For years I have had acne. People always say to use salicylic acid products to prevent clogged pores. When I use it, though, I end up getting tiny raised bumps all over the area. Is this some type of an allergic reaction? So, instead of salicylic acid, I should use benzoyl peroxide, right? But that only gets rid of zits, it doesn't help with clogged pores. What should I do?
Acne and less-than-clear complexions have several causes and treatment possibilities. It might be helpful to look back at some previous Go Ask Alice! answers before getting into a discussion of the treatment regimens you mention in your question. Take a look at Acne treatment and Antibiotics and acne in Alice's General Health archive.
Salicylic acid helps reduce the number of cells around the follicles of your skin's oil glands. Available in lotions, creams, and pads, it must be used continuously to keep pores unclogged. It's important to use this product as directed, since using too much may increase your chance of salicylic acid poisoning. Use of salicylic acid with certain other products may also cause severe skin irritation, so avoid the following unless directed by a health care professional:
- Abrasive soaps and cleansers
- Skin products that contain alcohol
- Other acne medications, including benzoyl peroxide, resorcinol, sulfur, or tretinoin
- Drying cosmetics or soap
- Medicated cosmetics
- Other skin medications applied topically
As you've discovered with your use of salicylic acid, several over-the-counter acne medications can have side effects — such as the tiny bumps on your face. Most side effects tend to go away after continued use. But any severe ones are a reason to see a health care provider. If salicylic acid is bothering your skin, don't use it.
Let's look at the other option you mentioned in your question: benzoyl peroxide. Benzoyl peroxide works in two ways: it kills the bacteria that help cause acne, and it has a drying effect that makes it easier to wash away excess oils and dirt. It does help unclog pores, so it might be what you're looking for.
There are a few things to keep in mind before you start using benzoyl peroxide. Your skin will probably be irritated during the first three weeks, and your acne might seem to get worse before it gets better. If nothing improves within 4 to 6 weeks, see a provider. Once you begin using benzoyl peroxide, continue using it to keep your acne away. Refrain from washing or using any other medications on the area you treat with benzoyl peroxide for at least an hour after. Also steer clear of the following, unless your provider tells you otherwise:
- Skin products with peeling agents, such as resorcinol, salicylic acid, sulfur, or tretinoin
- Irritating hair products, such as hair removers
- Skin products that cause sensitivity to the sun (ones containing lime or spices)
- Skin products that have a large amount of alcohol, such as astringents, shaving creams, or after-shave lotions
- Abrasive and drying skin products
It sounds like you've been trying to find the best treatment for your acne for quite some time. Why not discuss various products and options with a health care provider or a dermatologist before beginning any new regimens? If you are a Columbia student, you contact Medical Services (Morningside) or the Student Health Service (CUMC) to make an appointment with a health care provider on campus.