Eczema and acne aren't usually skin conditions you see at the same time, but that doesn't mean it can't happen. Both are inflammatory conditions, and can seem at odds with each other because they present in very different ways. Eczema is symptomatic of dryness and usually shows up in flakey and sensitive patches of skin, while acne is associated with oily skin and represents a micro infection of the pores that causes irritated, puss-filled bumps.
"Although I wouldn't say it is common...I have definitely seen many patients with eczema and acne," says Heather Woolery-Lloyd, MD, a board-certified dermatologist in Miami. "And as women get older, it is quite common to have dry skin and acne."
- Heather Woolery-Lloyd, MD, Miami-based board-certified dermatologist
Because the two conditions are essentially at opposite ends of the treatment spectrum—eczema needs a whole lot of moisture, while mitigating acne requires getting rid of the oil in your skin—Dr. Woolery-Lloyd says there are a few things you should never do when dealing with both at the same time.
4 things a dermatologist would *never* do when treating eczema and acne
1) Use drying, irritating acne-treatments
Many acne treatments work by eliminating excess oil from the skin, which can be a problem when your skin is eczematous. Because eczema-prone skin is already dry, drying it out even further can make both your acne and eczema worse instead of better. With that in mind, Dr. Woolery-Lloyd suggests avoiding acne treatments that are excessively drying, like benzoyl peroxide and witch hazel, recommends opting for gentler ingredients instead.
To mitigate acne, she's a fan of using prescription-grade retinoids, which can be monitored by your dermatologist to ensure they aren't irritating your skin and causing eczema flare-ups. For an over-the-counter option, look for mild retinoids that are suited for sensitive skin, like adaplane gel (which you can find at your local drugstore). Be sure to introduce these products into your routine slowly, and if you experience any irritation, "decrease the use of them to every other day or even three times a week if needed to prevent unwanted side effects," she says.
While keeping your skin clean is necessary to manage acne, you don't want to overdo it. When you over-cleanse or over-exfoliate, you can disrupt the skin microbiome and experience more inflammation, something that triggers both acne and eczema.
"I emphasize the importance of gentle cleansers," says Dr. Woolery Lloyd. "I would avoid using mechanical brushes, scrubs, or exfoliating products on acne in eczema-prone skin."
If you want to use something with a slight exfoliating element, opt for a formula made with mandelic or lactic acid, which are known to be the gentlest alpha-hydroxy acids that can still effectively slough off dead skin via chemical exfoliation.
3) Skip out on moisturizer
When you have acne it's tempting to go light on the moisturizer to avoid adding on to the oil that's already on your face. But Dr. Woolery-Lloyd says that using adequate moisturizer is key to keeping the skin soothed. "I always emphasize the importance of a ceramide-based moisturizer when treating acne in dry acne-prone skin," she says. "One study suggested that ceramide-based moisturizers may improve the tolerability of retinoids." That's because ceramides fortify your skin barrier, which not only helps soothe and heal eczema, but also makes your skin strong enough to tolerate certain acne-fighting ingredients that are known to cause irritation.
4) Move too quickly
"Start slow with acne in eczema-prone skin," says Dr. Woolery-Lloyd. "It is better to start with one treatment product at a time than to start an aggressive regimen with multiple products and get irritated."
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