Brief overview
- What helps against impure skin? What helps depends, among other things, on the skin type. The general rule is: don’t pick at pimples & co. and use cleansing and care products suitable for your own skin type (pH-neutral if possible).
- Causes of blemished skin: e.g. hormonal changes or excessive sebum production. Stress, poor diet and the (indoor) climate can probably also promote pimples, blackheads and acne.
- When to see a doctor? In case of long-lasting, extensive blemished skin or severe suffering, you should see a dermatologist.
- Treatment options: e.g. medications such as vitamin A acid derivatives or bacteria-killing solutions.
Blemished skin: What helps – and what doesn’t?
- Normal skin: The optimal case. It has neither too much nor too little oil and moisture and is easy to care for. Skin blemishes are not a huge problem, but can be caused, for example, by hormonal changes, incorrect care or air-conditioned/heated room air. Then a cleansing milk followed by a facial toner can help.
- Oily skin: It has large pores, is shiny and prone to impurities and acne. Sometimes it is hereditary, in other cases it is caused by hormonal changes (e.g. during puberty) or medication. Since oily skin is quite insensitive, you can usually use washing gel, facial toner containing alcohol, as well as drying skin care products.
- Dry skin: It has a limited protective function and should therefore only be cared for gently. The problem here is less impurities (germs can settle more difficult) than irritations, wrinkles and inflammations. Use only mild cleansing products (if at all). Moisturizing and oil-rich products relieve feelings of tension.
- Combination skin: Here the so-called T-zone (forehead, nose, chin) is oily, the rest dry. This means that a suitable care product must be used for both skin types.
- Do not doctor yourself and rather do not squeeze the pimples yourself. It is best to go with impure skin into the experienced hands of a beautician – she removes blackheads professionally. Otherwise, further inflammation and scars may occur.
- It is best to cleanse blemished skin only with “pH-neutral” (pH about 5.5 – this corresponds to the natural acid mantle of the skin), mild, fragrance-free and skin-friendly soaps or wash lotions. And don’t wash the skin too frequently either, as this can destroy the acid mantle and make blemished skin worse.
- Use water-based products (oil-free makeup, sunscreen, etc.). Greasy or oily creams and cosmetics clog pores and promote blemished skin.
- Products containing fruit acids, salicylic acid or lactic acid often beautify the skin.
- Covering measures and complexion-correcting make-up are recommended and good for the soul. There are special products for impure skin, which can be recognized by indications such as “non-comedogan” (do not clog the pores) or “fat-free”.
- Even though the influence of diet on blemished skin has not been proven: make sure you eat a healthy diet with plenty of fruit and vegetables and drink plenty – around two liters of fluid per day are recommended.
- Get plenty of exercise in the fresh air – this boosts the metabolism and is also good for the skin.
- It is best not to touch your face with your hands. Many bacteria live on the palms of your hands, which is why regular hand washing is generally advisable for your health.
- Use different towels for your face and hands.
- Enjoy substances and foods only in moderation that could aggravate your blemished skin. It’s best to observe if certain substances promote blemished skin.
Blemished skin: what doesn’t help
Toothpaste is a home remedy that is supposed to help with pimples and dry them out – but it doesn’t. Some toothpastes contain zinc, which has an anti-inflammatory effect. The ingredient fluorine, on the other hand, tends to boost inflammation. Toothpaste also removes too much oil from the skin. Reddish and inflamed areas of skin can form. Toothpaste can therefore make the symptoms even worse.
Tea tree oil is effective against inflammation. However, it can also trigger severe allergic reactions if it is applied to the skin in highly concentrated and undiluted form, warns the Federal Institute for Risk Assessment.
In general, many over-the-counter anti-pimple products are not guaranteed to work as hoped: In a dermatologically supervised practical test conducted by BR in 2016, none of the products tested (one with tea tree oil, one with zinc, one with salicylic acid) showed any noticeable improvement in the skin’s appearance after two weeks.
A year earlier, Ökotest awarded only four of twelve acne tinctures tested a “very good” rating; all the others failed. And Stiftung Warentest (4/2006) also took a close look at twelve anti-pimple products. The anti-pimple effect, application (e.g. removal, application, skin feel) and tolerability were tested. Result: Three products were good, but there were no miracle cures for blemished skin.
Blemished skin: causes and possible diseases
A blackhead occurs when the glands produce excessive amounts of sebum. The sebum cannot exit through the channel of the sebaceous follicle because the epidermis is highly keratinized. A plug forms that closes the exit of the follicular canal. The deposited skin pigment melanin reacts with the oxygen in the air and darkens the plug – this is how the typical appearance of blackheads is formed. They appear mainly on the forehead, nose and chin, and often all over the face if the skin is oily.
If skin inflammation develops from the blackheads, they are often referred to as pimples. The skin reddens, bacteria and other pathogens can settle and lead to an infection. A focal point of pus often forms at the tip of the pimple.
In addition to puberty, the second half of the menstrual cycle and pregnancy are often accompanied by acne, because this is when the concentration of testosterone in the female body increases.
Other factors
Twin studies have shown that hereditary factors also play a role in whether or not acne occurs. In addition, diet is said to have an influence on acne, although this has not yet been scientifically proven. In addition, climate (humidity, UV radiation) and other environmental factors are suspected of causing blemished skin.
Acne can also be caused or aggravated by numerous medications. Examples are glucocorticoids (e.g. for rheumatic or allergic as well as autoimmune diseases), androgens (e.g. for the treatment of breast cancer) and anabolic steroids, psychotropic drugs or neuroleptics (antipsychotic drugs, e.g. against delusions, states of agitation, etc.).
Impure skin: When should you see a doctor?
Everyone has unclean skin once in a while. So you do not need to see a doctor every time you have a pimple. However, if you suffer a lot from impure skin, if you have impure skin for a long time, if blackheads and pimples appear all over the place or if large-area nodules, blisters or skin inflammations develop, you should always see a doctor. Because without sufficient treatment – or if you touch the pimples yourself – large-scale inflammations and large scars can develop.
The right contact person for impure skin is a dermatologist, i.e. a dermatologist.
Blemished skin: What does the doctor do?
The doctor will first ask you how long you have had blemished skin, what remedies you have already used against it or also want to know a few things about your lifestyle: How do you eat? Are you taking any medications, if so – which ones? What about your nicotine and alcohol consumption? This will give the doctor some initial clues as to what could be causing the blemished skin.
Diagnosis
It is also important to get to the bottom of the causes of blemished skin. The form of acne – acne vulgaris or another type – also plays a role in the therapy. The dermatologist also checks whether there are other skin diseases that can cause blemished skin. A blood test helps to detect hormonal imbalances.
Therapy
If proper cleansing and care are not enough and the inflammation of the skin does not disappear, the doctor may prescribe medication. Usually he will use a combination of different substances – depending on the form and severity of acne:
Vitamin A acid derivatives (retinoids, e.g. adapalene, isotretinoin, tretinoin) are effective against the blemished skin with pimples and blackheads, as well as against inflammation. They are well effective for the treatment of mild acne.
Callus-dissolving and bacteria-killing solutions, creams and wash lotions also help with mild acne. Benzoyl peroxide dissolves the horny layer of the skin and kills bacteria. Azelaic acid is effective against blackheads, inflammation and bacteria. Salicylic acid dissolves the top layer of the skin and helps to open the pores. This allows the excess sebum to escape from the pores.
Pregnant women, nursing mothers and children under twelve years of age must not take certain antibiotics (e.g. tetracyclines)!
Hormonal contraceptives with antiandrogens can help women with acne. They are suitable for mild to moderate acne.
In general, one thing you definitely need for acne therapy is patience. Blemished skin with pimples, blackheads and acne does not disappear from one day to the next. You have to allow for several weeks before the therapy takes effect.
