Skin Drying From Proactiv, RetinA and Other Acne Treatment Products

Cynthia Bailey, MD|August 23, 2011

Skin drying from acne treatment products is really common.  There are simple tricks to figuring out how to fix it so that you can treat your acne without suffering from tight, dry, peeling skin that screams for a moisturizer. A reader sent me this exact question as a blog comment. Because I know that so many people with acne share the same question I didn't want the question, or the answer,  to get lost at the end of a post so I'm making an Ask Dr. Bailey article out of it.  It's a great question! Dear Dr. Bailey, I recently started using tretinoin for my acne and this information in How Do You Layer Skin Care Products With Tretinoin has been very helpful! Is there a type of moisturizer you can recommend to use on really dry skin with acne? It doesn’t seem to matter how soon I apply moisturizer after washing my face, it always seems to end up feeling really tight. But I’ve always heard oily moisturizers made acne worse and I don’t want that either. Thanks so much!! Donna Hello Donna, In my dermatology practice, the 3 most common reasons for why acne treatment products cause skin dryness are:

  1. One of the acne medicines in the products is causing irritation or allergic reaction (often salicylic acid or benzoyl peroxide),
  2. The cleanser used for washing is too drying and irritating.
  3. That tretinoin, if used, is being applied incorrectly.

Taking each of these one at a time: Why acne treatment ingredients cause skin to feel dry There are 3 main non-prescription active ingredients in acne products.  They are glycolic acid, benzoyl peroxide, and salicylic acid.  They are all wonderful and an work miracles for acne, but they can all be tricky to use.  In fact, some people can be allergic or just have skin that's easily irritated by one or more of these great ingredients. The first (glycolic acid) can be irritating but allergy is uncommon.  The Glytone Mild Gel Wash Cleanser and Glytone  Exfoliating Lotion that I've used for years on acne patients relies on this single ingredient to treat acne prone skin in people allergic to the second two ingredients.  With a potentially irritating ingredient like glycolic acid the key is to find that sweet spot where you're treating the acne but not irritating the skin.  It may be that alternate day use or lower concentrations are needed which is why there is a step up program starting with a lower concentration and moving to a higher one if your skin can tolerate it. Salicylic acid and benzoyl peroxide are trickier to use than glycolic acid.  They can irritate skin, but more importantly, you can be allergic to one of them.  Popular acne treatment products like Proactiv depend on benzoyl peroxide to treat pimples.  Neutrogena's popular Oil-Free Acne Wash and Rapid Clear Treatment Pads depend on salicylic acid as their active acne treatment ingredient.  When you're allergic to one of both of these ingredients your skin will never tolerate it.  Any application results in a dry, chapped, redness that gets worse and worse as you continue using the product. While irritation and allergy can be problems, most people with acne actually tolerate the use of these 3 highly effective acne treatment ingredients.  If you're not allergic then using them they are the fastest way to clear up acne and pimples without a prescription.  It's why I have them all in my OTB Skin Acne Treatment Kits.  My OTB Skin Acne Kits are the 911 Kits for bad acne and I have tons of patients using them to control their acne. Why acne cleansers cause skin dryness Acne cleansers often include acne treatment medicines like salicylic acid, benzoyl peroxide or glycolic acid and we just talked about why those ingredients can cause dryness.  They also usually are designed to lift a lot of oil from the skin and can just plain be too strong of a soap for more sensitive skin types.  The Glytone Mild Gel Wash Cleanser is a good acne cleanser in a milder soap base.  It still lifts off oil, dirt and makeup but does not overly strip the skins natural oils. Not everyone with acne has oily skin and for my dry skin patients with acne I find that Calming Zinc Soap is usually the perfect skin cleanser for them.  It's a naturally made soap meaning that the soap making process begins with oils which are then magically converted to soap and glycerin.  It includes another amazing ingredient called pyrithione zinc to control a common skin germ called pityrosporum, which contributes to many peoples acne, especially if they have dry skin.  Calming Zinc removes oil, dirt and makeup without harsh foaming agents like sodium laurel sulfate, making it perfect for sensitive skin; it never over strips your skin's natural oils. I often use both these cleansers for my patients with dry, sensitive skin that have acne.  In fact, one of my favorite acne treatment regimens that is also a highly effective anti aging regimen to fight the development of wrinkles is: In the morning:

At bedtime

Why tretinoin can cause skin to seem dry Many people don't know how to correctly apply tretinoin.  The trick is to start with the lowest dose and work up.  It's also important to wait 15 or 30 minutes after washing and applying other products before applying tretinoin (unless you are using RetinA Micro).  Tretinoin is always to be used at night because it breaks down in light and can cause a skin irritation when that happens.  I have written many posts on the subject to help people understand how to correctly use this wonderful medicine for acne and anti aging skin care including: How To Correctly Use RetinA (tretinoin) For Acne And Anti Aging Skin Care How Do You Layer Skin Care Products With RetinA Moisturizers for Acne Prone Skin If, after exploring which of these explanations is the most likely cause of your skin dryness from acne treatment products, and making adjustments accordingly, your skin still feels like it ‘wants’ a moisturizer then I recommend the Daily Moisturizing Face Cream for Oily to Normal Skin. This face cream works beautifully for my acne patients.  It's oil free, hydrates with ingredients like glycerin and feels light on the skin. Great question! Warm Regards, Cynthia Bailey MD, Dermatologist If you have questions about skin care or skin health please send them to me using the Contact Dr. Bailey button at the top of the page. 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.

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