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We need to have an honest conversation about spot treatment for acne. For starters, many of us have the concept of both spot treating and acne misconstrued. This leads to us using the wrong kind of products to spot treat and making acne worse in the long run. This post should serve as a helpful guide for accurately spot treating your skin—and which skin conditions best benefit from spot treatments (hint: it actually isn’t acne).

What is a Spot Treatment?

Before we can get into the correct way to use spot treatments in your skin care routine, we first have to talk about what it is. A spot treatment is a hyper-targeted approach to blemishes in which a skin care product/medication (“treatment”) is applied ONLY to the blemish-affected area. Spot treatments generally work best on small, superficial blemishes—think tiny pimples or fresh scars—but aren’t that effective on cystic breakouts or deep hyperpigmentation. More on this later.

How Would I Use a Spot Treatment for Acne?

Well, you can’t really use a spot treatment for acne but you can use it for the occasional breakout. Spot treatments work exceptionally well for that use case. Because not all breakouts are the result of acne. If you’re the type of person that gets pimples sporadically (maybe once or twice every few months) then you’re the type of person that may best benefit from using spot treatments. Spot treatments also work well for stubborn hyperpigmentation. You’d apply the spot treatment in the same way for both use cases.

I generally instruct all of my clients to use q-tips when using most spot treatments because it allows for precise targeting of the blemish and is easier to control than trying to use a pinky finger. You’ll want to dispense the spot treatment onto a q-tip and then apply over the blemish either by pressing or massaging into the skin. The best spot treatments for breakouts tend to be more on the heavy cream or gel side in texture so an even, thick layer of application will do the trick. My favorite spot treatment is Face Reality’s Sulfur Spot Treatment. Spot treatments for hyperpigmentation work slightly differently. I’ll do a different post on that later.

For breakouts, a spot treatment shouldn’t be needed for more than a week. If you’re approaching the end of a week of use and you’ve not seen any improvement in the breakout, well… that’s a good sign that you have more than a superficial breakout and should probably keep reading this post.

Why Can’t I Use a Spot Treatment for Acne?

If you’re a client of mine or a reader of this blog then you know that acne is a chronic skin condition. This means that retention hyperkeratosis is always happening wherever your folllicles are active and that your breakouts seem constant. A spot treatment just does not work in this condition. Not even as a temporary fix. If you’re lucky, you may calm a breakout in one very specific targeted area, but you’re doing nothing for the other areas of your face that are on the verge of breaking out. For acneic skin, any treatment should be applied to the entire face to be most effective at curtailing breakouts.

As mentioned in the beginning of this post, spot treating also doesn’t work well for cystic acne or nodules. The treatment usually can’t penetrate deep enough to effectively treat the breakout at the source. So while you may alleviate some of the symptoms of breaking out—like redness and swelling that appears on the surface—more c. acnes bacteria could be forming just below it, keeping you in a repeated cycle.

So What Do I Use Instead?

You have quite a few options, actually.

The standard for treating acne is benzoyl peroxide. The trick to making BPO work is in the application as it takes some time for skin to get properly acclimated. I typically have my clients start out using BPO via a face wash as it has limited contact time. And they will typically use it every other night for one month before moving on to use it every night. My current go-to BPO wash is The Humane Company’s Acne Wash 10%. It’s the only 10% BPO I have ever recommended and probably the only one I ever will. Since re-opening in March, most of my clients utilizing this cleanser as directed have seen a vast improvement in the appearance and reoccurrence of their acne lesions.

Other ways to use benzoyl peroxide include gels, creams, lotions, and—yes—even the occasional spot treatment. Reach out to a licensed esthetician to learn more about how you can incorporate BPO into your skin care routine the correct way.

An alternative to BPO (because not everyone’s skin can tolerate it) would be sulfur and sulfur masks are a great way to incorporate this ingredient in your routine. Sulfur is a great keratolytic that helps exfoliate the pore but excess use of it can be very drying. Setting a sulfur mask on the skin for up to 30 minutes anywhere from 1-3 times per week works best. The Dr. Dennis Gross or Vivant Skin Care masks are my go-to recommendations. But if masks aren’t your thing, you can use a sulfur face wash in a similar way you’d use the BPO one. Kate Somerville’s Eradikate cleanser is my favorite for that.

You can also use acne serums that typically have salicylic acid, azelaic acid, and/or mandelic acid as the primary ingredients. There are so many of these on the market, including the ones I make. So I’ll skip that for now.

Lastly, there is THEE gold standard for treating acneic skin and that is retinoids! Retinoids can be available over the counter or via prescription. For many with acne, they can be instructed to use retinoids daily or a few times a week. It generally will depend on the type of acne, although, in my practice I never encourage anyone to use a retinoid daily. I’ve just launched a retinoid called Moonshine that is a blend of retinyl propionate, peptides, and AHAs to effectively treat acne, hyperpigmentation and signs of aging. You know how they say big things come in small packages? Well, that totally applies to Moonshine. A pea sized amount once a week can dramatically reduce acne lesions and fade hyperpigmentation. I’m pretty proud of it.

TL;DR

You can’t spot treat acne, only sporadic breakouts. Spot treating as a concept is best suited for fading hyperpigmentation. And, lastly, acne treatment is best applied to the entire face to prevent and manage future breakouts efficiently.

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