Last but not least, you will need moisturizer when you are using some of the acne treatments above because they tend to dry out your skin and dehydration can lead to irritation which leads to breakouts. Similar to cleanser, my requirement to moisturizer is simple, safe product that can hydrate my skin and help retain the moisture. I don’t need anything fancy as I am still relatively young and I don’t need anything greasy as an oily skin.
Some of my favourite products: CeraVe daily moisturizing lotion and PM facial moisturizing lotion (more lightweight, also has niacinamide). I also like The Ordinary’s Natural Moisturizing Factor + HA, Curél Intensive Moisture Facial Cream and CosRx Hydrium Green Tea Aqua Soothing Gel Cream
Honorable mentions
Below are some products that I was using from time to time that didn’t made to the above list.
- Skinceuticals Phyto+: This has kojic acid and alpha arbutin. I will buy one when I need to deal with acne mark or want to brighten my face overall
- Skinceuticals Silymarin CF: A new product just launched 2 months ago as I wrote this article. A Vitamin-C antioxidant taylored for acne prone skin. Love it!
- The Ordinary Niacinamide 10% + Zinc 1%: Niacinamide is another ingredient that is so well rounded. It helps with acne, skin brightening, collagen growth, etc. This product in particular, is helping control oil with that 1% zinc. Usually you don’t need 10% of niacinamide, so instead of using this daily, I recommend finding a moisturizer you love that has niacinamide in it.
Final words
Alright, this is my quick knowledge dump around fighting acne and skin care. In some sense, I feel fortunate that I have some acne problems which pushed me to learn about cosmetic science and skincare. For example, I probably won’t know the importance of sunscreen or start using retinoids that early if I didn’t research so much in this problem space. I hope what I shared here can help some of you too!
Last but not least, I want to give credit to a lot of what I shared here to people who shared those knowledge to me:
I learnt a ton from Dr. Dray, Doctorly and Dr. Celina Chuang (YouTube channel in Chinese) about acne and general skin care. I learnt a lot about sunscren from MudiMood (YouTube channel in Chinese).
Overall, Curology has helped me the most in improving my skin condition.
I find NHS to be a great resource for general education in this area. Companies like Paula’s Choice also have ingredient dictionary and blog posts that are good reads too. Skinceutical’s ones are also helpful.
Happy skincare!
