We all know that one of the drivers of acne is pore clogging with oil and dead skin cells. So exfoliation is an essential part of any acne skincare routine. However, sometimes it can have a paradoxical effect! When acne breakouts pop up or persist, there’s a temptation to increase exfoliation. The assumption being that the skin needs to be cleared more aggressively. However, in practice over-exfoliation might actually make acne worse and even harder to control. In this article, we explore why over-exfoliation often backfires in acne skin and the optimal amount to exfoliate. We’ll also review alternatives that can better help reduce breakouts, inflammation and relapse.
How Does Exfoliation Help With Acne?
Exfoliation is commonly used in acne routines to help reduce pore blockage. Acne-prone skin often sheds dead skin cells slowly, allowing them to mix with sebum (oil) and accumulate within the follicle. By encouraging more regular cell shedding and clearing excess surface debris, exfoliation can reduce one of the driving factors that allows acne to form. In the correct strength and frequency, the right exfoliants can help provide clearer skin. The main benefits of using exfoliation for acne skin include:
- Reduced Pore Congestion: Exfoliation helps remove clear dead skin cells around the follicular (pore) opening. This reduces the chance of debris building up inside the pore and forming microcomedones which are the earliest stage of acne.
- Normalises Cell Turnover: Acne-prone skin often shows abnormal shedding (or desquamation if you want to be fancy). Gentle exfoliation can help normalise this so cells are shed more evenly rather than collecting in clusters and increasing the risk of blocking pores.
- Boosts Effects of Other Active Treatments: By clearing excess dead cells from the skin’s surface, exfoliation can allow active ingredients to penetrate better. This can improve their effectiveness as long as the skin barrier remains intact.
- Smoother Texture & More Even Tone: As a secondary effect, exfoliation can also improve roughness and uneven texture due to acne. It can also help fade superficial dark post acne marks to even out the skin tone and brighten the complexion.
Despite it’s many benefits, there are also some limits. What exfoliation does not do is treat acne by itself. Acne is driven by a number of factors including cellular and oil gland dysfunction, inflammation and immune signalling. These all require a multi-ingredient approach to tackle properly. Worse still, over-exfoliation can cause skin barrier damage and increase leading to more acne breakouts.
What Over-Exfoliation Does to Acne-Prone Skin
Over-exfoliation places acne skin under constant stress which can make it worse. By repeatedly removing protective lipids and disrupting the structure of the outer skin layers, it can compromise the barrier. This impairs it’s ability to protect the skin against environmental factors, increases water loss and shifts the skin into an inflammatory state. So rather than stopping breakouts, excessive exfoliation often creates the conditions that allow acne to persist and worsen. The main negatives effects of over-exfoliation on acne-prone skin include:
- Skin Barrier Breakdown: Excessive exfoliation strips essential lipids from the top layer of the skin (stratum corneum) and weakens tight links between skin cells. This leads to increased water loss and allows irritants to get into the skin more easily. All together this makes the skin dryer and more sensitive.
- Inflammation: Once the barrier is damaged, inflammation increases. In acne-prone skin, this tends to perpetuate breakouts.
- Reactive Sebum Production: As the skin becomes dry, oil glands may increase sebum output in an attempt to compensate. This excess oil can further contribute to pore congestion, acne forming bacteria overgrowth and ongoing breakouts.
- Less Tolerance to Other Treatments: Skin that is over-exfoliated often becomes sensitive to products that were previously well tolerated. Stinging and burning sensations are common symptoms which may lead to having to reduce the frequency or stop all together crucial acne treatments like retinoids.
- Shift Toward Inflammatory Acne: Non-inflammatory acne lesions like blackheads and whiteheads may initially improve but inflammatory lesions like papules, pustules or even cysts.often increase. Pimples become redder, more painful and slower to heal. These inflammatory breakouts are also more likely to leave behind post acne marks and scars.
- False Hope: Initially, surface texture may feel smoother and pores, blackheads and whiteheads can appear less visible. However, this improvement is short lived. As underlying inflammation builds, acne commonly returns in a more inflammatory and persistent form.
How to Avoid Over-Exfoliation
The most effective exfoliation strategy for acne-prone skin is to be intentional. Too little will not help acne but over-exfoliation can make it worse. Results depends on finding the balance that suits your skin. Here are our top tips to ensure you exfoliate correctly:
- Choose One Primary Exfoliant: Stick to a single exfoliating product in your routine. You only need one. This may be a leave-on acid or a wash off enzyme product. If you have very sensitive skin then you may be better off with exfoliating cleansers. Otherwise, toners, serums or masks tend to deliver the best outcomes.
- Find the Right Exfoliant for Your Skin: Generally, beta hydroxy acids (BHAs) like salicylic acid are great for oily acne prone skin as they can dissolve into oil and clear pores. However, if you have dry skin or can’t use BHAs, then alpha hydroxy acids (AHAs) like glycolic, lactic or mandelic acid are good alternatives. For those with sensitive or very reactive skin, azelaic acid may be best as it is gentle and has both anti-inflammatory as well as anti-microbial properties. Strength is also important but not how you think! As a general rule it is best to stick with low strengths that your skin can tolerate as stronger acids are not necessarily more effective but can irritate and inflame your skin.
- Limit Frequency: Exfoliating 2-4 times a week is usually enough for most acne-prone skin although azelaic acid can be used more often. Excessive use often leads to barrier injury. The best approach is to start at low frequency and gently build up. If irritation appears, reduce the frequency instead of changing products.
- Avoid Active Ingredient Stacking: Exfoliating products, retinoids like tretinoin or adapalene and benzoyl peroxide are hugely valuable for acne but can all irritate the skin. Avoid layering them together as that increases irritation without improving outcomes. It is best to use them at different times of the day.
- Barrier Support: After exfoliation, apply hydrating and barrier-supporting ingredients like glycerin, ceramides, panthenol or niacinamide. This helps reduce inflammation and improves tolerance over time.
- Listen to Your Skin: Redness, stinging, tightness or delayed healing indicate over-exfoliation. This in turn worsens acne and drives inflammation. In this case, always reduce frequency.
- Use Exfoliation as a Supportive Step: Exfoliation works best alongside treatments that regulate oil production, bacterial growth, inflammation and follicular behaviour.
What to Do for Active or Persistent Breakouts
When breakouts are active or keep returning despite a consistent skincare routine, the priority should be reducing inflammation, balancing oil and addressing pore clogging at the source. Adding more exfoliation in response to ongoing acne often worsens the problem. A more effective approach focuses on simple and targeted steps which include:
- Consider Reducing Exfoliation: If breakouts are persistent or started after adding or increasing exfoliation then the first step is to scale back. This is also the case if skin has become more sensitive, tender or angry in anyway.
- Optimise Actives: Ingredients such as zinc oxide, hypochlorous acid or benzoyl peroxide can all help as spot treatments to calm the skin and control acne causing bacteria as well as inflammation. Retinoids help regulate cell behaviour to treat acne at the source over the long term.
- Use Anti-Inflammatory Support: Calming ingredients such as niacinamide, panthenol, propolis and centella help reduce redness and improve tolerance to active treatments. This is especially important when acne lesions are sore or slow to heal.
- Avoid Frequent Product Changes: Constantly changing products in response to breakouts disrupts skin adaptation. Most acne treatments require several weeks of consistent use before improvement becomes visible.
- Spot Treat Sparingly: Inflamed lesions may benefit from targeted treatment. However, applying multiple actives over large areas increases irritation.
- Protect the Skin Barrier Daily: Use a light moisturiser and daily sunscreen as skin barrier damage and UV exposure both prolong inflammation and delay healing of acne.
- Seek Professional Help: If breakouts persist despite appropriate over-the-counter care, prescription treatments like tretinoin, roaccutane, spironolactone or antibiotics may be necessary. Seek help from your medical provider early to find the best solution for your skin.
In general, acne that worsens despite a consistent skincare routine which includes regular exfoliation should trigger a review rather than further escalation. Inflammation driven by irritation is a common and frequently overlooked reason why breakouts persist. A big culprit is over-exfoliation which can paradoxically make acne worse. Usually reducing exfoliation often improves skin tolerance and allows targeted treatments to work more effectively. Identifying when exfoliation has shifted from supportive to disruptive is often the first step in regaining control over acne.
At City Skin Clinic, we are extremely passionate about personalised skincare. Our virtual skin clinic offers safe and effective custom skin treatments. Where appropriate our doctors use ingredients such as Tretinoin, Hydroquinone, Azelaic acid, Clindamycin and Spironolactone to treat skin conditions like acne, hyperpigmentation, melasma and skin ageing. Start your online consultation today. The journey towards great skin starts here.
This article is intended for general informational purposes only and is not a substitute for medical advice, diagnosis or treatment. Always consult a qualified medical provider for any medical concerns or questions you might have.
