How Do You Know If a Product Will Cause a Breakout?
Many have struggled with this question at some point in their lives. Acne impacts us and we want to know how to control it. The first place to look is your skincare. If you’ve gone ‘down an internet rabbit hole’ studying the subject, you know the answers are confusing.
What Exactly Are We Calling a Breakout or Acne?
Obviously, a big red pimple with a whitehead counts. A huge and hard plug of a blackhead in a pore counts. What about clogged pores without a hard plug? Or an increased size and dilation of pores without stuff visible in the pore? Does that count? What about deep and painful acne cysts that never come to the surface? Is that part of the acne discussion regarding skin care products that can break you out? Not really. The pores are the size that they are and don’t change much. Deep cysts are triggered by internal causes and not products.
Do You Head Straight for Products Labeled Non-Comedogenic Or Non-Acnegenic if You Have Acne?
If only it were that simple! Even the dermatology profession struggles with these labels. The potential for an ingredient to actually break you out is heavily impacted by concentration, other ingredients in the product, proper usage, and how acne-prone your skin is. Infinite variables!
Definitions and Perspective
A comedogenic ingredient causes cells to stick together, causing a blackhead. The concept of skincare products causing blackheads started in the 1970s and 80s. Some of the first scientific studies happened on bunny ears and involved testing specific ingredients alone. Now humans are used. Testing is often done on the back and how the assessment is made varies.
Acnegenic is a term used to indicate whether something can cause a general worsening of acne.
A clinical use test is where individuals use a product under normal conditions for several weeks and are then evaluated for blackheads or pimples. This is the most meaningful way to determine if a product is compatible with a person’s skin. One can test on a small area of facial acne-prone skin, or even on non-facial skin such as the chest or back. These areas contain a high density of pores with oil glands.
Cosmetic acne is the term used by dermatologists to describe acne caused by skincare products. It was first described by French dermatologists in the 1940s. They reported on “brilliantines and hair pomades causing flare-ups on the temple and forehead facial regions.” The blackheads looked normal and this eventually led to research and tests, rabbit ears, lists of ingredients to avoid, and a lot of misunderstanding ensued (my opinion). Our entire understanding of acne has changed in the past decade or so. Acne is now considered an inflammatory condition, not simply a circumstance limited to blackheads, too much sebum, and bad bacteria.
Ingredients to Avoid
This list is from the original work on bunny ears surrounding comedogenicity and pore irritation. Takeit with a grain of salt though. Acne is not a simple cause and effect relationship. Still, some ingredients are notorious triggers of acne. These include:
- lanolins (acetylated lanolin alcohol, PEG 16 lanolin)
- lauric acid
- cetyl acetate
- ethylhexyl palmitate/octyl palmitate
- isopropyl isostearate
- isopropyl linolate
- isopropyl myristate
- myristyl myristate
I also recommend that if you have acne-prone skin, you should avoid thick, greasy, or waxy products. They seem to be more consistently problematic for my acne-prone patients.
I’ve practiced dermatology for 30 years and I’ve seen many acne-triggering variations in my patients that go beyond products. These variations include: eventual changes in skin, seasonal/climate changes, T-zone versus non-T-zone, stress, hormones, sweat, wearing clothing that might block glands or rub oil on your skin, and changes in complexions with age.
The bottom line is the issue of acne and ingredients is NOT simple. I always recommend we watch, wonder, and learn when we have acne theories. We also carefully test products on skin when we are worried that they might trigger a break out.
How to Test a Product to See If It Causes Acne
Do a clinical use test. Choose an area where a pimple won’t ruin your complexion. Add the product to your skin care routine and wait for at least 2 weeks. Look for blackheads, pustules, and at the general size of your pores. If it looks good, then consider doing split skin comparisons by using the new product on just one side of your face to gauge a difference.
If you don’t want to test the product on your face, use non-facial skin such as the chest or back, which are also acne-prone. Again, apply the product to a small area of skin for at least 2 weeks. If the results are positive, consider progressing to a limited area on your face and then to split face.
What Should You Be Doing to Help Control Acne?
Diet and smart lifestyle changes make a difference. Get those in order as best you can to fight acne. Click here to learn more about diet and acne.
Get the Rx SUMMARY:
- Foods that worsen acne: cow dairy products, bad fats, high carbs, and sugar diets
- Foods that help fight acne: Whole foods including real fruits and veggies, beans, nuts and whole grains.
- Get rest, exercise, try to create a balanced schedule for stress and rest.
Skin care options that are proven to help acne include:
Benzoyl peroxide: best in 2.5% concentration which works as well as higher concentrations with less risk of irritation.
Salicylic acid: penetrates oily pores to loosen blackheads.
Glycolic acid: loosens pore-clogging debris.
Retinoids: options include prescriptions such as tretinoin or non-prescription retinol.
If you have Pityrosporum Folliculitis type of acne, wash with pyrithione zinc. This is a time-honored remedy for this type of yeast acne.
Get the Routine:
Morning Skin Care:
Cleanse and Correct with Foaming Acne Wash. Add a second cleansing step by using the Acne Treatment Pads to help remove residual oil. The glycolic acid and salicylic acid help clean pores deeply as well.
Follow with Benzoyl peroxide 2.5% lotion.
Hydrate with Face Cream for Oily to Normal Skin.
Protect with Sheer Strength Mineral Matte Sunscreen. It is tinted to hide complexion flaws and the oil-absorbing matte base helps control shine.
Evening Skin Care:
Correct with Retinol.
Hydrate with the Face Cream for Oily to Normal skin.
Back and Chest Acne
Cleanse and Correct with my Body Acne Kit.
Fulton, James E, Comedogenicity and irritancy of commonly used ingredients in skin care products, J. Soc. Cosmet. Chem., 40, 321-333 Nov/Dec 1989
Draelos Zoe Diana, DiNardo Joseph C, A re-evaluation of the comedogenicity concept, JAAD March 2006, 54 (3) 507-512
Kircik Leon H, Advances in the Understanding of the Pathogenesis of Inflammatory Acne, J Drugs Dermatol. 2016: 15(1 Suppl 1):s7-s10