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Module: 3

Daily Skincare routine

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This module is all about skincare routines. In the first section, you’ll learn about which cleansers, toners,

moisturizers and exfoliators are good to use for those with acne. In the next section, we’ll go through a

range of natural and household remedies you could try in your skincare routine. Following this, we’ll

provide some advice on comedogenic ingredients and scar treatments. The module will finish up with a

section on the caveman regimen.

3.1 Product types

3.2 Natural and household remedies

3.3 Skincare advice

3.4 Caveman regimen

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3.1 Product types

There are a huge range of product types to use on your skin as part of your skincare routine. In this

section we’ll go through some advice on cleansers, toners, moisturizers and exfoliators, with a specific

focus on the products that will be beneficial for those who suffer from acne.

3.1.1 Cleansers

Cleansers used on acne-prone skin should be nonabrasive, gentle and alcohol free. It should match your

skin tone, whether that is dry, oily or a combination.

If you want a cleanser with added ingredients to fight acne and improve the appearance of the skin, you

might want to choose a medicated cleanser. Look for ingredients such as salicylic acid (helps to clear out

blocked pores, and can reduce redness and swelling), benzoyl peroxide (kills bacteria and exfoliates the

skin) and sodium sulfacetamide (prevents the growth of bacteria).

3.1.2 Toners

Those with acne are often recommended to use toners, which are also known as clarifiers or astringents.

These are liquid solutions, usually applied to the skin with a pad or cotton ball after cleansing. Said to

remove traces of cleanser residue, excess oil, makeup and dirt, they are not washed off, and are followed

by moisturizing.

Again, looking for products that contain salicylic acid, glycolic acid, or other acne fighting ingredients

will make the toner more effective in clearing up your skin. That said, a toner alone is not powerful

enough to clear up persistent acne.

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One common myth about toners is that they close the pores, which is not true. Pores do not open and

close with one wipe of toner, and this is misleading advice. Toners are not a skincare necessity, and

some people prefer not to use toners at all.

Often, those who choose to use them are those who have oily skin types, as toners can reduce oily

shine and keep skin from being too greasy. However, those with sensitive skin, or those using acne

treatments that dry out the skin, may choose not to use toner. This is because many toners have a

high alcohol content, and alcohol is drying to the skin. Some people may find that using a toner

worsens their breakouts. In conclusion, if you decide to use a toner, choose one that includes an

acne fighting ingredient such as salicylic acid, is low in alcohol, and does not burn or sting the skin.

3.1.3 Moisturizers

Moisturizers treat your skin when it is dry by helping it retain moisture. It also prevents it from drying

out again.

When selecting a moisturizer for skin that is prone to acne, there are certain ingredients that should be

avoided. These include alcohol, which can dry out the skin too much and lead to inflammation, mineral

oils, petroleum and silicones that can clog your pores.

Some experts advise those with acne to use moisturizers that are water-based, as this is a lighter

moisturizer that can provide moisture but prevent breakouts. Gel or oil-based moisturizers can clog

pores and aggravate acne. As with all the other skin products, products with salicylic acid and benzoyl

peroxide can help prevent acne breakouts. Be careful, though, that these active ingredients are not in all

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the products you use, as using too much can dry out and irritate the skin. Some moisturizers may

contain the gentle chemical exfoliants mentioned in section 2.1.2, and you may also want to look for

humectants glycerin and hyaluronic acid. These pulls water to the skin in order to retain its natural

moisture.

3.1.4 Exfoliators

Exfoliating is the process of removing dead skin cells through creating friction against the skin, or

through the use of an acid or enzyme. This could be done with a number of different products, or even

with a washcloth.

There are two types of exfoliants, physical and chemical. Physical exfoliants use an abrasive implement

or ingredient to remove the dead skin cells. Examples of this are microdermabrasion, and an over the

counter face scrub. These treatments are often not advised for those suffering with acne, especially for

those with inflamed acne. This is because they are too abrasive and will inflame and irritate the skin,

leading to more breakouts.

Chemical exfoliants use an enzyme or acid to dissolve the bonds that hold dead skin cells against the

surface of the skin. These may be found in lotions, toners, gels, masks, or other products. These

exfoliants are used in chemical peels available at spas, which can be beneficial for acne. Some people

prefer stronger chemical peels, and these are discussed in more detail in module 3.

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Some examples of chemical exfoliants include salicylic acid, glycolic acid, lactic acid and tartaric

acid, as well as adapalene and tazarotene. These can be beneficial for fighting against acne, though

it is advised to use them sparingly and use only one type of product at one time. If you are taking

any medications for acne, whether oral or topical, speak to your doctor to find out if your chemical

exfoliant is compatible.

3.2 Natural and household remedies

When people are trying to fight acne, they often turn to natural or household remedies. In this

section we run down some of the more popular ones that have been shown to work for many people.

If you decide to try these out, it is advised to do so one remedy at a time for a period of two weeks to

one month, to see how the remedy works for you.

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3.2.1 Natural remedies

Honey mask – It is often advised that raw, organic honey should be used, rather than the processed

honey that we normally eat. Raw honey was used in ancient times as an ointment for burns, scrapes and

other skin conditions, and has natural antibacterial properties. To use a honey mask, use one teaspoon

and spread it over the face. Leave on for 15-60 minutes, rinse off with cool water and pat the face dry.

Egg white mask – Egg white tightens and tones skin, shrinking large pores. It also contains lysozyme, an

enzyme which combats bacteria that causes acne. Whisk an egg white and apply to the skin for 15

minutes. Some people also choose to add honey and lemon juice to this mix.

Teatree oil – Some people apply tea tree oil directly to pimples, diluted with water, via a tissue, cotton

bud or cotton pad. It has natural antibacterial properties and dries out whiteheads, pimples, blackheads

and other blemishes. Others find it is too harsh for their skin, and use a few drops in an aloe vera gel or

with raw, organic honey.

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Jojoba oil – If used wrongly, jojoba oil can cause acne, but when used correctly can help it. It is very rich,

so it is advised to mix with aloe vera gel 1:1, or with a non-comedogenic moisturizer. This should be

applied to the skin sparingly, once a day or less.

Witch hazel – Witch hazel is an astringent and a disinfectant, with high levels of active ingredients that

can reduce swelling, cellular damage and inflammation. It also makes pores look smaller and halts

excess oil production. Apply directly to the skin on acne lesions (on its own or combined with tea tree oil

or apple cider vinegar) with a cotton ball.

Urine therapy – Some people have found that urine therapy has helped them cure their cystic acne.

Using their morning urine, they use a cotton pad and wipe it across their skin. Some people opt to let it

air dry, while others wash their face after 15 minutes.

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Lemon juice – Some forms of acne can be caused by imbalance in the pH of the skin. Drinking the juice

of two lemons twice a day, once in the morning, one hour prior to eating, and once at night, one hour

after eating, has proven effective for some people. Some choose to drink it straight, while others do so

with water.

Shea butter – Shea butter contains UV blockers, vitamin A (the main ingredient in Accutane),

vitamin E (which is low in acne sufferers, lupeolcinnamate (an acid with anti inflammatory

properties) and vitamin D. Studies have found that shea butter brightens the skin, reduces the

appearance of wrinkles, and improve moisture levels in the skin. Apply to dry skin after washing

as a moisturizer.

Clay – Bentonite clay is thought to help control the excessive production of sebum and draw out

toxins from the skin. The high silica content also means it softens skin. After washing your face,

mix the clay with water (and optionally, a few drops of tea tree oil), and apply as a mask. Leave

on for five to fifteen minutes and rinse with lukewarm water. Repeat once a week or more

frequently if desired.

Salicylic acid– This acid is derived from willow tree bark, and penetrates into the pore to

dissolve the build up of dead skin. It encourages the shedding of the skin’s top layer, preventing

congested pores. Use with shea butter, as shea butter has been found to dramatically increase

the healing properties of salicylic acid.

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3.2.2 Household remedies

Aspirin mask– The active ingredient in aspirin is very similar chemically to salicylic acid. It is an anti

inflammatory, which is why it can be effective in treating acne. One to seven pills are crushed and mixed

with distilled water to make a paste. Some people also choose to use organic honey to make the mask

less drying. Apply this paste to the face and leave 5 to 15 minutes. Use up to twice a week.

Calamine lotion– The active ingredient in calamine lotion is zinc oxide, which reduces inflammation

and soothes redness. It has an astringent effect with reduces acne outbreaks by absorbing excess sebum.

Many people apply calamine lotion as a mask and leave it overnight. Some reported using it every night,

then stretching it to three to five day intervals when they noticed a decrease in its effectiveness.

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Apple cider vinegar – Some people use apple cider vinegar as a toner, while others drink it. It is said to

be beneficial when used as a toner as it increases the acid level in the skin, contributing to the acid

mantle. Wipe a mixture of apple cider vinegar and water over your face with a cotton ball. The apple

cider vinegar should be organic, unfiltered and unpasteurized, and should contain the ‘mother’ in it. This

should then be washed off. To drink it, it is recommended to mix 2 tbsp of apple cider vinegar with 2

cups of water. Some people also recommend adding baking soda.

Epsom salts – Epsom salts have anti-inflammatory properties that reduce swelling, pain and redness.

Epsom salts diluted in water can be used as a face wash.

Milk of magnesia – Though generally used as a laxative, it can be used as a toner to reduce oil on the

face. It contains natural zinc, which helps to fight acne. Some people choose to dab milk of magnesia

directly on pimples and leave on overnight. Others choose to make a facial mask from it, leaving it on for

10 minutes and rinsing off with lukewarm water.

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3.3 Skincare advice

2.3.1 Avoid comedogenic ingredients

Comedogenicproducts block the skin’s pores and cause acne. When choosing skincare products,

check if any of the ‘highly comedogenic’ or ‘moderately comedogenic’ are in the first seven

ingredients on the list of any products you are considering.If you find them there, using that product

could worsen your acne.

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If the ingredients are contained further down the list on the back of the product, it means that only a tiny

amount is included in the product, and it still may be safe for you to use. Some people prefer to source

products that are 100% free from comedogenic ingredients.

Highly comedogenic

Isopropyl isostearate

Isoprorylmyristate

Laureth-4

Myristylmyristate

Oleth-3

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Moderately comedogenic

Acetylated lanolin

Acetylated lanolin alcohol

Butyl stearate

Cetearyl alcohol

Cocoa butter

Coconut butter/oil

D&C red #30

Deycloleate

Glyercyl stearate SE

Isopropyl palmitate

Isostearylisostearate

Isostearylneopentanoate

Laureth-23

Lauric acid

Mink oil

Myristic acid

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Myristyl lactate

Shark liver oil

Soybean oil

Stearic acid: TEA

Stearylheptanoate

Wheat germ glyceride

3.3.2 Scar treatments

Some people will develop scars after they’ve had acne. This is not always connected to the severity of the

acne they suffered from, as people have different responses to inflammation. Some people have a

‘secondary inflammatory response’ to trauma, and they are more likely to get scarring after their acne

has cleared up. Those with a ‘single inflammatory response’ tend not to scar.

To prevent scarring, first try to clear the acne. It is very important that you do not pick at your skin, as

this is the main cause of scarring. Leaving your skin mostly untouched is the best way to prevent getting

scars when your skin clears up.

If, when your acne is cleared, and you find you have scars, you might choose to find treatment to reduce

them. It is important to remember that many scars can not fully heal, but they can be improved. Experts

recommend that you do not take scarring too seriously, as it poses no threat to your health, and is often

seen more severely by the person who has the scarring than by others.

Some scar treatments include:

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Topical creams– In gel, cream or liquid form, you apply them direct to the scar up to three times daily.

Alternatively, silicone gel sheets can be purchased and applied to the scar with pressure.

Microdermabrasion – Carried out at a spa or at the esthetician, it improves skin glow and texture. A

handheld vacuum pump creates friction against the skin with very finely ground crystals at very high

speed, which detaches some of the outermost skin cells.

Cryosurgery – In this type of treatment, cold liquid nitrogen gets applied to the scar for between 10

seconds to 120 seconds. Sometimes steroid injections are also used. The liquid nitrogen freezes the scar

and damages the tissue. After the tissue dies it is sloughed off and the area becomes flat. Side effects can

include blistering and permanent lightening of the skin.

Skin rolling/needling – A needle-studded roller, tattoo gun without ink or a 30-gauge needle is used to

puncture the skin. This induces trauma, which is then healed with collagen remodeling. It can take up to

a year for results to be seen.

Punch techniques – There are three types of punch techniques. Punch elevation cuts a portion of the

scar and levels it to the surrounding skin level. Punch excision removes the scar, then the wound is

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stitched up. Punch grafting removes the scar, then replaces it with skin from another area in the body,

such as from behind the ear.

Steroid injection – Steroids can be injected into raised scars to interrupt the inflammation, thereby

reducing the scar.

Cytotoxic injection – An injection of antibiotics or cancer drugs is made into the scar to improve its

appearance.

3.4 Caveman regimen

The caveman regimen is an unusual skincare plan that has recently gained attention in skincare

online communities in general, but particularly among those talking about acne online. Celebrities

such as Alexa Chung, Lady Gaga and Selma Hayek are said to follow this skincare regime. In this

section we’ll discover the theory behind the regimen, and what it is like to put it into practice.

3.4.1 Theory behind the caveman regimen

The caveman regimen has a few different variations. From the most extreme to the least extreme:

Not washing the face at all. Not letting water touch the face at all. Do not use any products on the face.

Washing the face with only water. Do not use any products on the face.

Washing the face with a gentle cleanser or soap, but very infrequently, such as once a week.

Some adherents of this regimen say that the more extreme the approach, the better the results.

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The theory behind this skin regimen begins by talking about the acid mantle. The acid mantle is a

protective layer of skin that develops when you enter puberty. It’s made of sweat and sebum and it

protects your body from bacteria that could potentially invade your body and harm you. The pH of the

acid mantle is 5.5, which is slightly acidic.

The caveman regimen’s theory puts forward that we consistently strip the acid mantle from our skin by

washing it too often, using harsh chemicals with pH ratings that don’t suit our skin. This is one of the

reasons why the caveman regimen advises against washing the skin with bar soap, as it is alkaline, but

rather washing with a slightly acidic based product, if at all.

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The theory goes on to postulate that as the acid mantle breaks down, the skin is less protected from

irritation and bacteria, and this leads to acne. Some people have even gone as far to say that sometimes

we might create acne, or at the very least severely exacerbate it, through the irritation we cause our skin

with cleansing products and excessive washing.

To counteract this, the caveman regimen advises against washing the face at all, and against using

any products, even natural products, on the skin. The theory states that letting the natural oils and

sweat build up and protect your face will eventually make your acne decrease or go away altogether.

This is letting the skin heal itself without interfering in any way.

3.4.2 The caveman regimen in practice

The reason it is recommended that you don’t let water touch your face at all is because it can cause

irritation. In most places in the world, there are chemicals in the tap water, such as chlorine and fluoride,

which can harm the skin. In addition, water itself is quite drying. Washing with water on its own will dry

the skin, meaning that the skin will need moisturizer. As no forms of skin product are recommended

during the caveman regimen, it is better for the skin not to come into contact with water at all.

When you begin the caveman regimen, there will be a noticeable difference to the skin. For the first few

days, your face is likely to become very dry, very oily, or a mixture of both. Blemishes and zits may look

worse than they usually do, and you might suffer from breakouts. During this stage, it is especially

important that water is not used. Most acne sufferers wash their face twice a day and use a number of

products to try to heal their skin. As we stop doing so, the skin needs time to adjust. One of the first

things it will do is build up a dead skin layer, also known as a ‘dead skin mask’. This is not very

noticeable, but may be dry, flaky and itchy at first. Though this may give your skin a slightly rough

appearance, it remains to protect your skin as it heals, and it regulates sebum production.

Part of the theory behind this is that your skin renews itself every 28 days. Four weeks after beginning

the caveman regimen, your skin is likely to have improved significantly. At this point, some people

choose to wash their face with a gentle cleanser to remove the dead skin layer, but others maintain it is

more effective to let your skin shed naturally. By this point, your skin is better able to regulate itself and

produce the correct amount of sebum you need without creating acne. Inflammation in the skin will

decrease. Any spots or blemishes you have will be smaller and will go away more quickly.

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Some people are reserved about trying this regime for many reasons. One is that people may find it

unhygienic, and worry that without cleaning their face more bacteria and dirt will find its way into their

pores, causing acne. The theory behind the caveman regimen refutes this, though.

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Other reasons include that women might want to wear makeup, and the caveman regimen is not

compatible with skin makeup (though eye makeup is fine). Men would have to use a beard trimmer on

the closest setting, rather than shaving as usual. The hair has to be washed very carefully to make sure

water does not touch the face. Though a couple of splashes does not matter much, you will want to avoid

anything more than that.

The caveman regimen is best alongside a healthy diet and exercise. Though irritation from the outside is

not always the cause of acne, it is often one of the factors keeping it going. That said, all other causes of

acne should also be explored, such as diet, lifestyle, stress levels etc.

During the caveman regimen, it is advisable to focus on your skin as little as possible. If necessary,

avoid mirrors. Not focusing on the acne helps to lower your stress levels and stay on track. Many

people find it difficult to ‘do nothing’ for their acne, especially if they’ve been used to trying many

different remedies and strategies, but great reviews have been posted on acne.org, where this

method is rated 4/5, and 63% of people have rated it 5/5.