When you first start reading deeply into treatments for acne, it’s easy to get lost in the jargon.
There are so many complicated-sounding chemical names that come with their own indications and contraindications. This one is good for exfoliating dead skin cells, the other is good for lightning scars, while yet another is good for clearing out blocked pores. Product A is best applied at night, while Product B can be used during the day if you put a certain level of SPF. They might come in the form of cleansers, day moisturizers, toners, night creams. With all this information, where do you even start?
We’re here to help you crack the code! We list four common acne-fighting ingredients used in skincare and explain how they help you skin overcome this condition.
Retinoids
Retinoids may be derived from Vitamin A, but instead of clearing vision, they do wonders for clearing the skin. You might recognize some of the biggest names in this group of chemicals: isotretinoin, tretinoin, adapalene, and tazarotene.
These may come in topical formulations in the form of gels, creams, and lotions of varying strengths, or oral formulations. Note that retinoids are not advised for pregnant or breast-feeding women because it may have effects on the child.
How it works
Remember that pimples, blackheads, whiteheads, acne scars, and hyperpigmentation all start from one thing: microcomedones a.k.a. clogged pores. Among the most common causes of blockage are dead skin cells. Ideally, these slough off naturally to allow the pores to breath. But in acne-prone skin, the natural sloughing off can’t keep up with the amount of dead skin cells being produced.
This is where retinoids come in. These chemicals slow down the rate at which skin cells proliferate, which also means they slow down the rate at which skin cells die. Preventing the pile up helps keep our pores open and our faces acne-free.
Retinoids also target an important process behind the making of a pimple: inflammation. Now, inflammation isn’t always bad. It is the way our bodies fight off infection, after all. It only becomes a problem when the body becomes so dead-set on eradicating the invader that it starts hurting itself in the process.
This overreaction is what retinoids control. When inflammation is regulated, the chances of a zit popping out is greatly reduced.
Benzoyl peroxide
Benzoyl peroxide is among the most important players in the acne-fighting cinematic universe. It is most effective when left on, so benzoyl peroxide lotions, creams, or gel formulations are more commonly prescribed than cleanser or body washes.
How it works
Benzoyl peroxide’s mechanism of action relies on its antibiotic and keratolytic properties. This lipophilic chemical is easily absorbed on the oily surface of the skin, and it breaks down into benzoyl radicals and benzoic acid.
Benzoyl radicals target bacteria associated with acne--well, not the bacteria itself, but the environment it needs to live. One of the reasons that bacteria thrive in clogged pores is because the environment is devoid of oxygen. Benzoyl radicals cause a process called oxidation, which in simple terms means it creates molecules of oxygen within the skin. The environment within the pore becomes unviable for the bacteria to live, and they die off.
Unlike other acne bacteria-targeting treatments, there have been no reports as of now of antibacterial resistance to benzoyl peroxide. This is likely because the chemical affects the environment of the bacteria rather than the bacteria itself. The only way acne-associated microorganisms survive is if they adapt to an aerobic environment.
Meanwhile, the benzoic acid component works on breaking apart keratin. Keratin is a major component of hair and skin, but when there’s too much of it, it acts like glue that keeps dead skin cells together. These keratin plugs are difficult to remove, and block the opening of the pore. By breaking it apart, benzoyl peroxide targets one mechanism of comedone formation.
Salicylic acid
As early as 4000BC, the bark of a willow tree was already used to treat a variety of illnesses. Today, we know that the long-known healing properties of this plant are rooted in scientific fact. Though aspirin is the most well-known chemical in the family of willow-derived salicylates, we’re here to talk about the acne-fighting salicylic acid.
Of all the ingredients used to treat acne, this is perhaps the most ubiquitous. It’s not just found in skincare, it’s found in cosmetics too. Many makeup products marketed as “acne-fighting” contain 2% salicyclic acid or less.
How it works
This active ingredient is most known for its effect against blackheads and whiteheads. These are considered mild forms of acne, but they still create textured skin and give the appearance of large pores. Salicylic acid concentrates in the pilosebaceous unit and dissolves the clogging oil and dead skin cells that make up these comedones. Once the congestion is cleared, a blackhead or a whitehead can no longer progress to a full-blown pimple.
Salicylic acid was once thought to be a keratolytic, but more recent research argues that it is a desmolytic substance. This means that it breaks down the junctions between cells, and not just the keratin in between them. Its exfoliating action is then able to remove a full layer of skin particularly when administered using a high concentration. Products with more than 2% salicylic acid usually require prescription and are used as peeling agents.
Niacinamide
Niacinamide or nicotinamide is a derivative of Vitamin B3 or niacin. Every single cell in your body needs this vitamin because it is part of an enzyme used for converting food to energy at the cellular level.
Topical niacinamide has been getting raves from scientific researchers and acne-prone users alike, and it’s easy to see why.
How it works
Niacinamide’s skin-clearing effect is in large part due to its ability to decrease sebum production, to create an even skin tone, and to strengthen the integrity of the skin barrier.
Niacinamide appears to downregulate the production of triglycerides, which make up a sizable portion of the sebum released by oil glands. Because less sebum is produced, it’s less likely for our pores to be clogged up.
This chemical substance creates an even skin tone by addressing hyperpigmentation. Niacinamide prevents the transfer of pigment-producing organelles from melanocytes to keratinocytes. This creates a visibly lighter, more even skin tone.
The importance of the skin barrier is not just important for protection against the elements, it’s also responsible for giving the appearance of healthy, supple skin. Niacinamide helps reinforce the skin’s integrity by stimulating synthesis of key structural components, particularly collagen and ceramides. The “anti-ageing benefits” of niacinamide are rooted in these processes.
Conclusion
Each skincare journey is different, but all of us want to get started on the right foot. And the only way to do that is to read up on each product’s active ingredients and see if there is proof that it can indeed walk the talk.
We’ve summarized the mechanisms of action of retinoids, benzoyl peroxide, salicylic acid and niacinamide here, but there are many, many more on the market today. Some are backed by scientific evidence, while others are not. Learning to make our skin care choices based on facts rather than fancy advertising helps us avoid headaches and wasting our money on things that don’t work.
Research helps you narrow down the list of products to choose from to those that are most likely to give results, but at the end of the day, finding out which among that shortlist is best for you is a matter of good old trial-and-error.
Many active ingredients may have worked for the proponents of various scientific studies done over the years, but trying them out on your own skin is the only way to know if it will work for you. As long as you know what it’s supposed to do and are aware of the ways to mitigate its side effects, you will be one step closer to finding the regimen that clears up your skin for good.
This content is for general information only and is not a substitute for medical advice.
Resources:
Leyden, J., Stein-Gold, L., & Weiss, J. (2017). Why Topical Retinoids Are Mainstay of Therapy for Acne. Dermatology and therapy, 7(3), 293–304. https://doi.org/10.1007/s13555-017-0185-2
Tucker, R., & Walton, S. (2007). The role of benzoyl peroxide in the management of acne vulgaris. The Pharmaceutical Journal, 279, 48-53.
Arif, Tasleem. (2015). Salicylic acid as a peeling agent: A comprehensive review. Clinical, Cosmetic and Investigational Dermatology. 8. 10.2147/CCID.S84765.
Matts, Paul & Oblong, John & Bissett, D.L.. (2002). A Review of the range of effects of niacinamide in human skin. Int Fed Soc Cosmet Chem Mag. 5. 285-289.
