What’s the best face wash for acne?

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As we age and enter puberty, overactive oil glands in the skin contribute to one of the telltale physical signs of being a teenager: acne.1 Even decades later, acne continues to plague some adults.1 In fact, the Global Burden of Disease Study found that over a 10-year period (1990-2010), acne was the 8th most common skin condition with a prevalence of 9.4%.2,3 If millions of individuals are struggling to manage and treat acne, how can we keep our skin clear and happy? What is the best face wash for acne?

Building an acne-fighting skin care arsenal

A simple yet effective way to start tackling acne is to build a skin care routine with a good cleanser or face wash as the first step. The best face wash for acne should contain active ingredients such as benzoyl peroxide, salicylic acid or tea tree oil.4 While these agents are some of the most common over-the-counter (OTC) treatments, hyaluronic acid and anti-inflammatory compounds known as polyphenols – abundant in green tea – may also help treat acne.5,6 Let’s briefly delve into each of these active ingredients to determine what may work best for your skin.

Benzoyl peroxide

The first contender in the battle against acne is benzoyl peroxide. Due to its anti-bacterial and comedolytic properties, benzoyl peroxide is best suited for individuals with comedones.1,4 The formation of comedonal acne occurs when excessive oil production and the accumulation of dead skin cells lead to blocked pores.4,7 We experience whiteheads when this mixture is trapped in the skin (closed comedones) and blackheads when it is exposed to air (open comedones).7

Benzoyl peroxide is available at concentrations ranging from 2.5% to 10% OTC, however studies suggest that higher concentrations are not necessarily correlated with greater efficacy.4 As it turns out, less is better when it comes to benzoyl peroxide since more concentrated formulations are associated with a greater risk of experiencing side effects such as irritation, dryness and burning.4

Salicylic acid

Salicylic acid is readily available in skin care products due to its ability to treat acne. As a beta-hydroxy acid, salicylic acid works to chemically exfoliate the skin to clear pores and smoothen skin texture.4 The use of salicylic acid is therefore effective for treating comedones, much like benzoyl peroxide.4 Salicylic acid can also be used to treat other physical presentations of acne, including papules, pustules, nodules or cysts.7 Unfortunately, these types of lesions are associated with varying degrees of swelling, redness and pain due to their inflammatory nature.7

In OTC products, salicylic acid can be found at concentrations of 0.05% to 5%.4 Although it is generally well-tolerated, use of salicylic acid can be associated with irritation and peeling skin.4

Tea tree oil

Tea tree oil is an acne-fighting agent that is derived from a natural source, specifically the Australian plant species known as Melaleuca alternifolia.8 This essential oil has potent anti-inflammatory properties that make it a strong component against inflammatory acne.4,8 Various studies have demonstrated that the use of tea tree oil over at least 4 weeks can help reduce lesions for individuals with mild-to-moderate levels of acne.8

The reported side effects of using tea tree oil include dryness, stinging, redness, and itchiness.8 Tea tree oil can cause allergies, which is why patch testing on a small area of skin is suggested to make sure there is no reaction before fully incorporating it into your routine.8

Green tea (Polyphenols)

In addition to tea tree oil, another natural alternative for acne treatment may be green tea. The limited research on the potential of green tea to treat acne suggests that it works to decrease the amount of inflammatory lesions as well as reduce sebum production, which is one of the culprits behind the formation of acne.5 These effects are attributed to polyphenols, a class of anti-oxidant and anti-inflammatory compounds found in teas and other plants.5 The use of topical green tea is associated with short-term side effects, lasting for the first few days, that include stinging and itchiness.5

Hyaluronic acid

In cases where acne scarring is the primary concern, hyaluronic acid may be the best active ingredient to use.6 Although other forms of treatment – such as fractional CO2 laser therapy – can also be used in conjunction with hyaluronic acid, it has been shown to improve acne scars by hydrating the top layer of the skin’s epidermis known as the stratum corneum.6,9Hyaluronic acid can also improve skin texture and the appearance of wrinkles by restoring elasticity.6,9 By itself, hyaluronic acid is not generally associated with side effects, however if used with other active ingredients, it may enhance their penetration in the skin and contribute to irritation.9

So, what is the best face wash for acne?

When selecting the best face wash for acne, consider what your skin is experiencing. If you have open or closed comedones, then benzoyl peroxide may be right for you. If you have acne scars, then hyaluronic acid may be right for you. Ultimately, selecting a good cleanser with one of these active ingredients may be a good place to start if you want to start tackling your acne at home – speak with your dermatologist to determine which products might be best for you. 

Alongside finding yourself the best face wash for acne, completing your skin care routine with a gentle moisturizer and a broad spectrum sunscreen of at least SPF 30 may further help manage acne-prone skin.10

References:

1.        Hwee A, Heng S. Systematic review of the epidemiology of acne vulgaris. Sci Rep. 2020;10(5754). doi:10.1038/s41598-020-62715-3

2.        Hay RJ, Johns NE, Williams HC, et al. The global burden of skin disease in 2010: An analysis of the prevalence and impact of skin conditions. J Invest Dermatol. 2014;134(6):1527-1534. doi:10.1038/jid.2013.446

3.        Vos T, Flaxman A, Naghavi M. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2163-2196. doi:10.1016/S0140-6736(12)61729-2.Years

4.        Decker A, Graber EM. Over-the-counter acne treatments: A review. J Clin Aesthet Dermatol. 2012;5(5):32-40.

5.        Saric S, Notay M, Sivamani RK. Green tea and other tea polyphenols: Effects on sebum production and acne vulgaris. Antioxidants. 2017;6(1):1-16. doi:10.3390/antiox6010002

6.        Alsaedy SJ, Mosa KA, Alshami SH. The Efficacy of Topical Hyaluronic Acid Serum in Acne Scar Patients Treated with Fractional CO2 Laser. 2017;6(2):17-24. doi:10.5923/j.ajdv.20170602.01

7.        Ramli R, Malik AS, Hani AFM, Jamil A. Acne analysis, grading and computational assessment methods: An overview. Ski Res Technol. 2012;18(1):1-14. doi:10.1111/j.1600-0846.2011.00542.x

8.        Hammer KA. Treatment of acne with tea tree oil (melaleuca) products: A review of efficacy, tolerability and potential modes of action. Int J Antimicrob Agents. 2015;45(2):106-110. doi:10.1016/j.ijantimicag.2014.10.011

9.        Juncan AM, Moisă DG, Santini A, et al. Advantages of hyaluronic acid and its combination with other bioactive ingredients in cosmeceuticals. Molecules. 2021;26(15):1-43. doi:10.3390/molecules26154429

10.      Del Rosso JQ, Gold M, Rueda MJ, Brandt S, Winkelman WJ. Efficacy, safety, and subject satisfaction of a specified skin care regimen to cleanse, medicate, moisturize, and protect the skin of patients under treatment for acne vulgaris. J Clin Aesthet Dermatol. 2015;8(1):22-30.

Photo by Miriam Alonso from Pexels

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