5 Acne Routine Rules a Derm Is Begging You To Follow To Make Sure You’re Not Making Your Breakouts Worse

Photo: Stocksy / Olga Sibirskaya
Acne can be uncomfortable. If you've been struggling for a while, you may be tempted to go nuclear and try every single product you can get your hands on. But that can lead to more irritation and worsened acne in the long run, explains Marisa Garshick, MD, a board-certified dermatologist in New York City.

"While many of the active ingredients that we use and we recommend for treating acne are effective, they can also be drying or irritating or harsh on the skin," says Dr. Garshick. "If you use too many things, it can cause too much irritation to the skin and, as a result, lead to dryness, sensitivity, irritation of the skin."

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Not only can being too aggressive with your routine make an angry pimple even redder and more irritated, but it may also lead to more of its pesky friends popping up elsewhere on your face.  "Over-irritation can potentially backfire and cause more breakouts to occur because your skin can't really regulate its oil production," says Dr. Garshick. "Plus, skin is unable to effectively get rid of the breakout if it's already going through secondary irritation and inflammation."

To make sure you're not overdoing it and are on the path to clearer and calmer skin, Dr. Garshick says there are five acne routine rules you should always follow.

5 acne routine rules to stick to

1. Space out your active ingredients

The standard active ingredients for acne care are retinoids (which increase cell turnover, preventing buildup that can cause acne), salicylic acid (which exfoliates the skin and clears out gunk), and benzoyl peroxide (a topical antiseptic that targets acne-causing bacteria). For the most part, these aren't ingredients you want to layer.

"I usually recommend doing the retinoid in the evening and then either the salicylic acid or benzoyl peroxide product during the day," says Dr. Garshick. "Especially when starting an acne regimen, it's always best to space out your active ingredients." That's especially true with benzol peroxide with retinoids. "There are some prescriptions available that do combine these two ingredients and, in that case, where it's specifically formulated as such, it's generally thought to be okay, but typically it's not a great idea to apply the two at the same time," says Dr. Garshick. "It can cause some extra irritation and can potentially impact the efficacy of both of them."

If you're using a cleanser with active ingredients like salicylic acid or benzoyl peroxide, you can likely use it with a different leave-on active, just be careful as your skin adjusts to these formulas.

"Because cleansers aren't being left on, it's generally safe to use them in the same part of a routine [as other actives]," says Dr. Garhick. "So if you use your cleanser that contains benzoyl peroxide or salicylic acid, it is usually okay to put a retinoid on top of that. But my general preference for most people, especially when they're starting out, is to separate those—one in the morning, one at night. Then, once your skin has built up a tolerance and you feel like you need to use more, you may be able to get away with it."

2. Keep spot treatments and all-over treatments separate

The best, most effective acne treatment is prevention. But if you're dealing with active pimples, spot treatments can come to the rescue. These formulas are extra-potent so you don't want to mix them with your everyday acne-care routine.

"If you put on a salicylic acid spot treatment and then you put a retinoid on top of it, chances are that area may have a greater chance of becoming red, irritated, and potentially more noticeable than the breakout itself, so usually I say to just stick with one or the other," says Dr. Garshick. "If you're planning to spot treat for a few days, don't apply your normal [acne-fighting] face cream consecutively with that treatment."

If you feel like you need to keep both spot and all-over treatments in your routine, be sure to space them out the way you would your other actives—one in the morning, one at night.

3. Don't apply hydrocolloid patches over active ingredients

Hydrocolloid patches, also known as pimple patches, quash pimples by drawing out oil and gunk from whiteheads.

"Hydrocolloid patches, in general, are great and some actually have some salicylic acid or an active ingredient built into it," says Dr. Garshick. "The one thing to note, though, is that you don't necessarily want to apply it a patch if you have active ingredients on your skin. Because the patch is an adhesive, it's going to create some degree of occlusion on the skin. So if you have your retinoid below that and you're leaving your patch on for 12 hours or whatnot, you may increase the chances of irritation."

While Dr. Garshick is a fan of pimple patches, she recommends only ever applying them to clean skin without any other actives involved.

4. Take a break if you're seeing irritation

Though some acne-fighting ingredients are known to cause a bit of irritation, derms don't want you to simply endure any redness, stinging, burning, flaking, or dryness. "Those are all signs that you probably triggered some degree of irritation and it's worth modifying either your routine or the frequency of which you're doing it," says Dr. Garshick. If it's really bad, it can be helpful to take a break from your acne products.

"It's much better for your skin to give your skin a chance to repair, rather than just keep going at it," says Dr. Garshick. "The chance of your acne healing when it's red and irritated and inflamed is very low, so give your skin that chance and then resume the regimen."

5. Be patient

"Many of the ingredients are good, but not every person who's dealing with acne requires all of them," says Dr. Garshick. "When beginning an acne regimen or routine, I usually say it's best to start by incorporating one new ingredient at a time, seeing how your skin reacts, and then adding in others if necessary."

And remember: Even the most effective routine will take some time to work—there's no miracle treatment that will magically reduce breakouts overnight. "With acne, it can take two to three months for a lot of these treatments to really take effect and to really see a difference," says Dr. Garshick. "It's important to be patient and know that just because you're not seeing a result right away doesn't mean that that ingredient's not good for you. It may just be taking more time."

A dermatologist shares her best tips for managing adult acne:

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