5 Acne Sensitive Skin Products: Dermatologist Recommended Advanced Skincare Routine Techniques 

@drtwl.tv The Acne Sensitive Skin Paradox Acne and sensitive skin can co-exist. It is also especially problematic because acne prone skin tends to be associated with overproduction of sebum, yet we understand skin sensitivity as a problem with dry skin. While it seems paradoxical, such a phenomenon often described as oily-dehydrated skin—can be explained this way. Dry skin isn’t necessarily just dehydrated. We are referring to a disrupted skin barrier —which can occur in the presence of excess oil production. We delve into the science of this paradox in this week’s masterclass on acne skincare routines. Access this free tutorial created as part of the upcoming Skincare Formulation Series, a course created for advanced practitioners. Join Dr.TWL as she imparts her expertise in treating sensitive skin types with advanced skincare routine techniques. Learn to choose cosmeceutical products for non-prescription acne therapy. There are key considerations here which we will go through. I’ll also include a discussion on what to look out for in specific product formulations tailored to remedy such imbalances. Subsrcibe at www.twlskin.com for VIP access! #skincareroutine #skincareactives #skincareactives101 #skincareingredients #skincareingredient #singaporedoctor #dermatologist #singaporedoctors #skincare #dermatologist #tiktoksg🇸🇬 #skincareroutine #skincaretips #skincare101 #skincareproduct #dermdoctor #learningsfun #learnontiktok ♬ Epic Inspiration – DM Production

Acne and sensitive skin can co-exist. It is also especially problematic because acne prone skin tends to be associated with overproduction of sebum, yet we understand skin sensitivity as a problem with dry skin. While it seems paradoxical, such a phenomenon often described as oily-dehydrated skin—can be explained this way. Dry skin isn’t necessarily just dehydrated. We are referring to a disrupted skin barrier —which can occur in the presence of excess oil production. 

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The Acne Sensitive Skin Paradox

We delve into the science of this paradox in this week’s masterclass on acne skincare routines. Access this free tutorial created as part of the upcoming Skincare Formulation Series, a  course created for advanced practitioners. Join Dr.TWL as she imparts her expertise in treating sensitive skin types with advanced skincare routine techniques. Learn to choose cosmeceutical products for non-prescription acne therapy. 

Our in-house home acne treatment protocol option for hormonal acne designed by an accredited dermatologist now available via our pharmacy. Whatsapp us today.

There are 5 considerations here which we will go through. I’ll also include a discussion on what to look out for in specific product formulations tailored to remedy such imbalances.

1. Breakdown of lipid joints i.e. the “cement” in the brick-mortar model of sensitive skin 

The well known brick wall model of skin is used to describe a “leaky epidermis”, referring to skin barrier disruption underlying conditions such as eczema. The joints of the bricks are sealed by lipids, which is produced by healthy skin. While oil production tends to be beneficial for dry skin types, it does not necessarily translate into a healthy skin barrier. The key is a molecule known as ceramide, produced by the endoplasmic reticulum of healthy skin cells.

Genetics affect the quality and quantity of ceramide production. If you have a personal or family history of eczema, you may be at risk of developing both acne and sensitive skin. The surge in the male hormone testosterone at puberty leads to an increase in oil gland activity—this can compensate for skin dryness in many cases. However, if acne sensitive skin care products are used, this can trigger barrier disruption, which brings us to the next point.

Acne sensitive skin product recommendation tips: 

Do use a moisturiser even if you have oily skin. Choose a ceramide dominant formula instead of occlusives such as silicone or paraffin if you are acne prone—the latter can increase comedogenesis. 

2. Use of astringent skincare products 

Traditionally, acne was thought of as simply a condition due to excess oil production. This meant that early recommendations involved using astringent products such as harsh cleansers and toners that dehydrated skin. While the effects are quite instantaneous i.e. the shine does disappear, the problem is more complex than that.

The physical removal of grease does nothing to regulate underlying oil production. In fact, what dermatologists have observed is an increase in oil production—a phenomenon described as paradoxical reactive hyperseborrhea. The same problem arises when astringent toners containing salicylic acid, alcohols are used. 

Acne sensitive skin product recommendation tips: 

Ceramide moisturisers can be used at night if you are acne prone and live in a humid climate. In the day, a skincare layering method with hyaluronic acid serums and a lightweight moisturising emulsion can help to keep skin hydrated without triggering off acne flare ups. 

Instead of toners, choose facial mists with polyglutamic acid and botanicals that helps to boost the skin’s reserve of antioxidants. Research has shown that oxidative stress caused by excess oil production and environmental stressors worsens comedone formation. 

3. Inappropriate use of exfoliation methods to treat acne 

Another common misconception about acne sensitive skin care routines is that physical exfoliation helps to get rid of comedones. Pesky whiteheads and blackheads are merely a symptom of what’s going on in the deeper layers. Microcomedones begin forming at least 2 weeks before actual comedones surface—so the key is addressing the root cause of inflammation. Harsh exfoliation beads i.e. with sand/grit damage the skin barrier at the level of the epidermis, resulting in red, irritated skin. Superficial exfoliation methods are not able to address the process of microcomedone formation.

Acne sensitive skin product recommendation tips: 

Instead of abrasive beads, adopt the J-beauty method of water exfoliation. The water peels popularised by J-beauty brands are based on carbomers which form complexes when applied on skin. These complexes essentially “grab” dirt oil and dead skin cells and are rubbed off skin gently. The benefits of such an exfoliation method are that it automatically adjusts to each individual’s level of skin oiliness. This means that no excess oil will be stripped off skin.

Ditto for the skin cells—only the most superficial dead skin cells ready to be sloughed off will be removed. The ideal natural alternative to synthetic carbomers are polysaccharides present in algae, seaweed and plant material which have additional antioxidant and anti-inflammatory benefits. The resulting effect is a gently exfoliated epidermis, removal of dead skin cells and excess oil—factors that worsen the follicular plugging process in acne pathogenesis.

4. Poorly formulated chemical exfoliation products

Chemical exfoliation methods such as AHAs (glycolic acids) and BHAs (salicylic acids) are helpful as adjunct treatment of acne. Commonly performed in dermatologist’s offices, superficial chemical peels remove dead skin cells that contribute to retention hyperkeratosis. Retention hyperkeratosis refers to the increased deposition of retained keratinocytes, the top most layer of skin cells adhering to the epidermis. This occurs around the hair follicles, AKA the “pores”.

As a result, follicular plugging i.e. pore clogging occurs. Chemical exfoliation is preferred over traditional physical exfoliation methods in general because of its ability to dissolve superficial corneocytes selectively without breaching the protective epidermis. However, the duration of application and formulation of chemical peels matter. For instance, AHAs must be neutralised when used in concentrations of 20% and above—care must also be taken not to leave on the application beyond the prescribed application time. 

The challenge is when AHA and BHA containing products are used in home skincare. OTC skincare products are strictly regulated for its acid content, however, this does not always mean that users are reaction-free. Let me explain. Glycolic and salicylic acids do interact with skin immediately and also in the medium to long term. The latter is what is referred to as a cummulative effect. The types of adverse reactions have been described as irritant contact dermatitis and allergic contact dermatitis—the former is much more likely to occur with prolonged use in an acne sensitive skin care routine.

Acne sensitive skin product recommendation tips: 

Do choose enzyme peels based on papain or bromelain for home chemical peels. These perform the same functions of microscopic exfoliation, as do traditional AHA/BHA based chemical peels. Additionally, enzyme peels are well suited for sensitive skin types—these whole plant extracts possess anti-inflammatory and anti-microbial benefits while moisturising the skin. 

5. Disruption of the microbiome with certain acne medications

Prescription acne medications are required for moderate to severe forms of acne. These include topical and oral forms of retinoids that are really Vitamin A derivatives. Topical retinoid therapy is well-known for disrupting the skin barrier, a side effect due to its rather aggressive exfoliation of superficial skin cells. Oral isotretinoin therapy is reserved for the most severe and/or persistent forms of acne. It remains the most effective form of oral medication for acne as it completely stops sebum production. This however, is not without rather serious adverse events. Cheilitis is a severe form of lip eczema that can lead to bleeding, cracking and infections—it is also a well-known side effect of oral isotretinoin treatment. 

What is not spoken about often also is the ability of isotretinoin to disrupt the skin microbiome—the balance of good and bad bacteria on skin. Many of these bacteria are required to maintain healthy skin cell function, cell signaling i.e. cell talk processes that help to regulate sebum production, cell turnover and anti-microbial activity against bad bacteria. Acne sensitive skin conditions such as eczema have been linked to microbiome imbalances as well—microbiome dysbiosis perpetuates the inflammatory cycle that is responsible for persistent flare-ups. 

Acne sensitive skin product recommendation tips: 

Lactobacillus plus fruit extracts 

Rebalancing facial mists are preferred over toners because these are infused with botanical actives that help to encourage a healthy microbiome. The use of bacterial ferments such as lactobacillus plus fruit extracts are a fairly recent development in skincare formulations. These are highly beneficial for stabilising the skin ecosytem—addressing hydration, inflammation and microbial stability. 

Dr.TWL’s Tutorial Summary 

How to treat acne sensitive skin types

The traditional skin typing methods of oily/combination/dry skin does not address the more complex subtypes of oily-dehydrated skin. We have discussed how this arises from the interaction of certain astringent skincare products with acne prone skin. The best intervention would be in the form of carefully selected acne sensitive skin care products that have dual functions—addressing both issues simultaneously.

The Sensitive Skin Hormonal Acne Complex

Hormonal acne is one of the commonest dermatological conditions afflicting adults—one that is perhaps most distressing as well. While its regarded as treatable, the persistence throughout adulthood also means that a sustainable, long-term approach must be in place. Apart from dermatological care and prescription oral medications in the acute phase, acne sensitive skin care routines that target the various pathways we have described in this tutorial can play a critical role in long term maintenance and prevention.