The exfoliation of acne-prone skin.

Acne vulgaris is the most prevalent skin condition worldwide.

According to recent estimates, acne affects nearly 650 million teenagers and adults worldwide.

It emerges during adolescence due to hormonal fluctuations and can persist into adulthood or appear later in life. Acne is often accompanied by complications, such as scarring and post-inflammatory hyperpigmentation (PIH). A 2016 study also suggests that acne contributes to psychological and emotional distress.

If you have acne, you've likely been overwhelmed by the plethora of skincare options available on the market. From textured scrubs to chemical peels, exfoliants are essential skincare products. But how should one exfoliate their skin when they have acne?

Short answer: Yes.

Some exfoliants can assist in reducing the appearance of acne and fading acne scars. However, it is crucial to select a product that is both gentle and effective for your acne-prone skin.

Physical exfoliants, also known as mechanical scrubs, require manual rubbing, which can irritate skin already inflamed by acne. Therefore, they should be avoided in the case of acne.

Chemical exfoliants, also known as peels, utilise acids and enzymes to rejuvenate your skin and enhance its texture and appearance. Some chemical exfoliants are specifically formulated to be non-irritating and gentle enough for acne-prone skin.

Effective chemical exfoliants contain certain acids that help to remove dead cells, unclog pores, and improve skin texture.

• Retinoids

  Retinoids encompass vitamin A, its metabolites and its derivatives (both natural and synthetic). The retinol, the retinoic acid and the retinal are the three available forms of vitamin A. When applied to the skin, these compounds promote the extraction of comedones and soothe inflammation. They also stimulate skin cell renewal and directly act on blackheads and microcysts. They combat bacteria accumulated at the level of spots, such as P. Acnes.

• Alpha-hydroxy acids (AHA)

  These water-soluble acids exfoliate the surface of your skin. They are known to enhance the texture, elasticity, and density of your skin. Several of them exist in skincare products. Theglycolic acid, derived from sugar cane, is renowned for its exfoliating power on the upper layers of the epidermis, as well as for its astringent and unclogging virtues. It also has a moisturising power due to its stimulating effect on cell renewal and the synthesis of hyaluronic acid. The lactic acid is obtained by fermenting milk and certain fruits. In addition to its keratolytic properties, researchers have shown that it improves skin hydration. Due to its larger molecular weight than glycolic acid, it penetrates less deeply and is less irritating than glycolic acid.

• Beta-hydroxy acids (BHA)

  In comparison to A.H.A., B.H.A.act on the surface of the skin and within the pores. In skincare, the main B.H.A. used is salicylic acid, a fat-soluble acid. This active ingredient, originally extracted from willow bark, has interesting properties for the care of oily skin prone to imperfections. Thanks to its antiseptic action, it prevents the growth and proliferation of fungi, viruses, and bacteria, such as Cutibacterium acnes, a microorganism responsible for the inflammatory reactions of acne.

• Polyhydroxy Acids (PHA)

  They function like AHAs, but they pose fewer risks of side effects, such as irritation and tingling. As they are larger molecules, PHAs do not penetrate as deeply, and they are gentler on sensitive skin. They also have moisturising and antioxidant properties. The three main P.H.A.s used in cosmetics are the gluconolactone, an antioxidant that effectively combats inflammation; the galactose, which stimulates collagen production and the lactobionic acid known for its moisturising properties.

Please note, in cases of severe acne, consider consulting a dermatologist for treatment and prescription products rather than immediately turning to over-the-counter products.

The best acids for acne-prone skin are BHAs, as their sebum-regulating properties target the formation of comedones and prevent the pore blockages that cause blackheads. BHAs are also anti-inflammatory. Indeed, the salicylic acid plays a role in the arachidonic acid cascade and inhibits the synthesis of prostaglandins E2, molecules responsible for inflammatory and painful effects. In the treatment of acne, it thus soothes painful spots and visibly reduces redness.

• SMITH W. P. Epidermal and dermal effects of topical lactic acid. Journal of the American Academy of Dermatology (1996).

• HEARING V. J. & al. Applications of Hydroxy Acids: Classification, Mechanisms, and Photoactivity. Clinical Cosmetic and Investigational Dermatology (2010).

• ARIF T.Salicylic Acid as a Peeling Agent: A Comprehensive Review.Clinical, Cosmetic and Investigational Dermatology(2015).

• ROTSZTEJN H. & al. Lactic and lactobionic acids as typical moisturising compounds. International Journal of Dermatology (2019).

• Abad-Casintahan F, et al. Frequency and characteristics of post-inflammatory hyperpigmentation related to acne. (2016).

• Hazarika N. The psychosocial impact of acne vulgaris. (2016).