Breakouts happen for a lot of reasons . Find your trigger (stress, sweating, hormones or sun), then get on the right program (finally!) to see your spots go!
When You're Stressed
You're freaking out, and wham! A zit appears. Coincidence? Hardly! As tension builds, so do levels of cortisol, triggering oil production and inflammation, creating an environment that spurs the growth of P. acnes, the bacterium responsible for pimples, explains Amy Wechsler, M.D., a dermatologist in New York City. Here's how to get back in the clear.
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Do less. Panicking about breakouts makes you overtreat your skin, which can cause more problems, Dr. Wechsler says. It's hard to hold back, but keep things simple: Wash twice daily with a mild foaming cleanser that includes salicylic acid. This classic zit buster (found in Bioré Blemish Fighting Ice Cleanser, $7) is especially good at cutting through greasy gook that collects in pores. Follow with a spot treatment or mask containing the bacteria-killing ingredient benzoyl peroxide or sulfur, which works similarly and is gentler for sensitive skin. "The salicylic acid clears a path, so the product that comes next can penetrate better," Dr. Wechsler says.
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When You're Stressed
Flex your willpower! Overdoing it on alcohol and having a smoke are not doing your skin any favors. In fact, a study published in the International Journal of Dermatology confirms that these less than stellar habits exacerbate acne conditions. Although 82 percent of study subjects rated stress as a top factor, a hefty 50 percent in the study also listed booze and smoking as a main pimple precursor.
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When You're Stressed
See a skin doc. Logically, chronic stress leads to chronic acne. If you can't break the cycle, a dermatologist can. A typical game plan includes an Rx retinoid gel or cream (such as Differin), which exfoliates and clears pores faster than over-the-counter options. Antibiotics are another possibility. In pill or topical form, they reduce troublesome P. acnes bacteria; your M.D. will typically prescribe one for one to three months to "reset" skin.
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Afterward, your derm may suggest that you use prescription retinoids solely or that over-the-counter products are all you need. For chronic acne, your doctor might prescribe isotretinoin, a heavy-duty retinoid pill, for up to six months. It shrinks oil glands, curing about 70 percent of patients.
When You Work Out a Lot
Exercise-induced acne is its own special breed. It flares on the forehead, jawline, neck, chest and back, all areas where sweat lingers. "These pimples are itchy and a brighter red than normal zits," explains Cynthia Bailey, M.D., a dermatologist in Sebastopol, California. Sadly, most acne products don't help. Yeast, a normal skin microorganism that proliferates in damp conditions, is the culprit, not bacteria. The fixes:
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First, rule out heat rash. Excessive perspiration can clog sweat glands, causing red bumps, often between the breasts and middle to lower back. Heat rash typically fades after you stop sweating. Yeast zits can last weeks.
Don't be cheap. Spend the extra few bucks on sweat-wicking workout clothes that dry quickly. "Wet fabrics can trap moisture against skin and encourage yeast growth in pores," Dr. Bailey says. You'll feel cooler, too.
When You Work Out a Lot
Clean up at the gym. For anyone prone to workout-linked breakouts, letting sweat sit on skin for even 20 minutes can give rise (literally!) to the condition, Dr. Bailey says. An immediate shower is your best defense. Skip the gym's plain liquid soap and instead tote your own salicylic acid–laced wash (such as Murad Acne Body Wash, $40); it helps clear yeast from pores. If you don't like the shower at your local locker room, hit your own as soon as possible to keep yeast at bay.
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When You Work Out a Lot
Use special suds at home. You'll need a medicated soap that contains 2 percent pyrithione zinc to zap the yeast, Dr. Bailey says. Find it in special bar soaps sold at pharmacies or in DermaDoctor Born to Be Mild Medicated Face & Body Cleanser, $24. For the best results, allow the lather to sit on affected skin for several minutes before rinsing, Dr. Bailey recommends. Once skin is thoroughly dry, swipe breakouts with a salicylic acid wipe, like Philosophy Clear Days Ahead pads, $39; the pads also have alpha hydroxy acids to fade discoloration from past acne scars.
When You Have PMS
Got a pattern of preperiod breakouts? Your acne is likely fueled by hormonal shifts that occur in the days after ovulation, when oil levels surge, leaving pores vulnerable to clogs. Besides basic steps (cleanse morning and night; use spot treatments), these will help make your midcycle ride less bumpy.
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Book a facial. If you time it right, a visit to the facialist might help you love your skin all month long. A report published in the International Journal of Cosmetic Science found that when subjects with acne had midcycle comedone extractions, they had fewer premenstrual pimples. The theory: Extractions that precede monthly oil spikes can stave off clogging later in the cycle.
When You Have PMS
But avoid DIY squeezing. Yes, it's incredibly tempting. Thing is, in the hands of a rookie (i.e., you), overzealous squeezing can force bacteria through pore walls into surrounding skin, causing nasty inflammation that makes breakouts last even longer. Better to treat skin with good old benzoyl peroxide. Why it's a must: As BP kills bacteria, it also reduces inflammation in skin. Nix both issuesand bumps will fade quickly.
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"Benzoyl peroxide is the only ingredient that has ever been shown to make a pimple go away faster after it's applied," explains Jeffrey S. Dover, M.D., associate clinical professor of dermatology at the Yale School of Medicine. Find it in RX Skin Therapy Clarifying Facial Masque, $40, a double-duty skin helper. You can apply it all over the face as a mask or use it as a spot treatment only.
When You Have PMS
Try a pill. If other options haven't worked, your dermatologist may suggest medication. Oral contraceptives are one possibility. Some help minimize monthly breakouts by evening out hormonal flip-flops. Less well-known is a prescription pill called spironolactone, a diuretic drug used off-label to treat acne; it blocks androgens, the hormones responsible for increased oil production.
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It's sometimes paired with the Pill or used solo. (Your doc will decide.) PMS flares respond well to this drug, says Whitney Bowe, M.D., clinical instructor at the Mount Sinai School of Medicine. Get ready to glow!
When You're at the Beach
Hot weather, humidity and sweat are the holy trinity of pore cloggers—and you'll run into them anywhere you roam this summer. If you've linked rogue breakouts with days spent at the beach, sunscreen may be pushing your skin over the edge. Here's the lowdown on what works.
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Protect with less. When you shop for a sunscreen, buy one labeled noncomedogenic. "It's the simplest way to avoid the fragrances and thick consistencies that irritate and clog pores," says Meghan O'Brien, M.D., a dermatologist in NYC. Strengthwise, aim for at least SPF 30.
When You're at the Beach
Choose mineral sunscreens. If you have sensitive skin, you need to go a step further by choosing mineral sunscreens that list only zinc oxide or titanium dioxide (or both) as an active ingredient. They're less likely to cause irritation than chemical sunscreens (like oxybenzone) are. The trade-off: The minerals can look white and masklike. If it's labeled micronized, that's a clue the formula will go on sheer. Test it on the back of your hand before committing to a faceful.
When You're at the Beach
Get some bubbly. Wash up as soon as possible apres-beach. (If there's a public shower, use it.) Because water alone won't remove sunscreen, you'll want to cart around an acne-fighting wash such as St. Ives Naturally Clear Green Tea Body Wash, $6, in your beach bag.
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If lathering up in public isn't your thing, premoistened skin-cleaning wipes are a good second choice, says Jessica Wu, M.D., a dermatologist in Los Angeles. But they don't clean as deeply as real washing does, so you should still shower when you get home.
When You're at the Beach
Spread on resveratrol. Early research suggests that this common antiaging ingredient may do more than previously thought. Acne subjects who applied a topical gel loaded with resveratrol (the antioxidant found in red grapes) to the right side of their face daily for two months saw pimple numbers plummet, compared with the placebo-dosed left side, according to a study conducted at the University of Naples Federico II.
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