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How to cure a case of environmental acne
If I can’t attribute my newfound acne condition to adolescence, then to what do I owe this pleasure? I’ve tried to isolate which variables have changed in my beauty regimen, surroundings, and lifestyle in the past year or so to account for my problem skin, and my best guess is that it’s the outgrowth of urban dwelling in Philadelphia. Both my dietary and skincare habits are clean. The one thing that is decidedly not clean – and completely out of my control – is my environment.
A recent round-up of the 55 Best and Worst Cities for Your Skin (based on somewhat arbitrary factors such as dermatologists per capita, skin cancer rates, and climate data) ranked my former cities of residence (NYC and DC) at #8 and #13, respectively. Meanwhile, my current city drops ten whole notches to #23. Could my skin condition be an outward reflection of this data? After doing a bit of research, I discovered that environmental pollution is a common cause of acne and signs of aging, since contaminants in the air interfere with the skin’s ability to regulate moisture levels and increase the level of free radicals produced by the body.
A 2009 report in Dermato-Endocrinology details how environmental pollutants trigger a variant of acne called “chloracne,” which results from systemic absorption of certain chemicals. Unlike acne vulgaris, the signature skin disorder of adolescence, chloracne is an environmental skin disease that manifests itself in the form of blackheads, whiteheads, and straw-colored cysts. Unfortunately, the report finds that chloracne appears to be resistant to all forms of treatment, including retinoids, corticosteroids, and microdermabrasion. The only way to relieve the symptoms was to restrict exposure to the chloracne-causing chemicals.
Unfortunately for me, I couldn’t avoid stepping outside every day. After walking or biking over a mile to work in the morning amid city traffic, I would check myself in the mirror and often notice that black specks had become embedded in my moisturized skin. When I rubbed the specks off with a tissue, they would leave tiny smears of grease. Gross. No wonder my skin was rebelling against this contamination.
So, I developed my own treatment program, starting with postponing my a.m. cleansing ritual until after I arrived at the office. I would rinse my face with water first thing in the morning, apply sunscreen, make my commute, cleanse with a mild face wash like Terralina Gentle Face Cleanser, and apply a modicum of makeup to cover red patches and bumps. At night, I rotated my face cleansers every night and followed up with an anti-aging toner. With the exception of eye cream, I let my skin sleep in the nude throughout the night.
After being told during a facial that the sporadic breakout on my forehead was a constellation of “sweat bumps,” I started washing my face religiously after any form of sweat-inducing exercise. Sweat bumps are caused by blockage of the sweat glands which results in mild inflammation. Even if I ran errands or walked the dog at lunchtime and returned indoors with beads of perspiration on my forehead, I would wash my face and reapply the bare minimum of makeup. My cleansing habits began to border on excessive (and obsessive).
But the best way to beat city grime and environmental pollutants is to keep them from getting comfortable on the face, right? I hoped that by cleansing my face regularly and thoroughly, bacteria and dirt wouldn’t have a fighting chance to accumulate in my pores and form a plug. Yet, my face refused to clear up. Not a single day passed by when I could celebrate a fully clear complexion and forgo concealer.
Finally, I took a step back and decided it was time to call in the big guns. The last time I used an anti-acne program was Proactiv, circa 1999 (who didn’t fall for it at some point?). This time, over a decade later, I opted for a more informed, less commercialized option: Envy Medical Skin Clarifying Acne Treatment Pads ($25 in the TIA shop). Soaked in the exfoliant salicylic acid and the foaming surfactant sodium lauryl glucose carboxylate, the pads deliver a well-rounded punch to acne. These skin-cleansing ingredients are balanced out by aloe vera gel and menthol to soothe and cool the skin. Instead of denatured alcohol, often added to acne-fighting products because of its astringent and antimicrobial properties, these treatment pads incorporate the gentler witch hazel. The benefits of this natural extract extend beyond its astringent effect, which constricts body tissues and closes pores. Witch hazel’s tannin and flavonol components endow it with antioxidant and anti-inflammatory powers as well.
Salicylic acid is also a keratolytic agent, which functions by relaxing the cohesiveness of the outer layer of the epidermis and dissolving the intercellular cement. This action helps open up clogged pores, removes damaged surface tissue, and promotes the generation of new skin. An article in the October 2010 issue of Cosmetics & Toiletries describes two 12-week studies demonstrating that 0.5% and 2% salicylic acid pads were effective in reducing inflammatory acne and total lesions. Envy’s treatment pads contain the optimal amount of the active ingredient without stripping the skin of natural moisture, since concentrations of salicylic acid greater than 2% are known to trigger skin irritation.
My sensitive skin is no stranger to burning, itching, and peeling from even the most benign irritant. But swiping my face with Envy’s pads did not produce the usual drying sensation that I have come to expect from anti-acne solutions. I could certainly feel a slight tingle on my irritated zones and blemishes, and I made sure to rub the pad's medicinal foam into these areas. I left my skin bare overnight and hardly noticed a few microscopic flakes around my nose the next morning. A few days later, the majority of the red bumps had subsided. After two weeks of incorporating the Envy pads into my post-cleansing ritual, any adverse effects had given way to a relatively clear complexion.
However, Envy’s treatment pads are hardly perfect. Because they are fabric soaked in solution, rather than a liquid-based preparation, I assumed that Envy could do without noxious chemicals. Yet, the toxic pH adjuster sodium borate and suspect preservative phenoxyethanol rear their ugly heads. Also, most acne vulgaris must be treated by an antibacterial agent, as outlined in this 2004 PubMed article. Thus, if an acne condition is caused by bacteria, it cannot be cured by a treatment using salicylic acid alone. I haven’t been able to shelve my concealer quite yet, but I can thank Envy’s treatment pads for giving me a respite from a stubborn environmental breakout befitting a teenager.
Ingredients: Active Ingredient: Salicylic acid w/w 2.0%; Inactive ingredients: Water, Sodium lauryl glucose carboxylate, Lauryl glucoside, Sodium citrate, Aloe barbadensis (Aloe vera) gel, PPG-5-Ceteth-20, Disodium EDTA, Sodium borate, Simethicone, Menthol, Citric acid, Hamamelis virginiana (witch hazel) distillate, Phenoxyethanol, Caprylyl glycol, Fragrance