Miami dermatologist Christopher O’Connell treats acne in middle schoolers all the way up to patients in their 70s. Here, his all-time best tips for obliterating breakouts once and for all.
1. The first step is figuring out what kind of acne you have. If it’s clogged pores, an over-the-counter salicylic acid lotion or cleanser should clear it. If you have angry red spots and inflammation, you need to use something stronger like benzoyl peroxide. (Don’t overdo it: Spot treating with big globs of product will dry you out. Blend a thin film over the affected area instead).
2. Follow a regimen. Over-the-counter regiments like Proactiv aren’t as strong as prescription treatments, but they give you a system, which is more than half the battle. Stay with any new program for 6-8 weeks; if you don’t see an improvement, then you can consider new regimens.
3. Make sure everything you put on or near your face is oil-free and non-comedogenic. I see a lot of patients who have acne from wearing heavy foundation or concealer. Hair conditioners and oils can exacerbate blemishes, too, so focus on the ends of your hair, never your scalp.
4. If you aren’t getting results, a trip to the dermatologist can save you time and money. People often think acne is just a cosmetic thing, but it’s actually a medical issue and your appointment and prescriptions may be covered by insurance. Plus, dermatologists have a lot more in their arsenal than benzoyl peroxide and salicylic acid. Prescription retinoids like Differin and Tazorac fight acne and aging. Topical antibiotics can bring down inflammation without drying out your skin. I’m also seeing great results from Aczone, a new medicated gel.
5. If you have hormonal acne (i.e., you tend to break out around your period), using birth control pills can really turn things around. So can spironolactone, a prescription drug that also helps control hormone levels. If your acne has a rosacea component with redness and sensitivity, ask your doctor about prescription treatments like Finacea or Metrogel.
6. If you have severe cystic acne, and antiobiotic pills and cortisone injections aren’t helping, a 6-8 week course of Accutane can really change your life. Cystic acne scars can last a lifetime. (Note from ed: Accutane clears acne like nothing else, but can cause severe birth defects if you take it while pregnant).
7. To clear up bacne, use a benzoyl peroxide body wash. I especially like BenzEFoam, a new short-contact therapy that’s available by prescription. The problem with benzoyl peroxide creams is that they bleach your clothes and sheets. This one not only has a high level of the medication, but also absorbs almost instantly—put it on two minutes before you get in the shower and let it rinse off. If that’s not enough, we also offer in-office laser treatments for face, chest and back. They’re more expensive and rarely covered by insurance, but again, they make a big difference.
Products that Dr. O’Connell likes:
*Dr. Brandt Blemishes No More line (he’s one of the derms in Dr. Brandt’s Miami practice)
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