
Fact: We All Have the Same SkinThe Actual “Why” Is Still UnclearIn the End, It’s Not Your Fault
Life is deeply unfair. I know this because even though I consistently wash my face, apply a four-step prescription regimen, and avoid dairy, soy, and sugar, I still get zits. Meanwhile, my best friend, who sleeps in her makeup and runs off a steady diet of Mountain Dew, chicken fingers, and stress, has marble-smooth skin that glows with the light of a thousand moons.
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I am, as they say, acne-prone. But I think this label is bullshit. We all have pores and skin oils. “Why does my skin suck??” was the eloquent way I broached this question with my dermatologist friend via text. And then I posed the same question to another derm, and then another derm, until I felt sufficiently dismayed, yet clear, on what exactly makes your skin more acne-prone than your friend’s.
(Side Note: These Are My Go-To Acne Products)
“Everyone’s skin is, fundamentally, the same,” says dermatologist Mona Gohara, M.D. associate clinical professor at Yale. Yes, even you with your cystic acne and your friend with the face of a pearl. “Everyone has hormonal fluctuations, oil productions, and acne-causing bacteria in their skin that could, theoretically, cause massive breakouts at any time,” she says.
But the reason the entire world isn’t one giant walking zit is because “some people are genetically more prone to their sebaceous glands getting inflamed by hormones, oil, and bacteria,” says Dr. Gohara. So even though we all have the same acne-triggers—i.e. a raise in stress hormones, or a sweaty summer day, or a late-night pizza binge—we don’t all have the same sensitivities to those triggers. Which means the way you and your best friend’s skin react to the same trigger could be as minimal as getting one tiny blackhead for you, or as severe as a full-blown breakout of cystic acne on your BFF.
“This is a tough question,” says dermatologist Julie Harper, M.D., of the Dermatology & Skin Care Center of Birmingham. “The real answer is that we don't quite know what makes one person more susceptible to acne than another at a ‘nitty gritty’ pathogenesis level.” Yes, I know; that sucks to hear. “We know that there’s a genetic predisposition—you’re more likely to have acne if your parents had acne—and it may be that we're ‘inheriting’ certain strains of acne-causing bacteria that induce more inflammation than other strains,” she says.
But as for why your skin is more sensitive to inflammation than your friend's? Dermatologists still aren’t sure, but they think it has something to do with the TLRs (toll-like receptors) in your skin, which are little receptors that assess a threat (like a gallon of wine) and tell your body how to react (with a zit).
“We don’t have evidence, but it’s a theory that the TLRs in acne-prone skin are naturally more sensitive, causing a larger and more frequent inflammatory response to triggers,” says dermatologist Melissa Kanchanapoomi Levin, M.D., clinical attending at NYU Langone and Mount Sinai Hospital. Basically, you’ve got some air-traffic controllers in your body going a little overboard with their job, sending you into zit territory.
“Your risk of acne only partially has to do with how you take care of your skin,” says Dr. Gohara, which is kind of the worst thing to hear when you’ve spent the last year perfecting your skincare routine. But try to let it be a relief, because it means there’s really only so much that you can do.
“That’s why Accutane works so well for acne—it shrinks the gland, so the gland can’t function even if you have a sensitivity to triggers,” says Dr. Gohara. “It basically just closes the door so you can’t break out.”
Of course, Accutane isn’t right for everyone, and most people with mild acne find they can easily treat their breakouts with over-the-counter treatments. So until doctors find a magical cure (with zero side effects) for acne, try taking deep breaths, not hating your friend for her perfect skin, and one of these spot treatments, below.
Memebox I Dew Care Blemish Spot Patch
Image 1 of 5This tea tree-loaded gel acts as clear bandage for your zit—swipe on a thin layer, let it dry, and then apply your makeup or moisturizer on top, without worrying about it slipping or sliding off.
Memebox I Dew Care Blemish Spot Patch, $15
BUY IT: ulta.com.
Memebox I Dew Care Blemish Spot Patch
Image 1 of 5This tea tree-loaded gel acts as clear bandage for your zit—swipe on a thin layer, let it dry, and then apply your makeup or moisturizer on top, without worrying about it slipping or sliding off.
Memebox I Dew Care Blemish Spot Patch, $15
BUY IT: ulta.com.
Clinique Acne Solutions Clearing Concealer
Image 2 of 5Annoyingly, oil-slicked acne does not play well with makeup, which is why we're so in love with creamy, salicylic acid-packed concealer, which stays put as soon as you blend it on.
Clinique Acne Solutions Clearing Concealer, $18
BUY IT: sephora.com.
Indie Lee Blemish Stick
Image 3 of 5Dab this clear gel over bumps and pimples and let the soothing camphor and redness-reducing zinc sulphate shrink breakouts while you sleep.
Indie Lee Blemish Stick, $28
BUY IT: amazon.com.
Meow Meow Tweet Spot Serum
Image 4 of 5Yes, the packaging is adorable, but what's inside this little rollerball makes us even happier: a mix of essential oils, like calming jojoba and antimicrobial cajeput, that gently soothes painful, cystic zits.
Meow Meow Tweet Spot Serum, $29
BUY IT: amazon.com.
Murad Rapid Relief Acne Spot Treatment
Image 5 of 5The combination of witch hazel and salicylic acid in this gel knocks out blemishes on oily skin, while oat extracts help combat any irritation and redness.
Murad Rapid Relief Acne Spot Treatment, $22
BUY IT: sephora.com.
Chloe Metzger is the deputy beauty director at Cosmopolitan, obsessively writing about new makeup launches, the best hair products (curly girl here; whattup), and the skincare formulas that really work for every skin type (follow her on Instagram to see behind-the-scenes pics of that magazine life). She also has an unhealthy adoration for Tom Hanks and would like to please meet him one day, if you could arrange that. Thanks.
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