THE HV LAB: SPOT TREATMENT SCIENCE

Pimples, zits, and blackheads oh my! Nothing like a good spot in the middle of your forehead to make a good day turn sour. Acne is one of those things that we all deal with every once in a while; some of us for our entire lives. Whether your acne is cystic, hormonal, occasional, or just plain-old persistent, we’ve all tried the quick-fix remedies that promised to reverse the curse of our pimples. 

Disclaimer: I am not a scientist/chemist/dermatologist. I’m just an excited and curious enthusiast who has done some research and is here to share and discuss it. Also, we all have different skin with different needs, so there may not be a one-size-fits-all solution that works for everyone. Let’s figure it out together.

Here’s what I know: 

Spot treatments are products that are meant to be used on individual breakouts and not the whole face. Their main purpose is to heal or diminish individual blemishes, not to prevent future breakouts.

There are three ingredients that appear in most medical spot treatments (the non medical one is ice). These ingredients are: Salicylic Acid, Benzoyl Peroxide, and Sulfur.

Benzoyl Peroxide

Benzoyl Peroxide is a topical antiseptic. This means that it’s essentially a bacteria killer. Benzoyl Peroxide is an ingredient that can be mixed with Salicylic Acid, Sulfur, antibiotics (usually erythromycin or clindamycin), and synthetic retinoids (adapalene). Many benzoyl peroxide treatments are available over the counter but their most common prescription-strength equivalents come combined with other ingredients in the form of Benzoyl Peroxide & Clindamycin (Duac or BenzaClin) and Benzoyl Peroxide & Adapalene (Epiduo, TactuPump, Tactuo). Note: the ingredient shouldn’t be used in combination with Retin-A, as Tretinoin (its active retinol) breaks down in contact with benzoyl peroxide and will become less effective.

Benzoyl Peroxide often causes initial dryness, and the ingredient does have bleaching properties and is often used in tooth-whitening systems and hair bleaching products. The Proactiv Emergency Blemish Relief, Neutrogena On-The-Spot Acne Treatment, and Murad Acne Spot Treatment are common Benzoyl Peroxide-based spot treatments.

Salicylic Acid

Salicylic Acid is pretty much the only BHA (beta-hydroxy acid) used in skincare (let me know if you want an AHA vs. BHA post). BHAs are capable of dissolving fats and lipids, It has about a million medical uses, including soothing aches and pains, reducing fevers, and acting as an anti-inflammatory agent, but in the acne world it has three main properties: it is a keratolytic, comedolytic, and bacteriostatic agent. Keratolytics cause skin cells to shed more readily, by helping to remove the top layer of skin. Comedolytics help open up clogged pores – the word comes from comedo/comedone/comedogenic and refers generally to pores. Bacteriostatics stop bacteria from reproducing – not to be confused with bacteriocides (like Benzoyl Peroxide) which actually kill bacteria.  High concentrations of Salicylic Acid, however, can kill bacteria (moving from bacteriostatic to bacteriocide).

Acne spot treatments using Salicylic Acid usually contain 2% for leave-on treatments and 3% for wash off treatments. Common OTC treatments include the Proactiv Blackhead Dissolving Gel, the Clean & Clear Advantage Spot Acne Treatment, the Origins Super Spot Remover Treatment Gel, and about a million more.

Bear with me – just one more.

Sulfur

Sulfer works primarily as an absorber. It has keratolytic and comedolytic properties, and primarily works as a mild antiseptic which draws oil out of the skin and can help to dry out pimples. Sulfer is a gentler ingredient than Benzoyl Peroxide & Salicylic Acid, but can be more effective with skin that needs oil control.

Common products containing sulfur include the Mario Badescu Drying Lotion and the Kate Somerville EradiKate Acne Treatment.

Less Common Spot Treatment Ingredients

There are a handful of other ingredients that pop up here and there in spot treatments. The first of these is Tea Tree Oil – found in more natural products including the Lush Grease Lightning and Burt’s Bees Herbal Blemish Stick. Tea Tree Oil is primarily an antiseptic, but as an oil it is much less drying than the aforementioned ingredients. Other common treatments include blue light therapy (those little LED devices), birth control, retinoids (such as Retin-A), oral antibiotics, and Isoretinoin (you’ll know it as Accutane). These are acne prevention solutions, and not generally effective for spot treatments and controlling existing blemishes.

Here’s What I’m Still Wondering:

My question for you is, what works? I think I’ve nearly tried it all. I’ve been unsuccessfully riding the spot treatment train for years; all of these experiments and I’m still turning out my pockets looking for a solution. The only treatment I haven’t properly tested is Sulfur so maybe that’s up next on the list.

I used to swear by the Origins Super Spot Remover Gel and the Lush Grease Lightning, but lately both haven’t been working their usual miracles on me. The product market here definitely exists; I know Peter Thomas Roth even do little Salicylic Acid-based stickers that you can put on your pimples, but what I want to know is – have you tried a spot treatment that really works? I’m starting to think we just need to let our zits live their little lifespans without our interference, but the science seems to show that something should be working.

Let’s talk in the comments.

sign off

PS: Are you into these science-y posts? Should The HV Lab be a thing?

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Miranda Feneberger

Miranda Feneberger

In the middle of an existential crisis. If you have one of those super long phone chargers can you send it to me?