29. Anti-acne Cleansers

Doctor Jacob here, and today we're talking about anti-acne cleansers.

Anti-acne cleansers are really important to an acne treatment regimen, because most people wash their face and when they wash their face, many people use something more than just plain water. A cleanser is important because it can help remove some excess oil, and if you use makeup it can help remove makeup and so forth. So if we're going to use a cleanser, why not use an anti-acne cleanser if you have acne, it makes sense.

Before we jump into talking about all the different types of anti-acne cleansers and which one might be best for you, let's talk about how frequently washing the face should be done. I usually say once or twice a day, for most people. For most people with acne, if you're a little bit more oily it's twice a day, if you're less oily maybe just once a day at the end of the day. That's kind of a personal choice, a personal preference depending on how oily or dry you might be. If you are a type of person who washes twice a day, it may be beneficial to use two different types of anti-acne cleansers. For example, a benzoyl peroxide in the morning and a sulfur soap at the evening time. But let's talk about that later, and let's jump into the different types of anti-acne cleansers.

First up is benzoyl peroxide, an oldie but a goodie. We talked about this in an earlier episode, but I just want to recap and mention that benzoyl peroxide is a great anti-acne cleanser. I'll put several benzoyl peroxide-containing products, at different strengths, on the website for quick and easy reference. In case you want to purchase an anti-acne cleanser there, just go to the website and we'll get you one that's non-comedogenic, a great formulation, a great cleanser. It comes in two different strengths, 5% and 10%, and there will be links to either.

The stronger one is for less sensitive skin types, more oily skin types, whereas the weaker strength can be used for a more sensitive or eczema-prone skin. Just be careful to wash thoroughly, because benzoyl peroxide, like all peroxides, can bleach your clothing or towel.

Now let's move on to the next category. Aside from benzoyl peroxide, my favorite anti-acne cleanser category are sulfur-containing cleansers. I have two different on the website: sulfur-based bar soaps that contain sulfur, as well as in one of them salicylic acid. You'll see the brand products when you go there, but one is called KAVI Coral, the other is called KAVI Aqua. KAVI Coral is a 2% colloidal sulfur with also 3% salicylic acid for extra exfoliation. It's great for the face, as well as for acne on the chest or back; it can be used in the shower. For people with more sensitive skin or for patients who are pregnant or breastfeeding, 1% colloidal sulfur called KAVI Aqua bar soap is a really good alternative, because the salicylic acid is not really good for use in pregnancy.

So everything we've talked about so far with the sulfur soaps and the benzoyl peroxide - these are all over-the-counter, without a prescription. If we talk about prescription-strength acne cleansers we can get slightly more fancy, but it's not much more than we've already talked about with the over-the-counter stuff. So if you already have your hands on a anti-acne cleanser over-the-counter that you've gotten through our website, you don't really need the prescription stuff; it's not so much of an extra boost.

The prescription anti-acne cleansers combine sodium sulfacetamide with elemental sulfur. They come in a variety of strengths, for example 10% and 5%, 9% and 4%, 8% and 4% etc., with the sodium sulfacetamide usually at the higher percentage and the sulfur at the lower percentage.

Some patients say that these cleansers smell kind of funny and most of them do contain added fragrance to mask the elemental sulfur. What I like about the bar soaps which are over-the-counter, the KOVI Coral and KOVI Aqua is that they really don't have much of a smell, because the colloidal sulfur is very low in concentration but very effective, as compared to the elemental sulfur in the prescription products. So they can be great for treatment of acne, but they're also FDA-approved for the treatment of not just acne, but also rosacea, as well as seborrheic dermatitis. I'm talking about the prescription-strength sodium sulfacetamide and sulfur cleansers. So if you have one of those conditions, rosacea or seborrhea - seborrheic dermatitis as it is called - then that may be a good reason to use the prescription-strength cleanser. Or if your doctor prescribes it because you may have good insurance coverage and you get it for a very low copay. So that's a good reason to use one of these cleansers.

Now, which is the best cleanser? It really depends on the patient. For example a pregnant patient, KOVI Aqua would be a great choice. A patient with acne on the chest or back can use the KOVI Coral 2% colloidal sulfur plus salicylic acid. So it can be used in the shower, on the body. A patient with rosacea or seborrhea can use the prescription-strength sodium sulfacetamide cleanser. I suggest for people that wash the face more than once a day to combine one washing with benzoyl peroxide, usually in the morning, with another washing with the sulfur cleanser, either prescription-strength or over-the-counter sulfur soap, usually in the evening. That's a good way to get the benefits of both products in one day.

I'm Doctor Jacob, that does it for today. We'll see you next time.