I often feel like I'm playing Whac-A-Mole when trying to treat my skin. I add one new product into my routine, like a vitamin C serum or retinol that multiple people tell me "transformed their skin," and all of a sudden I'm dealing with little red bumps on my cheeks and breakouts at my jawline. Before I know it I'm spot treating with a Starface patch or benzoyl peroxide while trying to add hydration back to pimples that have dried up. The cycle is endless and expected, much like the daily skin-care ads I’m served on Instagram.
The problem, as New York City-based esthetician Sofie Pavitt explains, is the paradox of choice when it comes to products that leads us to overdoing it. "I see a lot of girls on tretinoin [a topical prescription often used to treat acne and fine lines] and I'm like, why?" she says. "Hyaluronic acid, niacinamide, tretinoin, retinoids, vitamin C — if we use everything, we'll just be a skull with no skin left."
What Pavitt offers her followers and clients (if you can get into her Chinatown studio, do it) is education, personalized treatment, and a simple at-home care routine to follow — and it works. The 360-degree approach and impressive before/after results earned her the title of "the acne whisperer" among "skin content" influencers, celebrities, and editors. (Similar to the concept of body neutrality over positivity, being "skin content" is the realistic goal, as our skin is constantly in a state of change.)
Here, Pavitt debunks some of the most common myths we’ve been fed when it comes to acne that keep many of us in the breakout cycle. Even if you can’t get a personalized facial or skin diagnosis (or a highly sought-after appointment with Pavitt, who books out months in advance), this advice will help you spring clean your routine and treat your skin with the right stuff.
Myth: Oily skin = acne-prone skin.
First, we have to understand that oily skin is not synonymous with acne-prone skin. Oily skin is a skin type, whereas acne-prone is a skin condition. "You can be dry as a bone and have really inflamed acne," explains Pavitt. "You don't treat that type of acne the same way you would if you have oily skin and non-inflamed acne, which is more of a pebbly texture. It's about finding your skin type and concerns and working on those two in tandem."
So, how do you figure out your skin type? You can see a dermatologist or an esthetician, or you can diagnose yourself at home, right now. "Wash your face, don't put anything on, wait an hour, and then look at your skin," says Pavitt. "If your skin feels tight to the touch and looks matte, you have a dry skin type. If you have some kind of sheen in the T-zone, down the center of your face, but feel dryish on the sides, chances are you have combination skin. If you have a light sheen all over, you have an oily skin type."
As for your skin condition, if you're reading this, you're probably at least a bit acne-prone. "If you have consistent and persistent breakouts, chances are you are predisposed to breaking out — 40% of the population falls into this category," says Pavitt. "Their cells shed at a faster rate, so you get a lot of dead skin cell buildup within the pore, on the surface of the skin, that will break you out or cause congestion."
Myth: Instant results are the best kind.
When treating acne or breakouts, it makes sense that we think we want clear, balanced skin as soon as possible — but Pavitt thinks we're wrong. Instead, we want to use ingredients that aren't necessarily the buzziest of the moment but work slowly but surely over time. Pavitt's hero acne-clearing ingredient is one you're probably not familiar with: mandelic acid, an exfoliating alpha hydroxy acid (AHA) with a large molecular size that is gentler than go-tos like glycolic or salicylic acid. "I think the reason why mandelic acid hasn't had its day in the sun because we're all obsessed with instant results," Pavitt says. "Mandelic acid is a low and slow [ingredient]. You've got to wait, like, three months to see a result."
Still, when you're consistent with your "low and slow" exfoliation and use a product containing mandelic acid, like Sofie Pavitt's new Mandelic Acid Clearing Serum, once a day, you're going to be impressed. "The before and afters on my Instagram are usually 12 weeks apart," says Pavitt. "That's just to show people to play the long game."
Myth: Daily exfoliation is bad for skin.
You've probably heard that daily exfoliation is going to "strip your skin" and cause it to dry out — but really, the key is how you exfoliate. "I firmly stand by daily exfoliation for acneic or breakout-prone clients," says Pavitt. "If you're blemish-prone, your skin is shedding and you need that daily help with your exfoliation."
With daily exfoliation, you want something gentle, like the aforementioned mandelic acid, combined with moisturizing and soothing ingredients as well. "I formulated that mandelic acid with hyaluronic acid and panthenol," says Pavitt. "Hyaluronic acid is really hydrating and panthenol is skin-soothing, so it helps with that barrier support." You're essentially sloughing away the dead skin cells that can be a precursor to acne, while ensuring that your skin stays balanced.
Myth: A prescription drug is the ultimate cure.
If you have a conversation with an acquaintance and acne comes up, you can bet they'll mention that they know someone who went on Accutane and saw their skin clear right up. Maybe they're even speaking from personal experience. The issue with prescription medication is twofold: It's not widely accessible to people who can't afford to see a dermatologist, and it's more like slapping a temporary Band-Aid on a bigger problem with deeper roots.
Pavitt says that it all goes back to instant results, which medication can offer. A dermatologist might prescribe a medication that will help decrease skin's oil production, like spironolactone or Accutane, or put you on an antibiotic like doxycycline or tetracycline to kill bacteria. These medications might work, but one of the the downsides is that you can become reliant, with no telling what will happen once you go off them. Accutane comes with no shortage of health warnings, and antibiotics can damage your skin's microbiome and create antibiotic resistance in the body. "If you really want to stay clear long-term without medication, daily exfoliation to get rid of dead skin cells is key," says Pavitt, adding that the result is as simple as healthy skin function. "The pore is clear, the oil has somewhere to go, and the bacteria doesn't have a food source."
Myth: Don't eat dairy, sugar, gluten, etc.
"What you put in your body is as important as what you put on it" is among the most overused tropes the wellness industry sell us. Of course what you eat matters, but no one should tell you to cut out entire food groups. "I tread really lightly around diet and skin," Pavitt says. "In my experience working with people with acne, which is such an emotionally charged skin condition, people will try anything to clear their skin. People will come to see me and say they're barely eating anything because they're scared they're breaking out from certain food groups."
The not-so-secret secret is everything in moderation, and then supplement if and when you need to. "I think that we have to focus on things that are great for the skin," Pavitt says, as opposed to what we fear is "bad" for it. She recommends that most of her clients take omega-3 fish oil supplements to help regulate the skin's oil production.
Myth: Spot treat your breakouts, not your whole face.
The acne industry has taught us to spot treat our pimples rather than addressing the face as a whole, but Pavitt offers an alternative that may be more effective for preventing future breakouts. "I like to use a benzoyl peroxide treatment as a face mask," Pavitt says. "I tell people to use it as a face mask all over or in problematic areas, like your chin, as opposed to just spot treating with it."
The idea is to treat breakouts before they happen, thereby ending the cycle. "When you see a pimple, the cycle to create it started 12 weeks ago," Pavitt explains. "You might as well treat the whole area, low and slow with benzoyl peroxide 2.5 to 5%. Short contact application, which means just applying it as a mask, is how you stop skin from getting irritated. Just a hint of it, wash it off, moisturize, and go to bed."
Myth: Retinol should be used as an acne treatment.
What makes retinol, and any similar vitamin A derivative, a tricky ingredient is that most of us don't really know how it works and how to use it correctly. "A lot of people don't realize that retinol is not an exfoliant; it encourages cell turnover," Pavitt clarifies. "Here's why I don't treat breakouts with retinol: People who are acne prone are super shedders and they have a lot of dead skin cells. When you add vitamin A into the mix, what does it do? It creates more cell turnover. For me, it's like, let's get the exfoliation process moving, then once you're cleared, you can add a retinol to speed up the process if you want."
So, you can still use your retinol, but make sure you have a proper exfoliation routine in place. "If you use retinol, you're going to increase the number of dead cells on the skin. When you use mandelic acid in conjunction with that, it's going to wipe away those dead skin cells and make your retinol work better for you," Pavitt explains. "Having an AHA with your retinol is really great, but I wouldn't use them at the same time in your routine. Alternate or do one during the day and the other at night."
A skin-cycling schedule is a good choice, but if that's too much fuss for you, Pavitt recommends a simple routine: cleanser, mandelic acid serum, moisturizer, and sunscreen during the day. At night, you can wash your face, apply a benzoyl peroxide flash mask (or mandelic acid if you didn't use it in the morning), moisturize, and go to bed. Give it 12 weeks, and you might just find you've transformed your skin.
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