So today’s topic is all about treating acne. The red marks, PIE, and then the brown marks, PIH. The reason why this video really was necessary is, generally speaking, for Caucasian skin, their main issue would be, say, the acne and then some PIE as well, red marks. But with us, it’s just an ongoing pigmentation process that takes place afterwards. And often, the pigmentation is more frustrating and irritating than the actual acne itself, which tends to be quite short-lived.
So actually with us, we have to be a little bit more aggressive with treating our acne from a younger age. I’ve actually made a video on preteen skincare. So I would even encourage our children to be taking care of their skin from about nine, 10 years old. And that video is useful because that’s when their skin starts to become a bit oily, a bit congested. And they’re not really taking care of it at that point. So it really is up to the parents, so that’s us, to make sure we can try and get it as under control as possible at that point, just so that they’re in good habits for later. And then you don’t have as much PIH and brown spots taking place. Because what happens is that you just literally get a map of every spot that’s ever taken place. And sometimes it can take years to get rid of, and I just don’t want that for us. So I hope you find today helpful. If that sounds good to you, please give me a thumbs up. Let’s dive right in.
So, first of all, what is happening when you get acne? So the sebaceous glands that basically go into the pore are overproducing sebum. So too much sebum is then coming into the pore. Don’t forget, the pore lining is just the epidermis. And so the epidermis is also shedding cells. So now we have a delicious soup here that is sebum and cells. And guess who loves this delicious soup? It’s those bacteria called P. acnes. So a plug forms and an anaerobic environment takes place. You love my hand? That is the pore. An anaerobic environment takes place. And P. acnes loves anaerobic environment. So that’s an oxygenless environment.
They then replicate and they feed on sebum. They feed on sebum and they release free fatty acids. Free fatty acids are so irritating. So now, imagine you have a soup of very irritating fatty acids. And what do you think then happens? It causes inflammation, i.e. red marks, and then the inflammation triggers those melanocytes. And those melanocytes are like octopuses over here. And then they start to overproduce melanin, and they go into the skin cells around it. Those skin cells come to the surface and you see pigmentation. I’m now going to put my hand down because I look very strange. But hopefully that makes it really clear as to what is going on and the different stages at which we need to control the process so that we get the outcome that we want.
So there are a few risk factors for acne, as I’m sure you know. So hormonally speaking, puberty, pregnancy, or periods. So the three Ps tend to trigger acne. Also diet. So sugar and carbs can exacerbate acne. And stress. Stress, for me, has really, especially 2020, wow, I mean, I really feel like we all were walking around with just acne marks and this is the reason. Stress equals cortisol and cortisol increases your sebum production. So it’s just, that was also a vicious cycle. So these are really the key risk factors for triggering or exacerbating acne.
“So Dr. V, that was great. I understand all of that. Which actives do I need to use?” So let’s start off with the acne itself. The two fundamental ingredients you need to be using are salicylic acid and benzoyl peroxide. When it comes to salicylic acid, I want you to be using about 2% or less. It’s anti-inflammatory at this percentage. It is fat-soluble. So it goes into that… oh yeah, the claw is back… it goes into the pore and it clears out that, unclogs the pore. So that is key because we want to get oxygen into that pore so that those P. acnes can die. I’m allowed to say that. And so that’s really important. We’ve talked about salicylic acid a lot.
A couple other ones that I love, I love the 2% salicylic acid masque from The Ordinary. I love the 2% from Paula’s Choice. I like the 2% from Beminimalist for our family in India. But those are just some that you should be able to get hold of, at least one of those. All right, then is the benzoyl peroxide. So this is anti-bacterial. However, it is very irritating and drying. And I don’t want you to be in a situation where you now have dry, acne-prone skin, or you damage the barrier. And dry acne skin is a bit harder to treat. And you’re also causing further irritation. So we just don’t want that to happen. That’s why I’d like you to stick to 2.5% maximum.
And if, at any point, you’re feeling sensitivity or flaking, then please ease off. With that, is enough to wear it a couple of times a week. Listen to your own skin. Don’t overdo it. More is really not best here, is what I’m trying to get at. We want to be effective without irritating. And the number one thing for skin of color is irritation. So it’s almost like in the other way. We have to say, “What’s not going to irritate my skin and what’s also going to be effective for me.” So please just bear that in mind and just keep an eye on your skin and check to see if it’s flaking or if you get any sensitivity with the benzoyl peroxide.
So now moving on to the red marks, that’s the intermediary stage. Those two key fundamental ingredients I want you to be using on your skin, one is azelaic acid and the other one is niacinamide. Now azelaic acid is an anti-microbial, but it’s also an anti-inflammatory ingredient. However, it does take time for it to work. This is not something that you put on a couple of times and you see instant results. It’s not some exfoliator that gives you those sorts of results. It takes time. So it’s important to remember that. And the other one is, with niacinamide, is don’t forget that it also increases cell turnover. Now imagine that your skin is already prone to acne. If you increase the cell turnover too fast, you’re going to get purging. It’s almost that all the spots come to the surface at the same time, which I don’t want for you. It’s too much stress is unnecessary.
So please just start off with 5% niacinamide. I know so many products, majority of the products with niacinamide are 10% plus. I really don’t know why that phenomenon happened. I think it might’ve started from The Ordinary making 10%. And then we all jumped on the bandwagon with 10%. But what I’ve found from doing polls on my Instagram, we’ve got about 180,000 skin of color enthusiasts following us at The Hyperpigmentation Clinic on my Instagram account. And often, two to 3000 people will respond to the polls. And when I asked the question about niacinamide, a lot of you were purging at 10%. And so my recommendation has changed since that point. And I’d rather you started off at 5%. If you’re fine and you’re not purging, then I don’t mind you stepping up, but don’t jump straight to 10%, especially if you have oily, acne-prone skin.
Now, for the brown marks, there’s actually a whole list of ingredients that I want you to use. So starting off with your vitamin A, retinaldehyde is 20 times effective as retinol 0.5%. And so it’s also less irritating, which is what I prefer for you, especially with skin of color. You can add in 0.5% retinol with it, if you want, just because at 0.5% is not going to cause much sensitivity. I certainly wouldn’t jump up to 1% retinol.
So the next one is vitamin C. I’d like you to use a fat-soluble and water-soluble vitamin C. So tetrahexyldecyl ascorbate, my favorite vitamin C as you know, and your water-soluble. So something like sodium ascorbyl phosphate. It’s because these both mop up free radicals, prevent any more damage from taking place, but they’re also tyrosinase inhibitors. So they do two functions for your skin.
The next category is, of course, tyrosinase inhibitors, absolutely essential. The ones that I love are things like alpha arbutin, dioic acid, kojic acid, dipalmitate, which is less irritating than kojic acid, and licorice extract. Those are just some of the tyrosinase inhibitors that you should be using.
Then vitamin E would be your tocopherol acetate, which is an anti-inflammatory, which is also important when you’re dealing with inflamed skin. So I know I’ve just given you a whole host of actives, and you think, “Okay. Dr. V, how am I actually supposed to wear this? How do I do it? What is the step-by-step routine?” So let’s do that now.
So first things first, you want to wash your face. So a benzyl peroxide face wash is important. So this is Acnecide, and I don’t mind you wearing 5% of benzoyl peroxide as a face wash because you’re washing it off. I wouldn’t want you to leave that percentage on the skin, but it’s a great way to first of all kill any bacteria that’s on the surface of the skin. Next, move on to your 2% salicylic acid. So this is, for example, the one that I would wear. This is The Ordinary. Can you see it? Yeah, The Ordinary 2% masque that I would wear a couple of times in the week leading up to my period, because I know that I just need to get that sebum under control. If, however, this is the other one that I would wear, if I am going through the acne breakout and my skin is oily at the time, then I would even wear this BHA 2% during the day. So this is 2% salicylic acid from Paula’s choice, called Daily Pore-Refining Treatment.
As you know, I don’t tend to recommend exfoliating during the day. This is purely when you have to weigh up that my skin is oily, versus if I exfoliate, am I going to be leaving my skin vulnerable to the elements. Oily skin is going to have more of an impact, and that’s why I would weigh it up. And if your skin is feeling oily in the morning, then it’s important to use your bacterial… My words just not coming out. You know what I want to say… The acnecide or your benzyl peroxide wash, followed by your 2% salicylic acid.
Then to combat the red marks, you want your azelaic acid plus your niacinamide. I recommend you use one product. So either you can use this from Naturium, which is the azelaic acid 10%, which got niacinamide it. The other one I like is Porebright from facetheory. And again, it’s the two combined. When you have to use multiple actives in order to treat multiple problems, it’s not a good idea to be wearing single ingredients. Because honestly, by the time you get to your third or fourth layer of actives, there’s just no room for penetration anymore. So you want to use combined products that will give you maximum punch per layer.
Now moving on to the brown marks. So I’ve got something really exciting to announce. As you know, we do have, for example, the Dark Circles Kit and the Lip Pigmentation Kit. Again, these are tyrosinase-inhibiting kits. We will be launching the Face Pigmentation Kit, which comes out in February 2021. So it’s really exciting. And that will have all of the tyrosinase inhibitors I’ve discussed. It’s going to have your three types of vitamin A, your two types of vitamin C, fat-soluble and water-soluble, all of the tyrosinase inhibitors, and your vitamin E. It will have no fragrance, no alcohol, no essential oils. So literally everything in this kit, and the kit is a two-piece kit, is the HPx Clear and the Vita A.C.E. And you basically wear your HPx Clear for two nights, Vita A.C.E on the third night, and you just keep rotating. So that is specifically for the brown marks, but it also does contain your niacinamide too, so you don’t need to top up with that either.
I’m going to put the link in the description box for the Facial Pigmentation Kit. And as you know, those people will receive an email with a link to unlock the website one hour before the rest of the world. And so if you are interested in the Facial Pigmentation Kit, please do sign up below. The other thing you need to top up is with your moisturizer. Now, the one I love is facetheories, is this one. As you can see, it is well used. And it’s the one I literally use for that week in the run up to my period. So it’s a Supergel Moisturizer, oil-free. And what it does is it doesn’t clog the pores, but at the same time, it stops my skin feeling tight. As you know, when your skin feels tight, you start to overproduce sebum, and then you have acne breakouts. It’s literally a negative feedback cycle. It’s something I really want you to break and avoid.
I also know that when you’re going through an acne breakout, you are so nervous about every single thing you put on your skin, because you really feel like at any moment, you could tip the balance and have a massive acne breakout. Believe me, I feel that same pain every month, as I’m sure majority of the females in the world do too. However, you just need to ensure you create a healing environment for the skin. As soon as you damage the skin barrier, or you allow the skin to become dry and dehydrated, you’re preventing your skin from being able to renew itself and repair itself. So that’s why it’s so important to hydrate the skin.
It’s also really important to remember that when you are out during the day, your dark marks and blemishes are only going to be exacerbated if you’re not wearing sunblock. It’s really important you find a sunscreen that you love, ideally SPF 50. You know my favorite is always going to be zinc oxide because it’s anti-inflammatory on an inflamed skin or melasma-prone skin. I want you to be using anti-inflammatories. I really have struggled to find an invisible zinc oxide SPF 50. It basically, it just doesn’t exist.
So as you know, I have been working on our SPF 50, which is invisible. It’s zinc oxide 15% and SPF 50. So just to show you what it looks like, is it hasn’t released yet, but you’ve all been on the journey with me in terms of making the sunscreen. And so I just wanted to show you where we’re at. So basically, I want to create a completely invisible sunscreen that you can wear under your makeup and that no one is going to know that you’ve got sunscreen on. So this is great for skin of color. I wanted it to be invisible on all our skin, all different skin of color. I did actually start off with trying to formulate different colors, but then I realized I’m alienating all the men who are not going to wear almost like a colored foundation. But also, I’m not going to get everyone’s color completely perfect. The only way to create a universal SPF 50 that’s zinc oxide, a broad spectrum, a mineral sunscreen, is by making it invisible. And so that’s basically what I’ve done.
And what I’ll do is I’ll put the link in the description box below as well if you want to sign up for the sunscreen. We’re not going to release that for a few months, but I am going to release it to the people who have signed up, just because you deserve it. So please do follow me on Instagram @thehyperpigmentationclinic, @skincarebydrv. If you’ve got any questions, please write them down below. Thank you x