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by dr alek nikolic

introduction

Most people think that oily skin and acne skin are the same thing and that they go hand in hand. However oily skin is seen as a skin type while acne is seen as a skin concern. Furthermore, people who have an oily skin type may not necessarily have acne and similarly, people who suffer from acne may have a dry skin type.

what is oily skin?

An oily skin type is often genetically predetermined and is thought to be caused by hormonal levels in the body. An excess of a hormone called dihydrotestosterone (DHT) is the main culprit for oily skin. DHT is a breakdown product of testosterone and is responsible for triggering sebaceous glands to produce sebum. Higher than normal levels of this androgenic hormone or increased sensitivity of the glands to normal levels of DHT result in a visible shine or oily feel to one's skin.

Typically an oily skin type will notice the following:

  • Visible and enlarged pores
  • Your face is shiny usually within an hour or two after cleansing
  • Usually appears ‘greasy’ by midday
  • Your makeup doesn’t seem to stay on your face
  • The oilier areas of your face may have blackheads, white bumps, or acne

Oily skin can be extremely hard to control because it is the result of genetically determined hormonal changes in your body, and you simply cannot control hormones topically. However oily skin tends to age better and is less prone to developing wrinkles, fine lines, and a sallow complexion.

Oily skin can harm self-esteem as well as body image; a greasy-looking or bright shiny skin often outweigh other concerns. Oily skin is both uncomfortable and is considered by most oily skin sufferers as being aesthetically unacceptable.

Sebum or oil production is important for the health of our skin and hair, but an excessive amount leads to several skin changes:

  1. Excessive shine that gets worse as the day progresses
  2. Increased number of pores
  3. Increased size of pores
  4. Visible blackheads
  5. Predisposition to bacterial colonisation and acne lesions

If you are not sure if you have oily skin then use the following guidelines:

  • Your face is shiny only an hour or two after cleansing
  • Your makeup does not stay on the face through the day
  • You have visible blackheads or get constant acne flare-ups
  • You notice an increased number of new pores appearing
  • The pores are enlarged and visible on the face
  • When touching your face your fingers feel greasy or have a shine to them
  • If you blot a tissue paper on the skin before cleansing in the morning it comes away oily or greasy

other causes of oily skin

Before deciding on a specific skincare regime to minimise oily skin it is important to eliminate other causes that may be increasing your skin’s natural sebum production. This is predominantly caused by an impairment of the vital outer skin barrier that can be seen with:

  1. Excessive cleansing and using harsh granular scrubs as this will aggravate and increase oil production due to skin barrier disruption.
  2. Being overzealous or over applying your skincare regime.
  3. Using products that are too harsh for your skin.
  4. Using products that are incorrect for your skin type.

the skin barrier and sebum production

The skin barrier is the outermost layer of your skin's surface, and it consists of cells and lipids (fats). The best way to understand the skin barrier is to use the analogy of a brick wall developed by Dr Peter M. Elias who described the cells (corneocytes) as the bricks and the lipid bilayer as the mortar. Corneocytes are dried out, non-living skin cells that are ready to shed. However, the mortar which is the stacked lipid bilayers that surround the corneocytes is responsible to act as a barrier that is highly impermeable to prevent the loss of water out of the skin and to prevent the entrance of harmful microorganisms or irritants.

The skin barrier plays a vital role in maintaining the outer skin mantle, sebum production and keeping water within the corneocytes. This retention of water allows them to swell up which in turn prevents the formation of gaps between these cells. Any changes in the skin barrier function or gaps between the corneocytes are the primary reason for all dry skin conditions, including dehydrated skin and dry skin types.

On the other hand, the skin barrier also controls the natural skin pH and the amount of sebum production. Any disruption can result in an over-response in the production of sebum resulting in oily skin with an increased inflammatory skin response and a predisposition to bacterial accumulation.

the recommended regime for oily skin

The skincare regime for oily skin is the same as for any other skin type, consisting of a cleanser, serum, moisturiser and sun protection.

cleansers:

Use a gentle, water-soluble cleanser twice daily and only twice daily even if it is tempting to wash more often. Everyone with oily skin should see cleansing and exfoliation as the same thing. We should not consider or use harsh granular scrubs or brushes and rather use chemical ingredients that do the job more effectively and more safely with specific skin benefits.

Using a good chemical exfoliator is a vital step in your skincare regime as using the correct exfoliating agents will provide several benefits:

  • Removal of dead skin cells
  • Reduce build-up of dirt and bacteria in pores
  • Removes oil and sebum effectively

The best exfoliating ingredient for oily skin is salicylic acid (BHA) as it can work in the pore itself (not just on the surface of the skin) delaying the blockage of pores and reducing the amount of sebum and oil produced. Salicylic acid has also been shown to provide anti-inflammatory effects so this will also help with skin irritation and a reduction of oil production.

A great add on after cleansing is to use a salicylic acid-based toner or solution to further enhance the deep pore removal of sebum, dirt and bacteria. An excellent choice is sk.in pure.

moisturisers:

One should only use moisturisers that are indicated for oily skin and we should choose a lightweight liquid, gel, or serum that contains ingredients that are non-comedogenic and that are not greasy or oily. One may even consider not moisturising in the morning and only applying at night. A great moisturising serum for oily and/or acne skin is sk.in marvel as it contains hydrating ingredients like hyaluronic acid and skin barrier repair ingredients that are non-comedogenic.

serums:

My two go-to ingredients for any skin type including oily skin, are vitamin C and vitamin A. Vitamin C is a great antioxidant that will help repair and maintain the skin barrier which in turn controls sebum production. Vitamin A or retinol will help to reduce pore size, improve texture, and reduce sebum production which are all great benefits for an oily skin type.

Vitamin C serum: sk.in gloss

Vitamin A serum: sk.in flash 1, sk.in flash 2, or sk.in flash 3.

sun protection:

Sunscreen is a vital step in one’s skincare regime. Here once again my recommendation is to only use sunscreens that are specifically indicated for oily and acne-prone skin and that they should contain zinc oxide and/or titanium dioxide as these ingredients tend to reflect harmful UV light preventing skin ageing and reducing inflammatory skin effects which will lead to an improved skin health and skin barrier function which ultimately leads to less sebum production.

acne skin

To this day we are still not 100% sure what is the exact cause of acne. It is thought that acne is a skin condition that occurs when your hair follicles become plugged or blocked with oil and dead skin cells. This blockage allows bacteria to collect and infect the hair follicle opening. Furthermore, acne may be related to hormonal changes and these types of changes are typically seen with teenagers and with adults.

Acne is most common among teenagers, with a reported prevalence of 70% to 87% but acne is increasing among younger children and even with adults. Studies have shown that up to 50% of all adults will suffer from acne at least once and that up to 25% of all adults are affected by chronic adult acne.

Acne can cause emotional distress and, depending on its severity, can over pigment the skin, known as post-inflammatory hyperpigmentation, and even scar the skin.

Acne scars range in size and depth and tend to affect up to 30% of all moderate to severe acne sufferers. They are classified according to their depth and shape:

  1. Ice-pick scars: these tend to be fairly deep in the skin and appear quite narrow or pitted.
  2. Rolling scars: these scars are wider than ice-pick scars and have a slanted or inclined edge.
  3. Boxcar scars: these are similar to rolling scars but have very well-defined borders.

Acne can also appear in many forms:

  • Whiteheads: these are closed pores with the sebum trapped inside.
  • Blackheads: these are open pores and the sebum turns brown when it becomes oxidised or exposed to air.
  • Papules: these are characterised by small red tender bumps on the skin.
  • Pustules: often referred to as pimples and this is caused when a papule has pus trapped in its head.
  • Nodules: these are characterised by larger solid lumps that tend to be painful and are typically below the skin surface.
  • Cystic lesions: these are nodules that have become pus-filled and are almost always painful or tender.

managing acne

The treatment and management of acne are dependent on the severity.

The severity of acne is often categorised as:

  • Mild: mostly whiteheads and blackheads, with a few papules and pustules.
  • Moderate: more widespread whiteheads and blackheads, with many papules and pustules.
  • Severe: a large number of painful papules, pustules, nodules and cysts.

Mild acne can be managed with a good topical skincare regime. While moderate and severe acne may need medical intervention including hormonal control, antibiotics and oral vitamin A medication. If you are suffering from moderate to severe acne it is a good idea to see your family doctor or dermatologist.

A good topical skincare regime should be used irrespective of the severity of the acne, but it is important to note that some active ingredients may be contraindicated with certain medical treatments such as oral vitamin A medication or Roaccutane. Roaccutane can dry out your skin so salicylic acid can further irritate and inflame the skin. It is contraindicated to use topical retinol when on oral Roaccutane.

My go-to ingredients for managing acne topically are salicylic acid, hyaluronic acid, and retinol.

sk.in pure contains salicylic acid 2% and several other ingredients that will help control acne and reduce further breakouts such as hyalasome hyaluronic acid 2%, niacinamide 4%, zinc PCA, and papaya & pineapple extract. The ingredients in sk.in pure and their effects are discussed below:

Salicylic acid is an ingredient that has numerous functions on the skin and as a result, can address both acne and ageing skin concerns. One of its main functions is to exfoliate dead skin which has multiple benefits including the stimulation of underlying cells to produce more collagen and elastin. Furthermore, salicylic acid can penetrate deep into pores, cleaning all sebum and dirt that has accumulated through the day, which will help to prepare the skin for your night-time regime and help minimise both blackheads and whiteheads. Salicylic acid also has soothing properties, improves skin texture and can even increase hydration levels of the skin.

Sodium hyaluronate cross-polymer is a chemically cross-linked hyaluronic acid derived from a non-animal source. It possesses an exceptionally high water-binding capacity resulting in excellent moisturizing abilities. It is also a scavenger of damaging free radicals, binds tightly to water molecules and delivers this water to the skin over time.

Niacinamide improves the skin's elasticity, dramatically enhances its barrier function, helps to reduce pigmented discolourations, and revives the skin's healthy tone and texture.

Zinc PCA has further benefits in managing bacterial count and improving acne lesions.

Papaya extract contains the enzyme bromelain, which can break down the connecting layers between dead skin cells and has antioxidant and skin-soothing properties.

Pineapple extract is the source of the enzyme papain, which has exfoliating properties.

When it comes to retinol my preference is granactive retinol or hydroxypinacolone retinoate (HPR) which can be found in sk.in flash and sk.in avenge HPR.

One of the major advantages of HPR, over retinol and other vitamin A derivatives used in active ingredient cosmeceuticals, is that it does not need any conversion to retinoic acid. Furthermore, once applied to the skin it can bind directly to the receptors allowing a cascade of events to take place which produce the anti-ageing effects, reduction in pigmentation marks and blemishes, improving the appearance of fine lines and wrinkles, reducing sebum production, minimising pores and improving skin texture. Furthermore, increased hydration and an improvement in the glow of the skin can also be expected.

There are several other added benefits in using sk.in flash :

  1. We provide 3 different strengths to allow your skin to slowly acclimatise to the Granactive retinol (hydroxypinacolone retinoate). This dramatically reduces the chances of unwanted skin reactions.
  2. Vitamin C (ascorbyl tetraisopalmitate) and Vitamin E act synergistically as antioxidants and reduce the damage caused by environmental free radicals.
  3. Our lipid-soluble vitamin C, ascorbyl tetraisopalmitate, will also target and help to reduce hyperpigmentation including post-inflammatory hyperpigmentation that can be seen with acne blemishes, improve skin glow, stimulate collagen, improve skin elasticity, reduce rough skin texture, and prevent trans epidermal water loss.
  4. Contains ceramides that repair and maintain the all-important skin barrier.
  5. Contains hyaluronic acid complex that increases skin hydration, plumps skin and repairs and maintains the skin barrier. The HA complex contains a mixture of low, medium, and high molecular weight HA that allows penetration to different depths of the skin.

Both the sk.in pure and sk.in flash can be found in a convenient value pack: sk.in blemish | acne treatment pack.

9 steps to help manage acne:

  1. Use oil-free products: Make sure that your moisturizers, SPF, makeup or any topical products you may be using are oil-free.
  2. Do not pop, squeeze or pick at acne as this can make the blemishes worse by spreading inflammation which can lead to further breakouts and post-inflammatory hyperpigmentation. Removing nodules or cystic lesions is rarely necessary; however, when comedone removal is needed, it should be performed by an experienced healthcare professional.
  3. Gently wash your face twice a day with a mild cleanser and pat dry. Acne is not caused by poor hygiene, and vigorous washing and scrubbing will not clear your skin. Over-cleansing, scrubbing, exfoliating, and using hard brushes or granules will inflame your skin barrier and make the acne worse.
  4. Use products that specifically do not clog your pores. These are called non-comedogenic. Make-up, sunscreen, hair products and toiletries that are not likely to cause or aggravate acne, state on the label that they are non-comedogenic.
  5. Avoid oily hair: If you have oily hair, keep it off your face and wash it daily.
  6. No oily hair products: Avoid using hair products that contain oil, such as pomades and gels.
  7. Sporting equipment: Wear cotton clothing or moleskin under sporting equipment to avoid skin-to-equipment contact.
  8. Keep out of the sun: Avoid excess exposure to sunlight, and do not use tanning booths or sun lamps. Contrary to popular belief, tanning does not clear acne; it simply masks acne. Furthermore, sun tanning will increase the risk of post-inflammatory hyperpigmentation. Some acne treatments can increase the skin’s sensitivity to sunlight and ultraviolet light from tanning booths and sun lamps. If you have acne, it is important to protect your skin by following sun-protection practices, such as wearing sunscreen and avoiding sunburn.
  9. Use the products recommended by your dermatologist, medical aesthetic doctor or skincare therapist: Using products that are specifically indicated for the treatment of acne will require time to start having an effect - a topical regime may take up to 8 weeks before an improvement is seen.

I hope that the above article has given you insight when it comes to oily and acne-prone skin and most importantly how to manage an oily skin type and an acne skin concern.

Dr Alek Nikolic

  1. Skin Pharmacology and Physiology, Review, Oily Skin: An Overview, Sakuma T.H. Maibach H.I., 2012.
  2. Influence of the sebaceous gland density on the stratum corneum lipidome. Matteo Ludovici, Nina Kozul, Stefano Materazzi, Roberta Risoluti, Mauro Picardo & Emanuela Camera, 31 July 2018.
  3. 2009 Mar-Apr; 1(2): 72–76. Epidermal surface lipids.
  4. Skin barrier and microbiome in acne. M. A. Rocha & E. Bagatin. Archives of Dermatological Research volume 310, pages181–185(2018).
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