Does washing your face cause more spots?

In response to this misconception, many patients with spots attempt to aggressively cleanse their skin multiple times a day. However, an alternative hypothesis is increasingly being put forward, suggesting that over-washing the face could lead to more spots. It appears that the disruption of the skin's barrier function could be associated with a comedogenic mechanism. A study conducted with individuals suffering from mild acne showed that these patients had a disrupted horny layer and a lower content of sphingolipids, lipids playing a crucial role in the skin barrier, compared to individuals with healthy skin. No difference in the rate of sebum secretion was observed between the two groups, suggesting that a disruption of the skin's horny layer could be part of the pathophysiology leading to the formation of spots.

This hypothesis was further supported in another study where a reduction in lamellar granules in the upper part of hair follicles exhibiting comedones was observed compared to "normal" follicles. Lamellar granules play a crucial role in the release of ceramides, lipids necessary for the proper functioning of the skin barrier. A decrease in these granules leads to a reduction in ceramides in the horny layer and an alteration of the barrier function. Researchers have also linked this decrease to a hyperkeratosis of the skin, one of the factors contributing to the formation of spots. This theory is based on the idea that the skin responds to an alteration of the skin barrier by producing a thicker horny layer.

When carried out excessively, face washing can damage the skin's natural hydrolipidic film and lead to a weakening of its barrier function, which could promote the appearance of spots.

However, it is crucial to emphasise that this risk only exists if washing is too frequent or is done with harsh, detergent-based products. When performed gently and with suitable skincare products, skin cleansing is an effective way to limit the onset of blemishes. A recent clinical study conducted with acne patients has indeed shown that the daily use of a gentle cleanser, compared to a soap-based cleanser, resulted in a significantly lower number of comedones and inflammatory papules. The improvement observed with the gentle cleanser can be explained by the fact that soap interacts with the skin barrier and contributes to the pathogenesis of follicular hyperkeratinisation, and thus to the formation of spots.

Skin cleansing and spots: how often should you wash your face?

With this in mind, the following question arises: how often should one wash their face to prevent blemishes? While few scientists have addressed this issue, there is a clinical trial that has examined the effect of face washing frequency on 24 men suffering from mild to moderate acne. These volunteers were divided into three groups in which cleansing was to be performed once, twice or four times a day for six weeks. A slight but significant improvement in open comedones and non-inflammatory lesions was observed in the group that washed their face twice a day. The usual recommendation of cleansing acne-prone skin twice a day therefore seems to be slightly supported by this study. However, the small number of participants calls for these results to be interpreted with caution.