How to care for oily skin with acne

Does oily skin cause acne?

Excess oil contributes to acne when it combines with dead skin cells and blocks hair follicles, the openings where hair grows. Bacteria can grow inside those blocked follicles and cause inflammation and pus. Oil is part of the process, not the whole explanation: hormone changes, certain medicines and greasy skin or hair products can also contribute.12

Which kind of spots do you have?

Blackheads and whiteheads are usually closer to the skin's surface and are not swollen or painful. Inflammatory acne means swollen, sore blemishes, including pustules containing pus and deeper nodules or cysts. You can have more than one type at once. This distinction matters because products bought without a prescription can help, but many people with inflammatory acne need professional treatment.13

What should your daily routine look like?

1. 1Cleanse gently in the morning and evening, and after sweating. Apply a gentle, nonabrasive cleanser with your fingertips rather than a washcloth, sponge or scrubbing tool. Remove makeup before bed.
2. 2Moisturize morning and evening. Choose an oil free, water based moisturizer labelled noncomedogenic, meaning designed not to clog pores. Products made for oily to combination skin are a useful place to start.
3. 3When outdoors, protect exposed skin with a broad spectrum, water resistant sunscreen with SPF 30 or higher. Look for a noncomedogenic formula, seek shade and use protective clothing.

Choose cleansers, moisturizers and makeup with the same attention to pore clogging, rather than checking only the acne treatment. Choosing skincare for oily to combination skin helps narrow the shopping list, without turning the bathroom into a branch of a pharmacy.3

Makeup can stay in the routine; it does not need to hand in its resignation. Choose noncomedogenic products and take them off at the end of the day.15

Which treatments can help?

Salicylic acid and benzoyl peroxide are options for acne treatment applied to the skin; a pharmacist can help you choose. Treatments for inflammatory acne also include azelaic acid, niacinamide and retinoids, which are forms of vitamin A. Niacinamide has anti inflammatory, moisturizing and soothing effects.13

Prescription options include topical medicines, meaning medicines applied to the skin, and tablets. Retinoids such as tretinoin and adapalene reduce inflammation and oiliness and help prevent spots. Antibiotics target bacteria involved in inflammation and pus. A doctor can also consider hormonal treatment or isotretinoin when appropriate.23

What if your skin is oily but easily irritated?

Choose gentle products labelled alcohol free. Leave out irritating toners and exfoliants: drying the skin can make acne look worse. Do not keep switching acne treatments, because frequent changes can cause irritation and breakouts. For adult skin, the strongest product on the shelf can be too drying, even when the skin is oily. A gentle cleanser containing salicylic acid or glycolic acid is one option for adult acne.46

How long does improvement take?

Acne treatment can take several weeks to a few months before you see a difference. Inflammatory acne often needs several months of skincare and treatment, and it can return during or after treatment. Continue a skincare routine after improvement to help prevent future blemishes. If your skin is not improving after a few months, seek medical help rather than repeatedly replacing the treatment.34

Could your hair products be contributing?

Hair oil can contribute to forehead acne, so shampoo oily hair more frequently and keep it away from your face. Hair care belongs in an acne routine review, even if the bottle insists it is in a different department. Greasy products can block follicles, and product buildup can contribute to scalp or hairline breakouts. For mild scalp breakouts, avoid oily products or products that leave residue, wash after sweating and regularly clean headwear and pillowcases. Persistent scalp bumps need assessment because acne is not their only possible cause.47

What if acne starts or returns in adulthood?

Adult acne often appears around the chin and jawline, but can occur elsewhere. Pregnancy and menopause can bring hormonal changes that contribute to breakouts. During pregnancy, acne can clear as pregnancy progresses or continue after birth. Stress can aggravate existing skin problems. If acne starts after beginning or stopping a medicine, discuss that change with your doctor. Testosterone treatments, some other medicines and stopping birth control can contribute to adult acne.6

When should you see a doctor?

• Get medical help for lots of spots, deep or painful lumps, or acne that is causing scars.
• See a doctor if treatment at home is not helping or acne is affecting your mental health.
• Have hot, swollen or red skin assessed for possible infection. Redness can be harder to see on brown and black skin.

Do not pick, pop or squeeze spots. Picking can prolong healing and increase the risk of scars and dark marks left after inflammation. Tanning is not an acne treatment: it can worsen acne, and some acne medicines increase sensitivity to ultraviolet light.4