Acne Fighting Treatments for Clear Results!

Airdate: 10/06/11

Real anti-acne solutions from world-renowned beauty expert and best-selling author Paula Begoun. Find out what causes acne, as well as what the research shows about how to prevent and treat breakouts for clearer skin than you ever imagined. Discover which products to use and which actually make your acne worse.

Paula Begoun: So today we are talking about acne, at least for the first part. Of course I will answer whatever questions you have when we get to the questions and answers. But this is about acne to start with and this is my subject. This is very personal to me. It's actually how I got into doing what I do. It was all about my struggle with my acne - my terrible, horrendous struggle with acne - and eczema as well, and we will do eczema as another topic, sensitive rashy skin, for another show.
00:00:36 But I started breaking - the day I got my menstrual cycle, the day I got my period, I was 11 years old, I had acne. From then on I struggled with acne. And by...for those of you who have read my books probably know this story. But it is etched in my brain; it is etched in my psyche and my soul, because it was so emotionally painful. I don't care what they say about acne in terms of it not being an important disease, it doesn't really matter.
00:01:10 Emotionally, oh my gosh, it matters. And from the age of 11 to 20 I had used every skincare product on the market. I had been to over a dozen dermatologists. And the most frustrating, painful, I don't even have a word. It makes me want to cry. I still had acne.
00:01:34 I still had acne after everything, I still had acne. Not only did I have acne, I also had almost with every routine - actually every routine I tried, I had red inflamed, dry, flaky, oily, still broken out skin. It's terrible. It was horrendous. And then there was a transforming moment, I will never forget it. So as I have written before, in 1976 in the United States the Food and Drug administration passed a law that all cosmetics had to have mandatory ingredient listings in descending order.
00:02:12 It was an astounding moment. And to keep it in perspective, the next country to get ingredient listings was Australia in 1995. The EU had got it in 2000. Canada, I think, just got it, actually they got it last year but it doesn't really take effect until this year. So, here I am...I'm a young girl, I'm a makeup artist. I'm working in the industry. And I'm using Clinique's Three Step System. I'm using that ugly freaking bar of yellow soap --
00:02:43 well, I was actually going to say a dirtier word than that but decided, well, I won't do that but I feel it - their toner and their even uglier yellow moisturizer, Dramatically Different Lotion. And I thought I was doing the right thing for my skin. Of course I did still have dry, flaky, red, inflamed, broken out skin.
00:03:05 And then ingredients started showing up on products. And then I could look at the products I was using from Clinique and see that the bar soap, that big expensive bar soap was just soap. And the ingredients that keep bar soap in their bar form, the same schmutz that builds up in your sink, can absorb into skin and clog pores. That's just a fact about those ingredients.
00:03:34 And then the cleansing agents are drying. You know, you wash with soap, you get done, and you feel like you can't open your mouth. You feel constricted. That is irritating and we will talk more about irritation. And then I looked at the toner and not only did it contain a ton of alcohol which we now know without any doubt is just hell on the skin, the third or fourth ingredient, can't quite remember now, was acetone.
00:04:04 Acetone! That's nail polish remover. What the heck was that doing in a toner? And then the Dramatically Different Lotion contained lanolin. I think it still contains lanolin.
Bryan Barron: It does.
Paula Begoun: It was a yellow, waxy, waiting to cause breakouts...lanoline is created by sheep oil glands. It is actually a substance that matches our own oil production really well and just what somebody with oily, broken out skin needs is an ingredient that puts more oil on the skin and can absorb it to the pore and clog it. I was devastated.
00:04:41 But it started my career, so I should maybe...I try to look at it with positive thoughts. But it was...god, I just remember the pain. I remember the pain of waking up, touching my skin, going, "Oh please lord, let it be smooth." And, of course, until I...actually until just fairly recently...I mean it is definitely better once - I will give you the rest of the saga in just a second.
00:05:05 But it just was terrible. Sometimes the blemishes were so large and awful. I just - for those who suffer breakouts, my heart, my sympathy, my research, my work, it originally started to deal with that issue. And that is some of what we are going to go over today. I don't want anybody to go through the pain that I went through and I know so many people do because of the bad products that are out there and the bad information.
00:05:36 Actually there's better information than ever before. But there are really bad products out there. So you can stop having the same problems I went through as a kid because nobody should struggle with that self-image because it just hurts. It just hurts. Oh god, I am; I'm re-experiencing it. I'm having an emotional breakdown here. Let me stop that.
00:06:01 So, I have a few things to go over before we get into some stuff around acne. First, let me do the best and the worst products of the week. Bryan did really good choosing these products.
Bryan Barron: Yes, they are acne-centric.
Paula Begoun: They are acne-centric. Should we start with the best or the worst? Should we start with the bad news or the good news?
Bryan Barron: You know, let's start with the bad news. It's almost the end of the week. We can --
Paula Begoun: Oh, so we should end sum up with the best. Okay. So, the worst, these really are sad. So the worst is Burt's Bees Dr. Burt's - Dr. Burt, how do you get the name doctor? Or what kind of doctor - is he a doctor? I've never seen that before. Is he a doctor...of what?
Bryan Barron: Unless you can get a doctorate for selling honey out of the back of your pickup truck in Maine.
Paula Begoun: Or maybe he is a Doctor of Political Science. He is not...I don't know where that comes from. So it is Burt's Bees Dr. Burt's Herbal Blemish Stick, $8.5 for just 0.3 oz.
00:07:03 The alcohol is the main ingredient and it also contains several plant oils that are known irritants, including lemon, eucalyptus and fennel. Not a single ingredient in this product is known to reduce acne or heal skin. If anything, because of the research we know now about irritating ingredients and what it takes to heal skin, this product is diametrically opposed to helping skin in any way, shape or form.
00:07:34 So let me just explain, real quick, two basics about acne. One is that irritation, anything that irritates the skin is bad for acne. It makes acne worse. First when you have a pimple it is red. Irritating ingredients makes it redder. That doesn't help skin. Irritation also hurts the skin's ability to heal. When you have a blemish you need it to heal. You need to fight the bacteria.
00:08:01 You need to fight the swelling. You need to fight the damage to the skin to prevent the redness. Anything that irritates the skin is going to make that process worse. That tingling sensation you feel from ingredients like lemon, eucalyptus, peppermint, menthol, camphor, alcohol, on and on are horrendous for any skin type but particularly for acne skin. The other thing about irritation, and this is fairly new research. I mean I actually had written about it years ago.
00:08:33 I have kind of always suspected this was true but now there is research backing it up is that when you irritate skin, when you use ingredients or, I don't know, hot water, rough scrubs on the skin, you not only break down the barrier of skin which hurts the healing process but you stimulate in the pore itself nerve endings that actually produce androgens. Androgens are the male hormones that produce oil, that cause skin to be oily.
00:09:04 Generates more sebum. So those very ingredients that you think are helping are actually making skin less able to heal and increasing oil production and oil production is the central cause, along with a particular acne bacteria, acne-causing bacteria called P. acnes that causes the problem in the first place. It's just insanity. Insanity! Stop the insanity!
00:09:34 The second product that is the worst of the week: it ah-veh-da or ah-vay-da, Bryan?
Bryan Barron: It is Ah-vay-da. But it actually should be pronounced Ah-veh-da because the name is derived from Ayurveda.
Paula Begoun: Oh, the Ayurvedic medicine from India?
Bryan Barron: Yes. I think when it came about they figured that no one would know or really care what that was and so they pronounce it ah-vay-da.
Paula Begoun: Actually some people do know and care what it is but it is very complicated and they really don't quite understand it, but that is a whole other story.
00:10:09 We will be doing a show upcoming on natural and organic products. I'm looking forward to that one, too. So this product is pads soaked in a solution of 1.5% salicylic acid and alcohol is one of the suspending agents. The pH of the product for the salicylic acid means that it won't work as an exfoliant. There is some research that says higher pH levels, and we will talk about salicylic acid in a little bit, can have effect. But even if that was true the amount of alcohol in this absolutely causes, again, free radical damage, hurts the skin's ability to heal, causes cell death, increases oil production, makes skin redder, makes acne redder.
00:11:00 This is bad. Do not use this. Oh, geez, let's do the good stuff. And cheaper. Best, Clean & Clear Persa-Gel 5, contains 5% benzoyl peroxide and a very simple fragrance-free gel that feels weightless. It is very, very good to consider. Not to mention it is $5.89 for one ounce. Cosmedicine's Speedy Recovery Acne Treatment On-the-Spot Gel. It is pricier; actually I said cheap but it is not that cheap.
00:11:36 It's $18 for 0.23 oz. It is a lovely silicone-based 2% salicylic acid with a pH that will allow for it to work as it should which exfoliates in the pore to help the pore perform normally. It also has some absorbing ingredients to absorb oil and soothing ingredients to reduce redness. It's only fragrance is a tiny amount of tea tree oil. Actually we are going to talk about tea tree oil in a few minutes here. It's worth a consideration. It is definitely better than the other two I just mentioned, the Burt's Bees and the Aveda.
00:12:13 So let's talk a little bit about...actually, what should I talk about? There's so much here. You know something, I will talk about this other stuff later. Let me talk a little bit about acne treatments because I've just got acne on the brain right now. So the gold standard for treating acne is benzoyl peroxide. That research is pretty conclusive. In fact some new research says that the 5% benzoyl peroxide is just about as effective and equal to the 10% versions. So what's nice about that is that you don't have to consider jumping up from the 5% -- so there is 2.5% benzoyl peroxide out there, 5% benzoyl peroxide and 10%.
00:12:59 Now 10% definitely causes more irritation and according to this new research suggests that that is going too high. It can have some negative kickback because it can be irritating and that the 2.5% or the 5% can be not only just as effective but more effective because you are less likely to get irritation from it. Benzoyl peroxide, a ton of research from the Journal of American Medicine, the Association, the [unintelligible] that benzoyl peroxide is the gold standard.
00:13:30 The next little friend of benzoyl peroxide is salicylic acid. Salicylic acid has been around forever, almost as long - if not longer than benzoyl peroxide. It is a known anti-irritant. It is related to aspirin. Aspirin is the acetylsalicylic acid. And salicylic acid retains aspirin's anti-inflammatory properties. It is just a little hero. It exfoliates skin, works as an anti-inflammatory agent and exfoliates within the pore to improve the pore aligning and has some anti-bacterial properties.
00:14:11 A well-formulated salicylic acid product with benzoyl peroxide is a godsend for skin. When those two products don't contain any irritants and are formulated in stable formulations that are gentle on skin - now some of the other ingredients you are going to see running around for acne. It's kind of interesting. Tri-Cyclen is a bit controversial but the research about Tri-Cyclen as an anti-microbial is pretty clear and that it has benefit for treating acne.
00:14:45 As a matter of fact in England it is under a monograph meaning that under the British, their version of the FDA, Tri-Cyclen is an anti-acne/anti-bacterial agent because it decreases the amount of that little nasty P. acnes bacteria that is in the skin. And that it is worth a consideration when you see it on a product that says it is for acne. Not as effective as benzoyl peroxide. Definitely doesn't play a role quite like salicylic acid to say the least. But as an additive, as another way to jump in there and treat acne.
00:15:26 Sulfur is an interesting one. Proactiv is big with their sulfur mask that they give away for free because I don't think anybody really likes it. It is irritating, it's a high pH. There is research about high pH products over 7, over 8 that actually increase bacteria content. But there is research about sulfur that in concentrations of 3% to 8% can help reduce acne. It's definitely out there. Unfortunately I think it has far more negatives than positives.
00:15:57 First most companies are not using that kind of percentage. They are using far less. Proactiv does not contain that high of a concentration. That's because it stinks; sulfur is a smelly crap ingredient. It has a really nasty, yellow look. It can stain clothes. It has a lot more limitations than positives. In terms of alpha hydroxy acids like glycolic acid and lactic acid, that works on the surface. It's not bad as an option but can't compare to salicylic acid. But when you can't use salicylic acid, those people who are allergic to aspirin or Guaifenesin, if I am pronouncing that word right, treatment - you can't use salicylic acid. So alpha hydroxy acids are an option.
00:16:45 Again, they just have limitations because they don't have anti-bacterial properties, they don't absorb into the pore and exfoliate within the pore and they don't - they are just limitations. Retinols are great. Retinol, the whole vitamin A molecule can break down and become tretinoin in the skin, the active ingredient in Retin-A and Renova and that's great. That absolutely helps improve cell formation so the pore, the skin of the pore and the whole system works normally and that absolutely helps improve pore function and then reduces acne.
00:17:23 The research about retinols and the active form of tretinoin or adapalene and Differin which are all different forms of the vitamin A molecule for prescription options are absolutely ones to consider. Tea Tree Oil, the notion that it is a natural way to treat acne, tea tree oil - yeah, it's a plant. Yes, it comes from an Australian tree, Melaleuca; interestingly enough, Melaleuca is toxic when you drink it. You don't eat tea tree oil. So much for it being that natural means better. And in research it didn't perform as well as benzoyl peroxide.
00:18:07 However, in order to work as well you have to have pretty high concentrations and because tea tree oil smells so bad nobody uses it that much in their formulations. So, bottom line, from all of the research that is out there - a well-formulated benzoyl peroxide product, a well-formulated salicylic acid product, we have a ton - well, I wouldn't say a ton. But we have many suggestions on for products that will help.
00:18:34 And in terms of the starting point, that is the best in terms of over-the-counter you can get. From there you have got to go see your dermatologist. Do not get sucked into buying the dermatologist's product. They are beginning to be my biggest bane. I'm going to do a whole show just on dermatology products - well, products that dermatologists sell. I'm getting so many letters and comments from women who have been to their dermatologist who are telling them only the products they sell are the best products. Such a fib.
00:19:09 Let's see. I've just been carrying on. I should probably take...should I talk about the Wonder Bar before, not the Wonder Bra, the Wonder Bar. Should I talk about that before?
Bryan Barron: Right. One actually did a lot for mankind and the other is probably not doing much of anything good.
Paula Begoun: Yeah, well I tried the Wonder Bra, and never mind. This is the Wonder Bar.
00:19:34 I won't talk about my strange experience with the Wonder Bra, which wasn't so wonderful. I'm sure it is wonderful for someone but that isn't my area of expertise. Okay. Oh, I also tried Spanx. Boy, that didn't work. That was just embarrassing. Desiree, you know what Spanx are, right?
Desiree Stordahl: Yes, I do.
Paula Begoun: Have you tried them?
Desiree Stordahl: I haven't tried them yet. I feel like that would be pretty uncomfortable.
Paula Begoun: Well have you ever heard of the word girdle? It's just a new version of a girdle. Well, Desiree, you are so adorably little and beautiful...never mind. So, Bryan, do you even know what Spanx are?
Bryan Barron: I do.
Paula Begoun: You do? You haven't tried them, have you? Have you ever put on a...well you are little, too. Never mind. I'm probably the only one in the business that has tried Spanx. And I know you haven't tried the Wonder Bra, Bryan, but even if you have I don't want to know about it.
Bryan Barron: Wonder Bars!
Paula Begoun: Yes, that is what I was going to talk about.
00:20:40 So, did someone ask us about this? How did this come to our attention?
Bryan Barron: Yes. Somebody asked us about it this morning and it has come up a few times in the past. So my curiosity got the better of me and I had to know why so many people were writing us to ask about this very expensive bar of soap.
Paula Begoun: This is a bar of ordinary, embarrassing soap. I mean it's - I don't have any words for how ordinary and mundane this $40, 0.9 oz. bar is. And if you buy the big size at 80 grams it runs $105. And all you are getting are cleansing agents, detergent cleansing agents, standard that show up in dozens and hundreds of cleaning products all over the world, thickening agents that are just thickening agents.
00:21:34 I mean they are not particularly horrendous but they are thickening agents. They don't serve any purpose or help for oily skin or cleaning skin. They just hold it together. It has some talcum in it. And then it has a type of algae derivative that they are making all kinds of claims about that is supposed to be this incredible secret. It is extracted from algae grown in Europe. I'm not sure if the algae can't grow anywhere else or if it is from Europe it must be better.
00:22:06 And then of course Moor mud, because mud from the Moor highlands I suspect is where this is from...because it is 3,000 years old and people kept such great records back then so we know they all had great skin because of the Moor mud. Of course they didn't. That is just nonsense. It is supposed to be great for skin. Of course, even if it was great for skin, in a bar cleanser you are rinsing the stuff off your face. So even if any of these ingredients which have absolutely no research saying they have any benefit for skin could help skin it would be rinsed down the drain anyways.
00:22:43 What you are really getting is about 99% cleanser, cleansing agents, thickening agents to hold the stuff together. And then some amount of, well, teeny amounts of clay and this algae. Nobody got clean or took care of their skin in any way, shape or form because of this product. How sad, $105 for 80 grams. Boy, is that like even a half a bar of soap?
Bryan Barron: And don't forget the healing process the skin is supposed to go through.
Paula Begoun: Oh, did I miss that claim? What's the claim? Oh, this is the only skincare product I have ever seen that states your skin will go through a healing crisis as it works to repair skin and purge toxins. Well first of all, skin doesn't have any toxins so that is just nonsense. But what crisis?
00:23:34 You know what it is - probably your skin is going to be itchy, dry, peeling and broken out from the...oh Bryan, that's funny. I missed that. We have to do some of the crazier, the myths that won't die, like there are toxins lurking in the skin somehow causing problems. Of course, nobody has ever said what those happened to be, what toxins are we talking about. Nobody has ever measured them.
00:24:04 Oh gosh, there is so much sitting at my desk. Let me just talk - this thing about Restylane that came up that was kind of an interesting thing. This doctor has a new line out that claims that he has done something incredible with hyaluronic acid, kind of nanoparticled it. Made is small so that it absorbs into skin and thereby it will work like Restylane. Restylane is the dermal filler that contains hyaluronic acid.
00:24:34 So let me tell you what's crazy about that. Just crazy. First of all, the way Restylane works, the way any dermal filler works is not that it is small but rather that it is a big, relatively big part particle size that only gets into skin because it is large enough that it needs to be injected. It is specifically injected in a very specific area - the lines around the mouth, the lines that kind of draw down around the lips, lines between the brows. And you place it very...or the lines around the mouth...if you don't place it accurately you can get a lumpy, distorted look.
00:25:19 So even if it somehow helped to make hyaluronic acid a smaller size to nanoparticle it, to get it into skin, it won't just go to the lines. It would go all over and if the claim is that it is going to work like Restylane, then after you keep applying it and applying and applying it, your whole face would get puffy because it wouldn't know to just go were an injected form of Restylane, of hyaluronic acid, would go.
00:25:50 The claim is just nonsense. It makes no sense. And by the way, let me just mention that one of the side effects, unwanted side effects of using dermal fillers in general, but in particular Restylane, the so-called natural fillers, is you can go though - it's a fairly painful process to get dermal fillers. I mean the results can be spectacular but one of the risks is that after going through all of this process to get dermal fillers to get your lines plumped up, it can go away in three weeks.
00:26:24 They last somewhere between six months to 18 months depending on what research and what kind of filler is used. But 18 months is kind of the outside for most of the so-called natural fillers. But it can, for some people, go away in less than a month. Don't let any doctor tell you these things are slam-dunk. They aren't. They all have their pros and cons. But the notion that it is showing up in a skincare product is somehow the answer to your problems because it is going to pump lines like Restylane is a lie. It doesn't work that way.
00:27:00 I'm out of breath. Oh, the iPhone app. Oh, I didn't get to the iPhone app! Oh, should I do it or take questions? I know everyone has their questions. Let's guys vote. Should we do the iPhone app or save it for another time?
Bryan Barron: You know, we can't keep putting it off so why don't you talk about it for a minute because it is really all the time it deserves
Paula Begoun: So there is a new...I don't own an iPhone yet. But there is a new iPhone app that says because you download it, you turn it on and your phone becomes one of those light emitting diode machines and you put it up against your skin and it fights acne.
00:27:37 Yes, it's true they make the claim. It is not true that it works. What were you going to say, Bryan?
Bryan Barron: Oh, I'm sorry. I could comment that our marketing director actually bought this app for her iPhone and when I was in a meeting with her last week she handed me her phone and it started flashing. So I was holding it up to my face and it was red and it was blue.
Paula Begoun: So, let's just be very -
Bryan Barron: It's silly.
Paula Begoun: There is research...there is no question that light emitting diodes and the red and blue nanometer light category does have some benefit for acne.
00:28:15 It's true. But the notion that your cell phone can somehow work if you held it up to your skin to deal with acne misinterprets how these light machines work, how you are supposed to sit in front of them, their impact on skin. Keep in mind that if that iPhone app worked your clock radio is a light emitting diode. Your remote control is a light emitting diode. You can sit it in front of your remote control or your clock radio. It doesn't quite work the way a real light emitting diode machine would that you work in conjunction with a dermatologist.
00:29:00 And I think it is cute. I'm sure a lot of people are downloading it. No one is going to get rid of their acne because of it. And, yes, that is all the time it deserves. Although there are a few more things I can say about it. But just mostly it is a joke. So, Desiree, can we have the first caller tonight?
Desiree Stordahl: Let's go to Kristi from Georgia with a question on prescription acne medicine.
Paula Begoun: Hi Kristi. How are you?
Kristi: Hi Paula. I'm good, thank you. I'm a big fan of your products and it has really helped clear up my skin, so thank you.
Paula Begoun: You're welcome.
Kristi: I'm 32 and I have mostly had acne since I think the day I turned 20.
00:29:40 And your products have really helped and recently I went to a dermatologist about some spots on my face that I wanted to get check out, these little scaly places. And he really wasn't so concerned about that. But he started asking me about my acne and I just said, well, with some certain products it has really cleared up. And he said, "Well have you tried prescription products?" And I said, I have, but you know normally they will try you on them for a couple of weeks, put you on an oral antibiotic. You will come back in a month, it doesn't work, and then everybody goes, "Oh, let's do Accutane."
00:30:13 And I said, you know, I've just kind of given up on dermatologists. So he prescribed me Differin gel and these clindamycin moist pads to wipe on my face. And the Differin gel --
Paula Begoun: Wait. Just clindamycin or clindamycin with benzoyl peroxide? Is it just clindamycin?
Kristi: I think it's just clindamycin. I can look on the bottle real quick.
Paula Begoun: Do you know the name of the product just offhand?
Kristi: It's clindamycin phosphate topical solution.
Bryan Barron: It's probably just clindamycin by itself.
Paula Begoun: Yes, it's just the clindamycin.
Kristi: It mostly just smells like alcohol and it is horrible.
Paula Begoun: Yeah, it's horrible. Okay, so here is...oh I'm sorry. Finish your question, sorry.
Kristi: I was just going to say, the question is he prescribed a different gel and when I went to get the prescription filled with my terrific insurance it is going to cost me $200. And --
Paula Begoun: For Differin?
Kristi: For Differin. Yes, because I have a PPO health insurance where I pay out of pocket and because of my deductibles and this and that it is going to cost $200 and I just, I didn't get the prescription filled because I said I can't risk $200 if it is just going to be another product that doesn't work.
00:31:32 And I didn't know how much you knew about Differin and if it was worth the risk or not?
Paula Begoun: Actually I happen to know a lot about Differin. I actually was consulting with the pharmaceutical company when they were launching Differin, when they were first doing the research about it. There is no question - Differin is just adapalene, the active ingredient in Differin is just another form of retinoid. Retinoid is the general class of ingredients derived from the whole vitamin A molecule which is retinol.
00:32:05 Retinol is the cosmetic ingredient and the other retinoids that are prescription are adapalene, tretinoin and the one in Retin-A and Renova, tazarotene, that's in Tazorac. There is research that it is helpful. However, the research from the Journal of American Medical Association [and Lancid] said that benzoyl peroxide outperformed any prescription items that a dermatologist could have prescribed. That study came out in 2004.
00:32:38 Now it doesn't mean that you shouldn't try prescription products but you would only try them if using benzoyl peroxide and salicylic acid, making sure that all of the other products you are using are gentle. The cleanser is gentle, you are not using any products that have irritants. You are using a liquid product that puts skin healing ingredients. If you know my work you know about skin identical ingredients and antioxidants that help skin heal.
00:33:08 That you are doing all of those things, then you are really...and it is never going to be 100%. You just don't clear up acne like that. You can keep it under control. But if the salicylic acid and benzoyl peroxide aren't working for you and everything else you are doing isn't working, then you do need to give it a go to see what the doctor has to offer.
00:33:34 However, let me recommend strongly you consider, if you do decide you want to do the dermatology route, the problem is that what he recommended for the clindamycin product, the alcohol is going to increase so oil production, free radical damage and hurt the skin's ability to heal. Most people, there are new products - not most people, most doctors. A lot of doctors now, I wish I had the name off of the top of my head. I will have it for next week.
00:34:04 They make clindamycin now with benzoyl peroxide. And the reason -
Bryan Barron: Paula, I know what that is called.
Paula Begoun: Bryan, you know everything, Bryan, absolutely everything.
Bryan Barron: Actually I don't, but thank you. It's called BenzaClin.
Paula Begoun: BenzaClin! Yes, that's it. I'm sorry, Bryan, go on.
Bryan Barron: Oh, it's also worth noting that the same company that offers Differin, Galderma, also makes a prescription product called Epiduo which combines the active ingredient in Differin, which is adapalene, with benzoyl peroxide.
Paula Begoun: Oh, right.
Bryan Barron: So that is another consideration.
Paula Begoun: So the comment I was going is another consideration, absolutely, from a prescription point of view.
00:34:49 But the other thing to consider is if you do go the prescription route you could absolutely do the adapalene and then like Bryan said you could do the adapalene mixed with benzoyl peroxide. But the mixture of clindamycin and benzoyl peroxide, what is intriguing about that is when you - clindamycin is a topical antibiotic. When you use a topical antibiotic you can actually, the P. acnes bacteria can become resistant to it.
00:35:18 They don't quite know the mechanism of action but when you stick benzoyl peroxide with the clindamycin it prevents that inhibition, that adaption of the P. acnes bacteria. So it stays fighting it for a long time. So if you are successful using - are you using my Clear system or are you using someone else's?
Kristi: Yeah, I've been using it for a couple of months now and it seems like it helps it a little bit more than the other products of yours that I was using. But I still just break out primarily around the chin area for about five years now that just won't go away. And then like around my nose area going down to my mouth. So it helps a little bit but it is still there.
Bryan Barron: It sounds like it could be perioral dermatitis.
Paula Begoun: Yeah, actually it does sound like perioral dermatitis.
00:36:10 I feel for you for the money. I think that you can stay the course. Are you using any of my Skin Balancing toner or my Healthy Finish toner? Are you using any of my -
Kristi: Well I was using those until I started using the Clear system.
Paula Begoun: So here is what I would like you to do. Desiree, will you make sure Kristi gets the Healthy Finish toner? Let's get that out to you so that you are putting something on your face that helps healing and soothes skin a little bit more than what my Clear line can provide. Because of the redness on your chin I want you to talk to your dentist about using a non-fluoride toothpaste. You could have having an allergic reaction to toothpaste.
00:37:01 I mean it does sound like perioral dermatitis and it might take a route to the dermatologist to treat that. And I know that is pricy but you know when you talk about that specific redness on the chin and the bad breakouts -
Bryan Barron: And how long she has had it.
Paula Begoun: Yeah. Yeah.
Bryan Barron: Five years is a long time to be dealing with a problem in the same area. And if it is not responsive to what you have been doing, it's probably not acne. Not that you don't have breakouts on other parts of your face, but what is around your mouth may not be related to the same.
Paula Begoun: Right. And I would encourage you to see a new dermatologist because he is giving you old product recommendations. I mean not the adapalene, although, but it sounds like he is not up to speed on the current research.
Kristi: He kind of irritated me, too, because I went in because my family has issues...well my grandma had lots of skin cancers always taken off of her. I'm very fair skinned so I am always covered in sunscreen.
00:38:06 And I went in to see him about these spots on my face and he was just like, "Ah, blah, blah, blah, these are spots that people your age normally don't get. You need to wear sunscreen." And I said, I do wear sunscreen, I've been wearing sunscreen, do you see how pale I am? And then that is when he went into the acne thing. And I just told him I didn't...the last dermatologist I went to put me on Tazorac and that ate my face up like acid. It was horrible. And he just said, "Oh, you have never been to a dermatologist like me. So I know what I am doing."
Paula Begoun: Obviously you won't be to a dermatologist like him again.
00:38:46 So three things and then I'm going to let you go and I need to take other calls. But one is that when you are fair skin and you have discolorations on your skin that you are suspect about, you need to get body mapped once a year by a dermatologist who knows how to differentiate different types of cancer. To push you off on that just pisses me off. Number two is you really need to take a look at my chapter in my book, I actually think it is even on my website at on how to treat acne and the options.
00:39:16 You really need somebody who has more state of the art products. I do think you have perioral dermatitis and not so much acne. So I do think there might be reason , but you have got to see a dermatologist but you have got to find a better one. Good luck, Kristi. And we will get you a couple of products that I think will help you.
Kristi: Okay. I appreciate it and thank you for all of the good work you do.
Paula Begoun: Take care, Kristi. Desiree, next caller.
Desiree Stordahl: We have Joanna from New York with a question on acne scars.
Paula Begoun: Hi Joanna, how you doing?
Joanna: Good, hi Paula. So lovely to speak with you. I've been a fan for years.
Paula Begoun: Thank you.
Joanna: And I love your work and I appreciate everything you do. I've learned so much.
Paula Begoun: Thank you. Thank you.
Joanna: And I have to tell you that I have become a Cosmetic Cop myself.
Paula Begoun: I love when there is more than one out there. I've got a whole team of people all over the world.
Joanna: Looking at all the counters, I want to look at the box and they look at me like I have five heads.
Paula Begoun: Well wait of the things we are doing with, I can't believe it, I actually approved it today - we are going to have an iPhone/Google phone, whatever phone app. So when you are standing at the counter and you don't want to schlep my big heavy book to the counter with you, you can have all of the 300 product lines that are on Beautypedia right there on a phone app. Bryan, how long is that going to take? When do you think we can get that?
Bryan Barron: They will probably need about six weeks to get everything done.
Paula Begoun: Oh, not as bad as I thought.
00:40:52 But nevertheless, Joanna, tell me your question. It's Joanna, right?
Joanna: Joanna. My question is I am 38 years old. Since I have been following you I have learned a lot about skincare and I have been taking good care of my skin. People think I'm in my 20s. But my big problem is I have post-acne scaring from a teenager. Some of them are indentations. And I don't know what would help with that. If [Microdermabrasion] is an option.
Paula Begoun: No, no. Well, actually, I don't mean no, no, no. So pockmark scars, particularly the small ones, but anything where the skin is indented, those kind of scarring - so you are not talking about what they call post-inflammatory scars from acne which are kind of red discolorations? You are talking about indented scars?
Joanna: Yes. Some are indented.
00:41:52 Around the cheek area.
Paula Begoun: Believe me, I know. There really isn't...are you using an exfoliant? Are you using a salicylic acid-based product?
Joanna: I use your products.
Paula Begoun: Are you using one of my 2% or 1% BHA?
Joanna: Yeah.
Paula Begoun: You are? Okay. So in terms of what the cosmetics industry can offer, that's about it. You can help cell turnover. You can give skin antioxidants and help repair and build up some amount of collagen.
00:42:25 But it is limited. The next step from there...Microdermabrasion is nowhere near as successful - no one is quite sure if Microdermabrasion helps skin because it is a temporary swelling effect and there is some research that says with repeated use you can actually get loss of collagen. So I am not a fan of Microdermabrasion until there is a lot more research being done on it and there is almost none.
00:42:50 And the research that is being done on it is mostly from the dermatologists who are using it. So that is not the best. So the options really are the IPL, the intense pulse light machine treatments that dermatologists can do or Fraxel or the pixilated laser - never mind. We will do another show. We have Dr. Brandith Irwin coming on in a couple of weeks who wrote a book called "The Surgery-Free Makeover."
00:43:29 She is going to talk all about IPLs and lasers and Fraxel. But in terms of what you can do about those indented scarring, there is nothing at the cosmetic counters. You are really looking at the treatments, unfortunately pricy treatments, that dermatologists can do that can help improve the overall appearance of skin, and particularly scarring. Now if scarring is deep enough -
Joanna: It's not that bad. It's not horrible. I can't complain [too bad]. But it is still...
Paula Begoun: I know. I have it, too. I have done IPLs and Fraxel on my skin.
00:44:06 And I definitely have improvement. I mean there is no question I have improvement. And it always shocks me when people compliment me on my skin. I always go, really? And then I think, wow, I really do make good products. And then I also have to remember I do make good products, but I also remember some of the work I've had done. And it did help but it still limited.
00:44:26 I still see the scarring. So save up your money. I'm saving you a lot of money. You are using my products. You are not wasting money, you've got great products. I know that.
Joanna: I know every ingredient.
Paula Begoun: So you can start saving money and put it in the bank and then in a couple of years you will have saved enough and you can consider an IPL or a Fraxel pixilated laser treatment which really can add that next level of anti-wrinkle texture improvement in your skin. Joanna, thank you for calling, dear.
Joanna: Thank you, Paula. Thank you for your hard work. Bye-bye.
Paula Begoun: Thank you. Desiree, next caller.
Desiree Stordahl: I've got Sonia from Ontario on the line.
Paula Begoun: Hi Sonia, how you doing?
Sonia: Good, how are you doing Paula?
Paula Begoun: Good. What can I do for you?
Sonia: Okay. I'm 40 years old and I have an issue. I'm a little bit nervous.
Paula Begoun: That's okay; take your time.
Sonia: I can't keep my hands off my face. And what I do is I squeeze the blemish because it hurts so much to release the pressure. My question is, does the blemish have to come out? Because to me when I think about a blemish, if you don't squeeze it, it stays in your skin and then it comes out in the same spot the next month or the following month?
Paula Begoun: Well, let's talk about anxiety picking at your face obsessively.
00:45:55 So first of all, it doesn't help. I mean, don't misunderstand...I am going to talk about squeezing blemishes, squeezing pimples. Because absolutely when you do it right it absolutely helps the blemish go away faster. There is no question about it. All the advice you have seen in not picking your skin, I don't know what those doctors are thinking. They are so wrong. You absolutely have to, exactly what you are saying is true. You have to relieve the pressure. It just keeps growing. In fact, there are comedone remover things that you can buy at the drugstore.
00:46:29 The problem with women and guys when they have acne is they overdo it. So what happens is it isn't just gently removing the pressure and the buildup sebum and the buildup white blood cells that cause the reaction to the bacteria in the skin. When you over-squeeze and you damage the skin, that causes ugly scabs on the face. That doesn't look better than a pimple and it makes matters worse.
00:47:05 Do something else. Find a different obsessive compulsive habit. Use that. I mean pick at a cinnamon stick or buy flowers and pick the leaves off of flowers. I mean find bubble wrap and squeeze, and pop the bubbles in the bubble wrap. You have got to find some other obsessive compulsive behavior because what you are doing to your face is going to cause you scarring. Scabs are not attractive anymore than pimples are.
00:47:35 But yes, absolutely, I would encourage women and men when they have a pimple to either consider buying one of those comedone extractors at the drugstore. It's like ten bucks. And it's just gentle pressure, or gently squeeze, protecting your fingers with Kleenex, gently squeeze to release the pressure in the pimple. If you over-squeeze you will absolutely cause yourself problems. You must put a benzoyl peroxide or salicylic acid without any irritants on afterwards.
00:48:10 Or wash your face and then put on a benzoyl peroxide or salicylic acid-based product. But you have got to do it carefully. And you have got to keep your hands off your face. And that comedone extractor is great, especially for smaller pimples on the face. But, yes, relieving the pressure...we all know that. I don't even know why doctors say don't do that. We all know that that helps. It is overdoing that causes the damage.
00:48:38 Bubble wrap. Go buy bubble wrap. Okay? Thank you dear. Next question, Desiree?
Desiree Stordahl: We've got Denise from Wisconsin.
Paula Begoun: Hi Denise from Wisconsin.
Denise: Hi Paula, how are you?
Paula Begoun: I'm good. Where are you? Are you up in the hinterland, the snow? Are you covered in snow?
Denise: I'm in Milwaukee and yes we are covered in snow. We just had a storm yesterday that pretty well buried us.
Paula Begoun: So that is why you are inside listening to me. Okay, I've got it. Tell me what I can do for you.
Denise: I have these particular white heads that only show up around the eye area. I have had them on my eyelids before. But in general I get them on my forehead or on my temples and if they are on my forehead near my eyebrow area. And I went to an aesthetician about ten years ago and she said they were a different kind of white head.
00:49:38 And it's true that...and I'm glad you just talked about squeezing...if I did try and just put some pressure on it to try to pop it, nothing would happen.
Paula Begoun: Because they are called milia. They are not a pimple. They are not probably red and swollen. They are just white little bumps on your face, right? So those are -
Denise: [Yeah].
Paula Begoun: Now you haven't gone to a dermatologist?
Denise: I haven't recently. But in the past I have - so is that what I need, to go to a dermatologist?
Paula Begoun: Yeah, so here is the problem is that milia is very tricky. They are not exactly clear why that happens to some women. I have some that I have struggled with.
00:50:26 Now personally I know how to remove them. I'm not going to teach anybody right now over the radio how to remove them. But they do have to be excised. They don't come out from squeezing. They actually have to be removed. Some aestheticians now how to do that and if you went to a really great aesthetician who wouldn't scar you then actually excising them is a great way to go. Dermatologists know how to do it, obviously, too. And unfortunately you have got to keep it up because for those people who have a tendency towards them, they do come back.
00:51:00 Are you using an exfoliant like a salicylic acid-based product? Are you using one of those?
Denise: Yes. I'm using your, what is it, the Clear skin line.
Paula Begoun: So you are using the extra-strength or the regular strength?
Denise: I think I'm the regular strength. I was going to try that first and then see if I needed to step it up.
Paula Begoun: Well the benzoyl peroxide, are you using the benzoyl peroxide product that comes with the Clear line?
Denise: Yeah.
Paula Begoun: So are you having other pimples besides these white bumps?
Denise: Oh yes. Your products have really helped a lot but I have basically struggled with acne since I was about 9 and I am 35.
Paula Begoun: I so know what you are talking about.
Denise: Yeah, I heard your story earlier and I really related. It's much, much better with your products.
Paula Begoun: Thank you. Thank you. But in terms of the white bumps, these milia that you are talking about, they are just white little tiny dots and they aren't red and swollen, they are not acne. They are very different. They don't go away. It doesn't matter what you use. Cosmetically they don't go away.
Denise: I have had them for years.
Paula Begoun: So you either need to go to...well actually, a dermatologist who has an aesthetician, what they call a dermatologic spa, the will probably have an aesthetician there who has been trained by the dermatologist or the dermatologist will excise them. And then it is just a matter of maintenance. You might have to go back.
00:52:29 The major thing is when you go to the dermatologist do not be seduced into buying their products. I will have another show talking about that. But you do need to see a dermatologist or an aesthetic dermatologist - a dermatologist who has an aesthetician trained to remove those. And I think you will be a lot happier.
Denise: Excellent, great.
Paula Begoun: Okay, I'm going to try to take one more call so I'm going to let you go. Stay warm!
Desiree Stordahl: Okay, Paula, we have Kim from Pennsylvania with a question on teen acne.
Paula Begoun: Hi Kim, how you doing? Kim? Did we lose Kim?
Desiree Stordahl: It looks like we lost Kim. So let's go to...we second...Deborah from New Jersey with a question on acne products.
Paula Begoun: Hi Deborah from New Jersey. What's going on?
Deborah: Hi Paula. I actually will pick up with Kim's thing. It's actually talking about teen acne. I have a 13 year old daughter who is really suffering with acne now. She has it around the hairline and blackheads on her nose and also the upper chest and back area.
Paula Begoun: Oh, that is particularly stubborn.
Deborah: Yeah, I'm trying to start investigating what products are out there for her. Like I saw Philosophy has a line.
Paula Begoun: Yeah, no, they all have lines. So here is what I am going to do because I only have a couple of minutes left. So first, you are going to stay on the line and Desiree is going to give you some information. One is you need my book, the original "Beauty Bible." You need to read facts about acne. And then I'm also going to give you a free subscription to with is a review of 300 product lines and all of their products so you can look up all of the acne products that are out there to see how they got reviewed.
00:54:26 There are some great acne products out there but there are some rotten acne products out there. I want you to stay away from the rotten ones. The third thing is that teenage acne isn't any different than anybody else's acne. A pimple is a pimple. If you are 50 years old, 20 years old, 13 years old, and how to treat it is the same across the board. It's just it is so painful for a young teenager to deal with those new images of themselves and to have it not be beautiful.
Deborah: They're in middle school, and so it is a tough age.
Paula Begoun: Tough age. So here is what I'm going to do. You are going to get the original "Beauty Bible." You are going to get a free subscription to Beautypedia and I'm going to send you the Clear line from from my product line. We are going to get you the regular strength Clear products and see how that helps your daughter. So don't just...I'm going to take you off of sound right now but stay around so that we can get the information from you so we can get those products out to you.
00:55:28 And the book and a subscription to Beautypedia. Take good care of that cute little daughter of yours.
Deborah: Thank you so much. I appreciate it so much.
Paula Begoun: All right. To everyone out there, it was another great Thursday. My heart goes out to all of you who are struggling with acne. I think that the information and the research that is out there that we provide on and will absolutely help your skin and save your skin. There are incredible options out there.
00:56:00 Those are the ones I want you to get to. I want you to stay away from the bad options that are hurting your skin and wasting your money. This is me, Paula Begoun, the Cosmetics Cop, keeping you "Beautifully Informed" with my Cosmetics Cop team, Bryan Barron and Desiree Stordahl. Next week we are going to be talking about how the industry formulates new products. I'm going to shock you. We are going to walk through how you get to a new product on the shelf. And then the week after Dr. Brandith Irwin discussing the surgery-free makeover; she is my dermatologist.
00:56:32 Thank you. Stay beautifully informed. We will see you next week. This is Paula Begoun, Bryan Barron and Desiree Stordahl. Good night.
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