6 Dermatologists and Skin Experts Explain Why Your Breakouts Are Out of Control Right Now – POPSUGAR
Posted: April 10, 2020 at 5:45 pm
Has your skin been breaking out like crazy or drier than usual since we all started self-isolating? Because mine certainly has. And after talking to other POPSUGAR editors and posting about it on Instagram, we've learned that a lot of people feel like their skin is freaking out right now. Much of it can be attributed to higher levels of stress and anxiety, sure, but we couldn't help wondering if there might be more to it. Turns out we were on to something. As dermatologist Shari Marchbein, MD, explained: "I do think a lot of it is stress, although many of us have altered sleep, work, life, and skin-care routines right now, so there's no way to pinpoint just one reason."
Obviously, we can't generalize everyone's situation, because there are a million and one factors that go into why someone's skin might be flaring up or acting like a moody teenager. But it seems to be too much of a coincidence that almost everyone is having the same problem since lockdown began even dermatologists. "I have to be honest; my skin just has a mind of its own and lifestyle factors make relatively little difference to what it wants to do," admitted London-based consultant dermatologist Anjali Mahto. The same might be true for a lot of us, but we still wanted to find out if there is anything specific causing our isolation breakouts and if there's anything we can do to help clear them.
By no means are we telling you that you need to "fix" or "improve" your skin right now. We'll lay out all the expert opinions for you, so you can take the advice you want and need whether that's all of it or none of it. We know the appearance of your skin may not be your top priority right now, but as beauty editors, we found the number one question we're being asked right now isn't how to perfect our at-home facial massage technique but: "why is my skin breaking out so badly since lockdown?" So, we're going to help answer it.
To get to the bottom of it, we spoke with six dermatologists and skin experts who listed six possible reasons spots are popping up quicker than we can control. These include humidity levels, lack of vitamin D, protective mask friction, and the inevitable stress.
Listing stress as a reason for increased breakouts feels both helpful and unhelpful right now. Given it's such an unsettling time, we're all stressed to some degree, and while practicing mindfulness or meditating can help, telling us to chill out is easier said than done. But here's the thing, nearly every expert we spoke to mentioned stress as one of the main reasons we're all seeing more spots than usual.
Stress can trigger elevated levels of cortisol (the stress hormone), causing an overall metabolic imbalance in the body (which also affects sleep). For women specifically, this decreases our oestrogen production, which subsequently means we have a higher amount of androgen (male hormone). "Androgen, when in abundance, will send messages to our sebaceous glands to produce more oil. The reaction makes our pores unhappy, causing them to swell internally, creating an inflammatory response on the skin, therefore producing a spot," explained Pamela Marshall, clinical aesthetician and founder of London-based clinic Mortar & Milk.
So, how do you avoid this happening? Well, we're not going to tell you to meditate and do yoga because, honestly, in these times, you do you (although, if you want help relaxing, we have talked to experts about how to do that right). But take some comfort in knowing that these unusual times aren't forever, nor is your skin freakout. While the condition of your skin might not be your usual, it's probably happening due to this totally normal response.
Stress leads us onto the next possible factor, differing sleep patterns. "When sleep deprived, the body makes more cortisol, which causes inflammation and can worsen skin conditions such as eczema, acne, and psoriasis," Dr. Marchbein explained. Trying to keep your sleep as consistent as you can will only do good things for your overall well-being and skin.
Another big reason for your skin taking a turbulent ride since lockdown could be the changes in humidity levels, especially since most of us have been indoors a lot more. "Heated indoor air loses a lot of moisture, typically containing just 10 percent of the moisture your skin needs," said Anne Wetter, MD, dermatologist and cofounder of Alll DNA skincare. "When you are inside in the dry air, the moisture transfers through your pores in the skin, giving you a very dry skin surface, even though you might normally have oily or combined skin. This will put your skin into a sort of 'turbo mode' where it tries to remoisturize, but instead it gives you irritated and red skin, or even acne."
To combat the low humidity level, Dr. Wetter recommends making sure you're keeping your skin hydrated with moisturizers containing the ingredients urea or glycerin. In addition to this, if you have access, use a humidifier. If you don't, she advises leaving bowls of water in your house and next to the computer or the place you're working/spending most of your time. It might seem strange and a bit precarious (make sure the bowls aren't close enough to spill on your computer), but it's worth a shot, right?
You've seen the pictures of doctors and nurses with their faces dry, chapped, and irritated from wearing multiple masks all day long. But wearing a mask can mess up your skin even if you're just wearing it to the supermarket or on your commute to work if you're an essential worker. This is because continual use of masks and protective equipment can cause friction on the skin, which can lead to sensitivity and irritation. Dr. Marchbein explained that this is basically a form of acne mechanica, which can be triggered by excessive pressure, friction, heat, or rubbing of the skin. "We see this with helmets, chin straps, and anything the rubs the face or occludes it." This can start out as smaller patches of irritated or bumpy skin but then form into larger spots. Now, to be clear, we are by no means telling you not to wear a face mask when going out in public (editor's note: while the UK government advises not to wear one unless you're sick, other areas around the world are encouraging it, including New York City); we're just noting that this is another factor to consider when trying to figure out what's going on with your skin.
To treat this form of acne, do not excessively scrub the area; this may cause further irritation. Instead, cleanse the affected area gently to remove any grime and sweat, and treat with a mild alpha hydroxy acid like salicylic acid and an oil-free moisturizer.
While discussing this article in our morning edit meeting, I told my fellow editors how many experts mentioned alcohol as a factor but that I didn't think I was drinking more than usual. My teammates agreed, but then 15 seconds later, we all copped to the fact that, yes, we have been drinking a lot more wine in lockdown. And based on our Instagram Stories, I don't think we're alone in that practice.
"When we drink alcohol, our skin becomes dry and can look wrinkly, in addition to causing puffiness in the face." said Susan Mayou, consultant dermatologist at the Cadogan Clinic in London. While drinking likely won't be the root cause of your skin woes, it probably isn't helping. It's up to you whether that extra glass of wine is worth it for dry and puffy skin in the morning. But if I'm being totally honest, for me, that extra glass is absolutely worth an extra spot or two right now.
An hour outdoors, at most, is a dramatic decrease in what most of us and our skin are used to. Our dry, dull, and angry skin could be due to a "lack of vitamin D synthesis from not spending much time outdoors," Marshall said. "Vitamin D is crucial to cell differentiation and development." Dr. Wetter agreed, noting that "UV light in moderation has a beneficial effect to some skin conditions like acne. Staying inside will prevent this." According to the NHS, "your body can't make vitamin D if you're sitting indoors by a sunny window because ultraviolet B (UVB) rays (the ones your body needs to make vitamin D) can't get through the glass." For this reason, Marshall and the NHS both recommend increasing your intake of vitamin D from food sources and potentially taking a vitamin D supplement (although, please consult your GP before adding any nutritional supplements into your diet).
Now that we understand a little bit more about what may be causing our breakouts, we wanted to know exactly why our skin is full of both spots and dry patches.
Acne occurs when the hair follicles in your skin get clogged, which is usually caused by oil, dead skin cells, leftover makeup, and dirt. "The skin relies on its lipid layers to keep out potential irritants, such as bacteria, viruses, and fungi, and to maintain a consistent cell turnover," Dr. Wetter explained. "When your skin becomes dry, its ability to perform these tasks is limited, causing buildup of dead skin cells on the surface of the skin, which can easily become irritated and inflamed, creating a potential breeding ground for acne." To combat this, she stresses the importance of still cleansing morning and evening, even if you aren't wearing makeup as normal.
Having said that, don't be tempted to run to your beauty stash and apply every chemical exfoliator and foaming cleanser you own to try to clear your skin. "I believe less is more when it comes to skin care," Dr. Mahto said. "It's about picking ingredients wisely that have multipurpose ingredients." For acne, she recommends using evidence-based ingredients such as AHAs and retinoids in your routine to control oil production and blemishes. Board-certified dermatologist Erin Gilbert's view also reflects this: "Harsh exfoliation can worsen the inflammation you are experiencing with an acne breakout. This is why you want to use a mild AHA," such as salicylic acid. She likes the Skinceuticals Blemish + Age Cleanser ($92) and Vichy Normaderm Phytosolution Purifying Cleanser ($18).
"Be judicious, and don't overuse these to the point of excess dryness. I see so many patients who have overused harsh antiacne regimes and complain of severe irritation and redness," Dr. Gilbert said. "If that happens, you'll be tempted to apply a heavy moisturizer, but then the cycle of breakouts will start all over again." For moisturizers, she recommends creams with the ingredient niacinamide as it has anti-inflammatory properties, such as CeraVe Hyaluronic Acid Face Moisturizer ($14), and we like Paula's Choice Skin Balancing Moisturizer ($29).
Another treatment, recommended by Dr. Marchbein, are spot patches. These are "hydrocolloid adhesive stickers that contain certain active ingredients such as salicylic acid and/or tea tree oil, which are delivered to the spot while it's in place. By covering the pimple, these active ingredients are able to penetrate the skin more deeply, allowing them to potentially work better." We love Zitsticka Killa Patches ($29), which uses 24 microdarts to dispense the ingredients (don't worry, it doesn't hurt), and the pack also contains antiseptic wipes. We're also using Starface Patches ($22), which come in the most adorable box ever.
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