Impacts of acne on skincare, make-up and styling

People often developed skincare practices which suited them and fit in with their lifestyle. One product or routine would not suit everyone and finding the right skincare habits and products was a very personal thing. Some people also found that after a while they would have to change something in their routine to get the best benefits. Taking particular medications could also mean changing skincare routines, such as avoiding face washes whilst on isotretinoin.

Skincare practices

People had different approaches to their skincare. Some had no single routine or a very simple routine. Will says he would ‘sort of play it by ear’ rather than have a set routine for skincare. Others had daily routines which involved many different products, including removing make-up, using face wash and moisturisers, and wearing sunblock in the summer. Most people had learnt about what suited their skin best over time. For example, Becky avoided exfoliators as they made her skin more sensitive. A few mentioned washing with warm, rather than cold water, to help open the pores.

Tom wasn’t sure about the instructions for his topical cream, including about when to moisturise.

Age at interview 15

Gender Male

Age at diagnosis 15

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Tom used to have a complicated routine using creams and moisturisers but now just washes his face with soap each morning and night and takes medication.

Age at interview 15

Gender Male

Age at diagnosis 15

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Fatima explains the 6 step treatment she uses every other night.

Age at interview 21

Gender Female

Age at diagnosis 12

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Keeping up with a routine could be important, but also challenging. Ollie and Rachael didn’t need much extra time to get ready in the mornings. Others found it hard to carve out the time needed for their routines. Having acne could interfere with other daily routines like shaving. Some people who were on isotretinoin chose to shave, as they heard that waxing could damage their skin.

When Ish forgets to do his routine it has a big impact on his skin. He finds it stressful having to use several products on his skin every night and sometimes doesn’t have the energy to do it.

Age at interview 22

Gender Male

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For Ollie, shaving with acne can be painful and leave scars.

Age at interview 16

Gender Male

Age at diagnosis 13

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Skincare products

Some products used by young people in their skincare routines include:

  • face washes, scrubs/exfoliators, cleansers and toners
  • moisturisers and serums
  • face masks
  • lip balms
  • sunscreen
  • products for scarring

Most people used a face wash once or twice a day. Alexandra has a mild scrub for her face and a coarser one for her body. Moisturisers were said to be especially important for people on isotretinoin (e.g. Roaccutane) because the treatment dries out the skin. Will had very dry lips when he was taking isotretinoin and used to take lip balm to school, which ‘set a trend’ amongst his peers.

However, ‘over-cleaning’ the skin could make it dry and irritated. Shu En says she tries to get a balance between oily and dry skin in her skincare routine. Becky and Hester pointed out that acne is not caused by how often people wash their faces.

Generally, people preferred products ranges made for blemish-prone skin. Harriet and Marga use oil-free moisturisers. Some found it helpful to look at the ingredients list of their skincare products and opt for certain ones, such as those containing tea tree oil or salicylic acid. Chris found products with aloe vera helpful. Another feature of skincare products that some people looked for was the label ‘hypo-allergenic’ (meaning it is less likely to cause allergic reactions).

Before she went to the doctor for the first time Hester had tried many different products, but most things were ineffective.

Age at interview 21

Gender Female

Age at diagnosis 15

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These could be shop-bought or prescription products. Some people had tried products from abroad, which they had bought over the internet or while on holiday. Some felt particular brands suited their skin better than others. More expensive or well-known brands were not always seen as better. Most people felt shop-bought products only worked for mild acne though, and medical treatment to clear ongoing acne would be needed beyond this.

Although Harriet has tried lots of different brands she now goes for the plain brands (not scented or coloured).

Age at interview 21

Gender Female

Age at diagnosis 12

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A few people preferred getting products from their doctors rather than pharmacies. Shu En thought that ‘if I go to a dermatologist the creams are medically tested, so they’re definitely, they’re much more effective’.

For Molly, over-counter brands didn’t work well and were too expensive in the long term. She thinks it’s better to get products from the doctor.

Age at interview 20

Gender Female

Age at diagnosis 11

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As well as skincare products, people talked about other products that were useful. Quite a few people talked about sunscreen, especially those whose skin became more sun-sensitive due to treatment. Some talked about the difficulty of finding a suitable sunscreen for acne-prone skin. Devan also had to find shampoos that don’t irritate the sensitive skin on his scalp.

Night time routines and the practicalities of skincare

Sleep was often seen as a good time for skin to repair and most people had a skincare routine before bed (see also the section on sleep). A few people mentioned changing their pillow case frequently to avoid bacteria exacerbating their acne. Harriet said she tried to avoid sleeping on one side for the whole night, which would make it difficult for her skin to breathe.

Quite a few people talked about having to change their pillows and sheets due to blood stains from their spots or bleaching from face creams they used. This could be something they were very conscious of when staying over at a friend’s house or a guest house.

When she was using a cream with a bleaching agent Harriet had to be careful about staining her clothes and using other people’s towels.

Age at interview 21

Gender Female

Age at diagnosis 12

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Staying out late or being away from home also meant taking skincare products out with them.

Emma prefers to remove her make-up before going to sleep, which can impact on her social life and hobbies.

Age at interview 20

Gender Female

Age at diagnosis 10

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Makeup

Many people used makeup to cover up or distract from their acne. A few young women said they wouldn’t leave the house without makeup. Other people used foundations, BB creams and/or concealers only for nights out or other special occasions. Wearing makeup could boost confidence and make people feel they had more control over their acne and scars. Some found their acne would often still show through, flake more or be more visible when the makeup wore off. As Hester found, applying and removing makeup could be too painful with sore spots.

Chris sometimes uses Blemish Balm (similar to tinted moisturiser).

Age at interview 20

Gender Male

Age at diagnosis 17

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Although it can get her down some days, Sarah says acne has not been something that has really affected her social life. If she is going to see someone she uses make-up to cover it up.

Age at interview 22

Gender Female

Age at diagnosis 16

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Deborah usually takes a little kit with her when she goes out with her friends in case she needs to take her make-up off. She describes one occasion when she forgot her kit.

Age at interview 25

Gender Female

Age at diagnosis 12

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It was thought by some that wearing makeup was sometimes expected of young women. There could be social situations in which they had to rely on friends being understanding about their skincare regime. Harriet’s friends often wanted to do ‘makeovers’ and sometimes, when her acne was painful or when she was on medication, she had to tell them not to put certain makeup on her.

Some people worried that makeup might stop their skin breathing and ‘clog it up’, making their acne worse. Others, like Marga, felt strongly this is not the case and, far from being a ’cause’ of acne, makeup offers her a ‘safety net’ to feel more confident. Even so, some people bought special makeup suitable for acne-prone skin or avoided makeup. Although a few people mentioned having spots on their neck, wearing hair up in a bun was also seen as better for keeping it off the face.

When she was younger Shu En used to wear her hair down to cover her spots but thinks that made the acne worse.

Age at interview 19

Gender Female

Age at diagnosis 9

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Abbie preferred going to parties where it was dark and talks about doing her hair and make-up to make her acne less visible.

Age at interview 17

Gender Female

Age at diagnosis 13

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It was liberating for Naomi when she wore make-up during sixth form.

Age at interview 22

Gender Female

Age at diagnosis 9

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Clothes

Some people talked about the impact of acne on their choice of clothes. This includes those who avoided wearing clothes which revealed acne on parts of the body such as the back and chest. Some people said they felt especially uncomfortable about wearing swimsuits or beach wear. Alexandra sometimes had spots on her back and around her bra strap and had to wear bandages to reduce the pain. When having acne impacted on confidence and self-esteem, people sometimes preferred to ‘dress-down’. Becky mentioned that she wore dull colours so she wouldn’t draw attention to herself.

Emma was quite shy and talks about avoiding certain clothes that would reveal acne scars on her body.

Age at interview 20

Gender Female

Age at diagnosis 10

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