The Regimen Help
Want the full enchilada? Read through the FAQ. / Just have 5 minutes? Take the Questionnaire. / Just have 2 minutes? Read through the biggest mistakes.
The Regimen FAQs
Q My skin is itchy after I apply the benzoyl peroxide. Is that normal?
A Yes, a little itchiness is normal, especially in the first few weeks.1-2 You can expect this itchiness to gradually subside as your acne clears up.Back to top
Q My skin is burning and/or red after I apply the benzoyl peroxide. Is that normal?
A Many people who begin The Regimen report redness for the first 1-3 weeks, after which time the redness subsides. If you start The Regimen too quickly and you have sensitive skin, you should expect redness/dryness, sometimes severe. If you are new to benzoyl peroxide, it is a good idea to use just a light coating of benzoyl peroxide at first, and up the dosage over a period of a few weeks. According to the Gale Encyclopedia of Medicine:3
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The most common side effects of anti-acne drugs applied to the skin are slight redness, dryness, peeling, stinging, and a warm feeling to the skin. These problems usually go away as the body adjusts to the drug and do not require medical treatment. Other side effects should be brought to a physician's attention. Check with a physician as soon as possible if any of the following side effects occur:
- Blistering, crusting or swelling of the skin.
- Severe burning or redness of the skin.
- Darkening or lightening of the skin. (This effect will eventually go away after treatment with an anti-acne drug ends.)
- Skin rash.
Q When I apply the moisturizer it burns/stings. What should I do?
A Some people may experience light burning or stinging when they are new to The Regimen. The skin may be sensitive from the benzoyl peroxide and this may cause an uncomfortable sensation when the moisturizer is applied. This usually goes away within a few weeks as the skin adjusts to the new products. Also, be sure you did not start out with a moisturizer that contains glycolic acid (AKA alpha hydroxy acid - AHA). If you are going to use one of them, it's usually best to wait at least a month before doing so. The glycolic acid and/or lactic acid in them may create a brief sting or burning sensation to the skin.Back to top
Q My skin looks absolutely terrible. It is peeling off, red, and I am miserable. What do I do?
A You are either allergic to benzoyl peroxide or you started too fast. An extremely small percentage of people are allergic to benzoyl peroxide and experience swelling and/or crusting. If your skin swells up, discontinue use immediately. Most likely if you are experiencing severe dryness/redness, you simply started too fast. It takes a few days to a few weeks for your skin to become acquainted with benzoyl peroxide and the redness/dryness should subside with time. Using a non-overdrying liquid cleanser can help prevent this dryness as well. Also, be sure to moisturize liberally. If you really can't stand the dryness, stop The Regimen completely, give your skin a few days to recover, and begin again with a much smaller dosage of benzoyl peroxide, only ramping up the dosage as you feel comfortable. But remember, you eventually need to use A LOT of benzoyl peroxide to achieve total clearing.Back to top
Q My skin is dry from the benzoyl peroxide. Nothing seems to be able to make it non-dry. What do I do?
A First, be absolutely sure you are using plenty of moisturizer. If using Acne.org Moisturizer, use 2 full pumps if moisturizing the entire face. Feel free to go up to 3 pumps if need be. Acne.org Moisturizer is calming to acne-prone skin, so using more will not make you break out. On the contrary, keeping your skin in balance should help you achieve consistently clear skin. You may also add 5-6 drops of jojoba oil into whichever moisturizer you are using each time you apply it as well.
If you are feeling dry but are completely clear, you may also try gradually reducing the amount of benzoyl peroxide you use. Use as much as you need to stay clear but reduce dryness.
Lastly, substituting your usual nightly moisturizer with an AHA moisturizer a few nights a week can help.Back to top
Q I have sensitive skin. Can I do The Regimen?
A Absolutely. Just be certain to start with a small amount of benzoyl peroxide. Use only a pea size amount and apply only once per day for the first week. Even with a small amount once per day, you may still experience redness, dryness, and itching. Continue very slowly increasing your dosage of benzoyl peroxide after that point and you can expect even sensitive skin to adapt well. It is also imperative that you generously moisturize from day one, every time you perform The Regimen. Adding 5-6 drops of jojoba oil to each moisturizer application can also boost hydration and help calm the skin.Back to top
Q How long until I should expect improvement?
A See the what to expect section of The Regimen.Back to top
Q The Regimen is not working for me. What's going on?
A Take this quiz for lots of helpful answers.Back to top
Q My skin is extremely oily. Do I need to moisturize?
A Yes. Moisturize from day 1 of The Regimen since it can take a week or two for the dryness to set in. Even if your skin is oily, you should find that regular moisturizing, especially with a moisturizer that contains jojoba oil, should help control your oil production. If you find your oiliness unbearable, consider buying oil absorbing cloths from the drugstore. You can use them to very gently dab away excess oil. Some members have reported that the brown paper towels in many school bathrooms do a good job with this as well.Back to top
Q I have oily skin that won’t absorb the full 4mL (2 pumps) of moisturizer. What do I do?
A Try applying only 2mL (1 pump) of moisturizer, wait for it to dry, and then apply another 2mL (1 pump).
Extremely oily skin may only require 2mL (1 pump) of moisturizer.
Q The Regimen worked, and I am clear now. Do I need to keep using the benzoyl peroxide?
A Yes, benzoyl peroxide will prevent new outbreaks. There is no topical cure for acne, just ongoing treatment. Most people eventually grow out of acne. This varies widely from person to person. Some people only experience acne for a short time in their teen years, while others see it persist well into adulthood. Others may not experience acne when they are a teen, but notice breakouts starting as an adult. The Regimen can keep you clear during whichever period of your life that you experience acne, until it naturally subsides.3Back to top
Q Why wait between washing and treating and between treating and moisturizing?
A This is the result of many years of trial and error. I found this is how The Regimen works best. Follow The Regimen this way until you are completely clear. Then you can safely change one variable at a time, such as waiting a shorter amount of time between steps.Back to top
Q Can I use The Regimen with the prescriptions I am currently taking?
A You will need to ask your doctor this question. Some doctors prescribe benzoyl peroxide with other acne medications, but it is important that you not experiment on your own.Back to top
Q Can I use The Regimen in conjunction with additional products or over-the-counter medications?
A Do not do this until you are completely clear and have been that way for some time. Once you are completely clear, it is okay to add in one new variable at a time. If you begin The Regimen and are adding in other variables from the get go, you will have no way of judging whether The Regimen works for you.Back to top
Q Can I use salicylic acid with The Regimen?
A The jury is still out. Some medical text books warn against the combination of salicylic acid with benzoyl peroxide, calling it "overly irritating".3 Several people on The Regimen have also noted this. This warning is echoed when combining benzoyl peroxide with several other acne medications as well, resorcinol and sulfur to name two.3 Remember, irritation aggravates breakouts.
However, some acne.org members have used salicylic acid with benzoyl peroxide successfully. If you want to try this, first use The Regimen without salicylic acid until you are completely clear. Then, feel free to add in one variable at a time such as the addition of salicylic acid.Back to top
Q Should I moisturize at night?
A Yes. The Regimen works best with twice daily moisturization.Back to top
Q The moisturizer is balling up with the benzoyl peroxide. What's going on?
A This is normal when using a cream based benzoyl peroxide. Using a gel will eliminate the problem. If using a cream, gently slough off remnants with your fingers.Back to top
Q What's the best way to shave?
A Use a two blade razor. Single blade razors tend to pull at the hair and lend themselves to nicks and three or four blade razors can over-irritate. Blade shaving with a two blade razor is also far less irritating than any electric razor. The two best 2 blade razors are the Gillette Trac II and the Gillette Sensor Excel. If you can't find either of these, try a disposable two blade razor such as the Gillette Good News. Once you have your razor, use a generous amount of lather from your cleanser as shaving cream. Try shaving in the shower or immediately afterward so your skin is thoroughly moistened and prepared. While shaving, use gentle yet confident strokes, always going with the grain. This means for most people going down on the face and up on the bottom half of the neck. If you have a pimple or pimples to shave over, try to be gentle and if at all possible only shave over the area one time. One final note: shaving daily is less irritating than waiting a few days between shaves. The longer you wait, the more irritating shaving becomes. Either grow a beard or shave daily.
Click here for a more detailed page regarding shaving.Back to top
Q What should I do when it comes to unsightly facial hair? Can I get laser hair removal performed? What about bleaching, plucking, threading, or waxing (sugaring)?
A Any form of hair removal is potentially irritating and as we know, irritation can aggravate acne. However, many women are going to remove facial hair no matter what. So what is the best way to go? Since laser hair removal is a permanent solution and is relatively gentle on the skin, this may be your best bet. Once you’ve gone through several procedures, the hair is permanently removed and there will be no future irritation. However, laser hair removal requires a larger up-front financial investment. As far as ongoing maintenance options are concerned, bleaching is perhaps the gentlest option since no actual hair is being removed. However, if you use a bleaching cream, be sure it specifically claims to be non-comedogenic (will not clog pores) and double check the ingredients against the comedogenic ingredients list here on Acne.org before you apply it. Plucking, while more time consuming than threading or waxing (sugaring), will likely be somewhat less irritating since only the hair, and not the skin itself, is touched. Threading and waxing (sugaring) are the roughest options, and even with the best practitioner will produce irritation. The soothing creams that your practitioner applies after the threading or waxing (sugaring) present another challenge since these creams often contain pore-clogging ingredients. If you would like to try threading or waxing (sugaring), first, get yourself completely cleared up on The Regimen. Once you are completely clear, you may try one of these two methods and see if you can stay clear.
Which laser is best?: In the one study which has been performed in the area of laser hair removal and acne, the Alexandrite laser was shown to be a slightly better option than the Nd:YAG.4 However, no conclusions can yet be drawn and due to the lack of evidence in this area, you may go with whichever laser you wish.
Note: Be sure to let your laser or waxing (sugaring) practitioner know all of the medications and treatments you have been using prior to the procedure.
Q Does benzoyl peroxide prolong red marks after acne lesions have gone away?
A There is no empirical evidence on this topic and input is mixed on the forums. However, the topic is somewhat moot because the best treatment for red marks is prevention of acne. The prevention of acne prevents future red marks from forming in the first place. And the best topical treatment we have for acne is benzoyl peroxide. So, while there may be a slight chance that benzoyl peroxide may prolong red marks in a few select individuals, when we look at long term red mark prevention, preventing acne in the first place takes precedence. Read more »Back to top
Q Can I use a mask with The Regimen?
A Do not do this until you are completely clear and have been that way for some time. Once you are completely clear, it is okay to add in one variable at a time. However, if you begin The Regimen and are adding in other variables from the get go, you will have no way of judging whether The Regimen works for you.Back to top
Q How can I get the rest of the product out of the bottle once it gets low?
A Click belowBack to top
Q My most recent bottle of Acne.org Treatment looks/feels/smells different than the last one. Why is that?
A We assay every batch and carefully make sure it is uniform. Temperature can change the viscosity of the gel which can affect the way it appears. Also, the newer the batch is, the thicker it tends to be and the stronger the scent will be. It will get thinner over time and the smell will subside.Back to top
Q What can I use to spot treat while on The Regimen?
A For many, AHA works wonders as a spot treatment. If you see the beginnings of a zit forming use a 10% glycolic acid (AHA) lotion and apply it to that one spot after you apply the benzoyl peroxide. This works best when you get it just as it starts emerging. If you wait too long nothing except for time will help. If you want to do everything you possibly can to prevent a pimple from forming, try The ZIIT Method (Zinc + Ibuprofen + Ice + Treat).Back to top
Q Hey Dan, how do you choose which ingredients to use and which not to use when preserving Acne.org products?
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I strive to use the most inert ingredients possible while still preserving the products. Formulating products is a delicate dance between making sure not to use ingredients that are harmful and at the same time preventing mold and bacteria growth in the product. Preventing this mold and bacteria growth is of paramount importance. The skin care industry learned this the hard way through inadequately preserved make-up which left several consumers blinded for life. It is dangerous to use skin care products which are not free of mold and bacteria. You want to be absolutely certain that your products are preserved well. I use preservatives in extremely small amounts (in the .1% range) which minimizes any adverse effects, while at the same time preserving the products well. I am always on the look-out for better preservatives. The ultimate goal is to preserve products with only organic compounds, but as of right now we do not have such a luxury. Rest assured I am on top of this issue and will be vigilant about protecting you guys, both from harmful preservatives as well as from mold and bacteria overgrowth."
Q Do I rinse off the benzoyl peroxide?
A No. Once it is applied, leave it on the skin.Back to top
Q Can I get microdermabrasion treatments while on The Regimen?
A Microdermabrasion creates unnecessary irritation. Irritation from microdermabrasion treatments can perpetuate the acne cycle. A much better way to exfoliate the skin is to simply add glycolic acid into The Regimen after 3-4 weeks. If you add it before this amount of time has passed, it can sting badly, so be sure to wait. Glycolic acid is an acid derived from sugarcane which provides chemical exfoliation. This form of chemical exfoliation is superior to manual exfoliation for acne-prone individuals because it helps you avoid irritation. Plus, glycolic acid actually helps with acne symptoms and is a welcome addition to The Regimen.Back to top
Q Can I use drugstore products instead of Acne.org products on The Regimen?
A You can theoretically use drugstore products. However, you may not get as clear and may not see results as fast. Acne.org products are specifically made for The Regimen and each ingredient is carefully chosen. For best results, you will want to use Acne.org products. If you absolutely must use drugstore products, be sure to take this guide with you.Back to top
The Body/Neck Regimen FAQs
A No. Glycolic acid is very moisturizing and is the last step in The Body Regimen or The Neck Regimen. No additional moisture is required. If you require sun protection, however, feel free to apply a sunscreen 15 minutes after finishing The Body Regimen or The Neck Regimen.Back to top
Q Can I use The Regimen for the face (cleanser, 2.5% benzoyl peroxide, moisturizer) to treat my body or the back of my neck?
A Probably not. The body and back of the neck are made of much thicker skin than the face and usually requires the addition of 10% glycolic acid to clear completely.Back to top
Q How do I treat the front of the neck?
A The thinner skin of the front of the neck is much more sensitive than the thicker skin of the back of the neck and should be treated in the same way as The Regimen for the face. Start with a pea size amount of benzoyl peroxide only once per day for the first week when treating the front of the neck, and be sure to moisturize generously. Even when starting with a small of an amount of benzoyl peroxide once per day, the front of the neck is so sensitive that you will probably experience dryness, redness, flakiness, and itchiness which will last for the first week or so. Feel free to moisturize as frequently as necessary and add in 5-6 drops of jojoba oil each time you moisturize.Back to top
Benzoyl peroxide FAQs
Q Does benzoyl peroxide unclog pores?
A Benzoyl peroxide is comedolytic which means it breaks down clogged pores. However, there is no miracle product that can quickly get rid of a full fledged pimple once it has established itself on your skin. That said, benzoyl peroxide can clear up acne faster than would be possible without benzoyl peroxide and does a brilliant job at preventing future acne. For even better spot treatment results, glycolic acid can be administered alongside benzoyl peroxide.Back to top
Q Does benzoyl peroxide cause wrinkles?
A No, it does not cause wrinkles; however, some people experience wrinkling around the eyes due to applying benzoyl peroxide too closely to that area. This wrinkling is due to dryness and is not permanent. Avoid the eye area with benzoyl peroxide. It is also important to avoid the eye area with moisturizer that is applied over the benzoyl peroxide. This is because the moisturizer can mix with the benzoyl peroxide and bring the benzoyl peroxide with it.Back to top
Q What is the difference between a tinted and vanishing formula benzoyl peroxide?
A Cream based benzoyl peroxide sometimes comes in a tinted formula. Tinted formulas do not vanish, but rather leave a foundation type look which helps to mask acne. Most people on the forums seem to prefer vanishing formulas.Back to top
Q I can't get a 2.5% benzoyl peroxide. Can I use a higher concentration?
A 2.5% is best. However, anything up to 5% should most likely be fine, albeit more drying and no more effective.6 Avoid 10% preparations which will over-dry.5 One exception is when dealing with pimples on the back or body. The skin on the body is tough and may withstand 10% nicely. If you can find a 10% much cheaper, feel free to try it on the body.
So why not simply use less of a 10% solution? Through trial and error Dan (and thousands of acne.org members since) found this does not work. Exactly why is unknown, but using less of a 10% solution does not clear acne nearly as well as a generous amount of 2.5%.Back to top
Q Is benzoyl peroxide safe? Does it cause cancer?
A A quote from The British Journal of Dermatology, 1990:
So far no skin malignancies after the clinical use of benzoyl peroxide have been reported. A possible relationship between the use of the compound and the occurrence of malignant melanoma has been looked at in two case-control studies, both with negative results...However, since the average latent period for skin carcinogenesis is of the order of 15-25 years, this requires further follow-up...Thus, the question of carcinogenic potential of benzoyl peroxide is as yet not fully answered, but at the present time it seems likely that this compound is safe to use.7
A quote from Regulatory Toxicology and Pharmacology, 1995:
Topical benzoyl peroxide has been used in the treatment of acne for over 30 years, with no reports of adverse effects that could be related to skin carcinogenesis. Two case-control epidemiological studies have found a lack of association between the specific use of benzoyl peroxide and skin cancer. In addition to these findings in humans, 23 carcinogenicity studies in rodents with benzoyl peroxide, including 16 employing topical application, have yielded negative results. An increase in skin carcinomas was reported in 1 study in which benzoyl peroxide in acetone was applied to the skin of SENCAR mice for a 1-year period; however, this study did not employ adequate control groups to fully understand the unusual findings, and the results were inconsistent with those of 6 other similar studies.8
A quote from "Acne and Rosacea: Third Completely Revised and Updated Edition," 2000:
Following application to the skin, benzoyl peroxide is rapidly metabolized to benzoic acid, a harmless chemical. Extensive use in human beings has failed to demonstrate absorption. The drug is eminently safe.9
After decades of research, a final ruling from the FDA Federal Registry, 2010:
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After reviewing the data, we now conclude that benzoyl peroxide can be adequately labeled to minimize the risks associated with benzoyl peroxide while delivering effective acne treatment...We, the Food and Drug Administration (FDA), are issuing this final rule to include benzoyl peroxide as a generally recognized as safe and effective (GRASE) active ingredient in over-the-counter (OTC) topical acne drug products.10
Q What can I do to help prevent benzoyl peroxide from bleaching my stuff?
A The fact that benzoyl peroxide bleaches fabric is its biggest drawback. Sometimes there's not a lot you can do about it. However, these tips may help:
- Wash and dry hands thoroughly after handling benzoyl peroxide.
- Do not rub sweat from your face on your clothing.
- Put your clothes on first, then apply benzoyl peroxide. If you apply benzoyl peroxide first and then put on your clothes, hold your shirt neck holes open wide while pulling them so they don't touch the face. Do the same when removing your shirts.
- Use white towels.
- Wear a white t-shirt under clothing if you are treating your back/chest with benzoyl peroxide.
- Dab sweat off with a clean dry towel to avoid run-off onto clothing.
- Take your shirt off before washing your face in the sink so the wash water doesn't get splashed onto your shirt by accident.
- When washing at the sink, if you have a carpeted bathroom, place a towel under your feet to catch any drips that may fall while you are washing.
- Use white pillowcases and sheets. In a pinch, an old t-shirt can also be used as a pillowcase.
Q Does benzoyl peroxide bleach the skin?
A No.Back to top
Acne.org AHA+ (10% Glycolic Acid) FAQs
Q How do I know if I should use Acne.org AHA+ lotion?
A If you have been using benzoyl peroxide for at least 3-4 weeks, it is safe to add in AHA. Before this time it will likely sting too much when applied. People use AHA for spot treatment, body acne treatment, to help fade red marks, or in place of their nightly moisturizer 2-3 times per week to provide chemical exfoliation and faster skin turnover.
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I have always kept some AHA around as a secret weapon... It works amazingly well to stop a zit in its tracks on the rare occasion that I feel one developing. I also use it a few nights a week in place of my moisturizer. This takes my skin from clear to perfect and even toned."
Q Is there anything special I should know about using AHA?
A If you are new to The Regimen, wait at least three weeks or so to let your skin get accustomed to the benzoyl peroxide before you consider adding in the AHA+ lotion. If you have super sensitive skin, try only a small dab of it under the jaw line for a few days to make sure your skin reacts to it well. When you are ready, start out by using a small amount so you can see how your skin is going to react to it. Then you may increase the amount as you see fit. Alpha hydroxy acids can make the skin more sensitive to the sun, so it is important for you to use a sunscreen each day while using an AHA. This is no joke. My skin is definitely more sensitive to the sun after using AHA for a few days. Prevent burning by using a moisturizer that has SPF in it or a separate sunscreen. Lastly, be sure that no other products you are using have any AHA in them. AHA will most commonly be listed on the ingredient label as glycolic acid or lactic acid.Back to top
Q Do I need to be on The Regimen to use the AHA+ lotion?
A No. It can be a nice enhancement to The Regimen, but is not a requirement and many people who are not on the Regimen can benefit from its exfoliating and skin calming properties.Back to top
Q I feel stinging and/or itching when I use the AHA+ lotion. Is this normal?
A Yes, this is normal with alpha hydroxy acids. If it is unbearable, decrease the amount and frequency of use. But a bit of stinging is to be expected.Back to top
Q I'm having problems with the Acne.org AHA+ lotion leaving a yellow residue or balling up. How can I prevent this?
A Be sure to wait 5-10 minutes after applying the benzoyl peroxide treatment gel before applying the AHA + lotion. If it is still balling up, try using less of it and see if that helps.Back to top
Q Is it safe to use over-the-counter glycolic acid products over the long term?
A Alpha hydroxy acids, such as glycolic acid, have been used in cosmetic and therapeutic dermatology for about 40 years, with many people using them as a regular part of their skin care regimens for the past 30 or so years.11
In 1998, the Cosmetic Ingredient Review (CIR) Expert Panel, which was established in 1976 with the support of the U.S. Food and Drug Administration and the Consumer Federation of America, determined that alpha hydroxy acids are not carcinogenic/mutagenic, are not reproductive/developmental toxins, and are not skin sensitizers.12
However, we know from four decades of research that alpha hydroxy acids are potent. They can speed cell renewal (one of the reasons AHAs can help speed up the healing of acne lesions) and act as powerful exfoliators, which gives the skin a “glow” but also makes the skin more sensitive to the sun.13-16 For these reasons, the CIR recommended limiting concentrations of AHA to 10% and in a pH of 3.5 or above. This is what you will find in over-the-counter AHA-containing products.
According to a 2010 article in the journal Clinical, Cosmetic and Investigational Dermatology, “The photosensitizing effects of glycolic acid were small, but may be an important factor for public health, considering that HA (Hydroxy Acid)- containing products are being used by a large segment of the population for many years and in many cases over a lifetime.” They went on to add, “ We also found that the enhanced photosensitivity was reversed within a week of terminating the treatments.” The authors noted that despite the many years scientists have had to produce research on AHAs, it can still be difficult to draw conclusions based on the research since such different concentrations, pHs, UV-exposures, and light sources were used. The authors of the article went on to conclude, “Some investigators, therefore, still recommend that caution should be taken when using these products, in particular with their chronic use.“17
From the available evidence and recommendations it is prudent to limit your use of AHAs to 10% or less and at a pH of 3.5 or above and to be certain that you protect your skin from the sun every day while you are using glycolic acid and for at least one week after your last use.
Other Products & Supplies FAQs
Q Can I use cosmetics? Which kind are best?
A Here is a quote from the National Institute of Health:
While undergoing acne treatment, you may need to change some of the cosmetics you use. All cosmetics, such as foundation, blush, eye shadow, lubricants, and hair-care products should be oil free. Choose products labeled noncomedogenic (meaning they don't promote the formation of closed pores). In some people, however, even these products may make acne worse.5
Try your best to apply make-up as sparingly as you can until you get completely clear on The Regimen. Choose sheer, water-based varieties and apply with a featherlight touch.
For more on make-up and acne and to take a quiz to see if you may be experiencing cosmetic-induced acne, check out the make-up page here at acne.org.
For more discussion on make-up, see the cosmetics and grooming forum.Back to top
Q Is a toner necessary?
A No. Toners are one of those instances where it's best to save your money. They are not only unnecessary, they can over-dry the skin. Over-dry skin is irritated skin and irritation can aggravate acne. When you read opinions from skin care experts and dermatologists, most of them tend to agree on this point. If you do find someone recommending a toner, keep in mind whether or not they are trying to sell you one. Toners tend to be high profit items.Back to top
Q Can I use skin lightening products while on The Regimen?
A Do not use products with the active ingredient Hydroquinone. Hydroquinone topical should not be used with benzoyl peroxide, hydrogen peroxide, or other peroxide products. A temporary darkening of the skin may occur. For more on Hydroquinone read here.Back to top
Q How do I get rid of the red/dark marks left after the blemish goes away?
A People with darker skin tend to suffer with these marks more often. For more information on post-inflammatory hyperpigmentation, click here. You can visit the red marks forum for discussion and suggestions. However, try your best to avoid adding in products and new methods until you're completely clear of active acne. The most important goal regarding red marks is to prevent future acne and thus prevent future red marks from forming in the first place. Here is a quote from the American Academy of Dermatology and Roche Laboratories regarding red marks:
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A red mark on the skin called an erythematous macule will fade in four to six months after an acne outbreak - but it may get temporarily redder when your skin gets hot or when you exercise. This red macule is not a scar, and is not permanent. In a dark skinned person, the macule may appear as a darker patch on the skin. This is not a scar, either.
Q What do I do for bacne (acne on the back)?
A Check out the back and body acne page of acne.org for a full report on back acne and an effective regimen to clear it up.Back to top
Q I exercise during the day and sweat. Should I wash afterward? And what's up with the white residue on my face when I exercise?
A Sebaceous follicles (where acne is formed) and sweat glands are separate parts of your skin which do not touch. Sweating should theoretically not affect acne since acne is formed in the sebaceous follicle and sweat does not enter this area. Sweating does not warrant a third washing. If you want to wash after a workout, try to plan your workout before your morning or evening regimen.
You may notice that if you sweat within a few hours after you do The Regimen with a cream-based benzoyl peroxide that your face can turn milky white in the places where you did The Regimen. This is normal but annoying and is mostly caused by using a cream based benzoyl peroxide. Either switch to a gel based benzoyl peroxide or feel free to very gently dab your face with a towel to get rid of the residue.
Read my blog post for more on sweat and irritation.Back to top
Q I am going to be swimming during the day. Should I do a third Regimen application afterward?
A The consensus on the forums seems to be that swimming does not adversely affect acne and a third application of The Regimen is not warranted. Your skin may become very dry after a swim, so although you may not need to apply benzoyl peroxide again, be sure to take moisturizer along.Back to top
Q Will my skin become resistant to the beneficial effect of benzoyl peroxide?
A Propionibacterium acnes (P. acnes), the bacteria in acne lesions, cannot survive in the presence of oxygen. Benzoyl peroxide creates oxygen. Therefore, it is physically impossible for this bacteria to develop a resistance. If The Regimen works at first, it should always work.Back to top
Q I like to lay out in the sun in the summer. Is this OK?
A Try to limit sun exposure on facial and body acne prone areas to 10-20 minutes per day if you have lighter skin and 20-30 minutes per day if you have darker skin. Some sun may actually be beneficial for your acne symptoms, so there is no need to avoid the sun altogether. However, it is important for you to avoid getting sunburnt. After 10-30 minutes, depending on your skin tone, do one of the following: (1) get out of the sun, (2) put on a wide brimmed hat to protect your face and/or put on clothing to protect your body, or (3) apply a sunscreen. The three sunscreens I recommend are Neutrogena Clear Face SPF 30 (my favorite, relatively affordable), Olay Complete All Day Moisturizer with Sunscreen Broad Spectrum SPF 15 – Sensitive (relatively affordable) or Philosophy Hope Oil-Free SPF 30 for Normal to Oily Skin (expensive).Back to top
Q Can I use tanning beds?
A There are a few reasons why tanning beds may be a bad idea for someone who is acne prone:
- While a small amount of UV exposure can be beneficial for acne prone areas of the skin, tanning bed sessions tend to provide too much UV exposure. This can ultimately bite back with a breakout in the weeks following tanning as the skin attempts to heal itself. If you've ever noticed that you tend to break out mysteriously a week or two after using a tanning bed, the tanning bed may be the culprit.
- Horizontal tanning beds force your back to come into contact with a glass surface for an extended period of time. That glass surface slowly gets sweaty. We know that prolonged irritation, especially when combined with sweat, can aggravate body acne. Add to this scenario the UV damage to your skin and evidence starts emerging that horizontal tanning beds may be a close to perfect back acne catalyst. If you are acne prone on your back, avoid horizontal tanning beds altogether. If you must tan in a tanning bed, choose a standing variety and limit your time in the booth to one of the shortest durations available at the salon. Then, continue with an ongoing back acne treatment regimen to prevent post-tanning breakouts. (If you are prone to acne on your face and neck, cover these areas or wear a non-comedogenic sunscreen while inside a tanning booth. Then, after exposure, continue with an ongoing face and neck treatment regimen to prevent breakouts.)
For the sake of argument, there may be a reason or two that tanning beds are not so bad.
- Tanning beds can ease the depression caused by lack of sunlight. Less stress can mean less acne.
- Tanning beds can help provide vitamin D, a powerfully important hormone in our bodies.
Q What do you think of Proactiv? And where can I find other Proactiv Solution Reviews?
A Proactiv is on the right track but some major flaws seem to prevent it from delivering on its promises to many people. In my opinion, the cleanser they include is overly irritating. Furthermore, they tell you to wash for one to two minutes which adds to the irritation. The benzoyl peroxide they provide is 2.5% which is a good call. However, they recommend a "thin layer". For dramatic clearing, one needs to use a generous amount of benzoyl peroxide. When you do use a generous amount of Proactiv's benzoyl peroxide lotion, its scent will tend to nauseate and it will run out quickly.
It will prove cheaper and far more beneficial to buy a non-comedogenic cleanser, an unscented 2.5% benzoyl peroxide medication, and moisturizer. However, if you currently own Proactiv Solution products, don't throw out the benzoyl peroxide lotion. If you can handle the smell, it should work fine, as long as you use it within The Regimen and are generous with it. I would not recommend using their cleanser.Back to top
Q Will lifting weights make me break out? What about my protein shake?
A There is no research on this topic, but let's explore using what we do know. First, exercise keeps the body in shape and helps the mind deal with stress. Since stress hormones can contribute to acne, this is a good thing. Anecdotally, people on the forums have mostly reported that lifting weights does not negatively affect acne. However, if someone goes on a weight gaining diet along with their weight training and he/she suddenly adds excess calories to his/her diet, the excess caloric intake can increase testosterone levels in the body. Increased testosterone levels can aggravate acne. So if you find yourself breaking out during or after a "bulking" cycle, this may be the cause.Back to top
Q Hey Dan, how old are you, when did you start getting acne, how severe was it, and are you clear now?
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A I'm 41. I started getting acne at 11. It was severe at times in the past, but there were always people worse than me. I stay remarkably clear now."
Q Hey Dan, you're 41 years old. Haven't you grown out of acne by now, Regimen or no Regimen?
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Unfortunately, no. I started The Regimen at 24. Every year or so I stop the Regimen to see what will happen. The result? Breakouts, and within days. My family genetics see breakouts occurring into the 40s and 50s. The issue of when a person develops acne or grows out of acne is highly personalized, and one that science still does not fully understand. Babies and even senior citizens must sometimes cope with acne."
- Lim YL, et al. "Pruritus is a common and significant symptom of acne." Journal of the European Academy of Dermatology and Venereology.2008; 22(11): 1332-1336.
- Reich A, et al. "Acne itch: Do acne patients suffer from itching?" Acta Dermato-Venereologica. 2008; 88(1): 38-42.
- Ross-Flanigan N. "Anti Acne Drugs." Gale Encyclopedia of Medicine 1999. Find Articles. Look Smart. 2001.
- Carter JJ, Lanigan SW. “Incidence of acneform reactions after laser hair removal.” Lasers in Medical Science. 2006; 21(2): 82-5.
- "Questions and Answers About Acne." National Institute of Arthritis and Musculoskeletal and Skin Diseases Jan. 2006. National Institutes of Health. 2001.
- Comite H, et al. "Comparing 2.5%, 5%, and 10% Benzoyl Peroxide on Inflammatory Acne Vulgaris." International Journal of Dermatology 1986; 25(10): 664-7.
- Lindelof B, Linden S and Sparen P. "Is Benzoyl Peroxide Carcinogenic?" The British Journal of Dermatology 1990; 123(1): 129-30.
- Binder RL, et al. "Benzoyl Peroxide: An Integrated Human Safety Assessment for Carcinogenicity." Regulatory Toxicology and Pharmacology 1995; 21(1): 87-107.
- Kligman AM and Plewig G. Acne and Rosacea. Berlin: Springer, 2000.
- "Classification of Benzoyl Peroxide as Safe and Effective and Revision of Labeling to Drug Facts Format; Topical Acne Drug Products for Over-The-Counter Human Use; Final Rule." Food and Drug Administration. March 2004.
- Yu RJ, van Scot EJ. “Alpha-hydroxyacids and carboxylic acids.” Journal of Cosmetic Dermatology. 2004; 3(2): 76-87.
- Andersen FA. “Final report on the safety assessment of glycolic acid, ammonium, calcium, potassium, and sodium glycolates, methyl, ethyl, propyl, and butyl glycolates, and lactic acid, ammonium, calcium, potassium, sodium, and TEA-lactates, methyl, ethyl, isopropyl, and butyl lactates, and lauryl, myristyl, and cetyl lactates.” International Journal of Toxicology. 1998; 17(Suppl 1); 1-241.
- van Scott EJ, Ditre CM, Yu RJ. “Alpha-hydroxyacids in the treatment of signs of photoaging.” Clinical Dermatology. 1996; 14(2): 217-226.
- Green BA, Yu RJ, van Scott EJ. “Clinical and cosmeceutical uses of hydroxyacids.” Clinical Dermatology. 2009; 27(5): 495-501.
- Sams RL, et al. “Basal cell proliferation in female SKH-1 mice treated with alpha- and beta-hydroxy acids.” Toxicology and Applied Pharmacology. 2001; 175(1): 76-82.
- van Scott EJ, Yu RJ. “Control of keratinization with alpha-hydroxy acids and related compounds.” Archives of Dermatology. 1974; 110(4): 586-590.
- Kornhauser A, Coelho SG, Hearing VJ. “Applications of hydroxyl acids: classification, mechanisms, and photoactivity.” Clinical, Cosmetic and Investigational Dermatology. 2010; 3: 135-142.
Having trouble with The Regimen? Take 5 minutes to honestly and carefully answer the questions below to help get you on track.
Despite the detailed instructions on The Regimen page, people still make mistakes. This is a list of the biggest mistakes people make on The Regimen.
Starting too fast or quitting too early
Many people complain that their skin is too dry, too red and too flaky as they start the Regimen. This uncomfortable reaction is sometimes unavoidable. However, this redness and dryness should subside after a few weeks. Start slowly and you can limit these side effects. Even when starting slowly, you may still experience discomfort for the first few weeks. This is not a reason to quit. If you see severe crusting or swelling you may be allergic and you should stop, but initial redness, dryness and blotchiness are to be expected.
Not using enough benzoyl peroxide
While it is vital that you start with a small amount of benzoyl peroxide, after a period of a few weeks, it is equally important that you ramp up to the full dosage. When in doubt, use more BP at this point. This is absolutely critical to the success of the Regimen.
Not being gentle enough
When you apply the BP it should take several minutes. This requires patience. Make sure to go slowly and let the BP glide over your skin. Try to be patient and let it absorb on its own without forcing it.
Not using the right products for the job
The Regimen does not work with 10% BP, moisturizers or sunscreens that contain comedogenic oils, exfoliating cleansers that can irritate, or irritating shavers. For best results use the recommended products.
Adding in other products or steps
It is important that you wait until you are completely clear before adding in other products or steps to the Regimen. After you are completely clear, it is safe to add in one variable at a time and see how your skin will react.
Removing Regimen steps
The Regimen works as outlined, so it is important that you not skip any of the steps. Cleanse, apply BP and moisturize twice daily, every day.
The main point I am trying to get across is that the Regimen will work best when followed closely. I have personally coached a lot of people through the Regimen and have noticed that when followed precisely, the Regimen works for just about everybody. But even when people think they are following the Regimen, they often are not. It is worth your while to print out the Regimen checklist and take it into the bathroom with you. It is also a good idea to watch the video several times before embarking on the Regimen. This will save you a lot of time down the road. Although the temptation to develop your own regimen from the get go is strong, try to trust the Regimen until you are completely clear. Then you can change one variable at a time to your own specifications and see what happens."