Hi Dr. Bailey,
I’m using salicylic acid 1.5% and it doesn’t exfoliate very well. It just barely loosens surface dead skin. Are the alpha hydroxy acids better for that? (I’m thinking of the lower concentrations) because I’m sensitive. I read that SA just dissolves the top layer and AHA remodels the stratum corneum so they work differently and it sounds like AHA would make skin look better if that info is correct (is that right?). Also, what do you recommend for a person with acne prone skin who needs hydration and worries about breaking out with suspect moisturizers? (I don’t want a product that leaves skin dehydrated in low humidity like some products do that are just humectants alone where hydration evaporates quickly. PCA Hydrating Serum is a great one. I’ve been through tons and finally found one safe for acne prone skin and effective at keeping my skin hydrated being in air conditioning all day. ~ Lisa
This is a great topic about how to build the best complete acne skin care routine for sensitive skin in low humidity and dry climates.
First things first, take a look at my Acne Advice pages. You will find a lot of information there about how I use products to treat acne for different skin types. I talk about how to pick the best moisturizers for breakout-prone skin. One product that my acne prone patients love is my Instantly Luminous Multi-Action Serum. Similar to the PCA Serum that your skin loves, my Luminous Serum has glycerin and hyaluronic acid. It has much more – none of which breaks out skin – including sodium PCA (a natural component of skin that binds moisture), tons of varied molecular weight hyaluronic acid and glycerin. This means that it’s full of pharmaceutically pure and stable water-binding ingredients to fight that dehumidified, dry air conditioned air.
I typically start people with sensitive skin on the 2%/2% combination of salicylic acid (SA) and glycolic acid (GA) together for their synergy, in my Salicylic and Glycolic Acid Acne Treatment Pads. I find that combination of SA and GA helpful when used as both a cleanser and as ‘toning’ pads. Since acne prone skin is notorious for breaking out from time to time even when using the best skin care, I tell my patients to treat any new pustules with my 2.5% Benzoyl Peroxide Treatment Cream. Extremely acne prone areas of the face are also nicely controlled by daily application of 2.5% benzoyl peroxide (BP) cream after toning with the pads. This 2.5% benzoyl peroxide strength is the sweet spot for BP acne treatment; it is unlikely to irritate sensitive skin, but is well proven to control the acne causing bacteria, p. acnes. The Instantly Luminous Serum is non-comedogenic and thus also ideal for acne prone skin.
You are right that Salicylic Acid is not as helpful as Alpha Hydroxy Acids (AHAs) at exfoliating and changing the stratum corneum. Salicylic Acid is great at getting through oil, and therefore is a great help for keeping pores clean. That said, I find AHAs much better at brightening the complexion and dislodging black heads.
The product combination of glycolic/salicylic acids and benzoyl peroxide is the basis of my Ultimate Acne Kit. These products are also available individually if a person needs only one product to control their acne skin problems. I always recommend that people with dry skin and acne prone complexions, or who are exposed to low ambient humidity for long periods of time, use a non-comedogenic moisturizer on the drier areas of their complexion. The ideal solution is to layer my Daily Face Cream for Normal to Oily skin on top of their acne treating products. During sunlight hours, it is also important to layer a high-tech zinc sunscreen. I recommend one that is entirely oil free such as my Sheer Strength Pure Physical Sunscreen.
Thus, the complete skin care routine for acne in low humidity, dry air conditions would include products for the 4 essential steps of a Complete Skin Care Routine:
- Cleanse (With the Foaming Acne Treatment Cleanser containing 2% SA/2% GA to both brighten and treat)
- Correct (With the 2% SA/2% GA Acne Treatment Pads)
- Hydrate (With the Instantly Luminous Serum applied to the entire face. If needed, spot treat a breakout with the Benzoyl Peroxide 2.5% Treatment Cream. Additional moisture can be created by applying my Daily Face Cream for Normal to Oily Skin)
- Protect (With a final layer of Sheer Strength Pure Physical Sunscreen)
This Complete Skin Care Routine is both acne treating and anti-aging, plus it locks in moisture, even in low humidity. It is the basis for healthy and attractive skin now and for years to come. It combines powerful acne fighting treatment with high tech skin hydrators and the best sun protection technology available today. These products blend pharmaceutically pure ingredients into stable formulas so that you can trust that the active ingredients are working to help your skin. And finally, know that this skin care routine will feel good on your skin. I have designed my complete skin care routines to layer on smoothly, because it’s important that your skin feels as good as it looks.
I hope that helps, Lisa. Thank you for sending such a great question that many people have.
Cynthia Bailey, MD Board Certified Dermatologist
Disclaimer: Please realize that availing yourself of the opportunity to submit and receive answers to your questions from Dr. Bailey does not confer a doctor/patient relationship with Dr. Bailey. The information provided by Dr. Bailey is general health information inspired by your question. It should not be a substitute for obtaining medical advice from your physician and is not intended to diagnose or treat any specific medical problem (and is not an extension of the care Dr. Bailey has provided in her office for existing patients of her practice). Never ignore your own doctor’s advice because of something you read here; this information is for general informational purpose only.