I have noticed in the past that many of my patients have fallen into the assumption that excessive cleansing with drying facial washes is what’s needed to control oily skin, that the more the better, right? wrong! After I became a dermatologist I learned that the more you try to dry your oily skin the more your skin will try to compensate for it by increasing the sebum production (which gives the oily complexion and shine). Minimize cleansing your face to only twice daily routine, morning and night. It should be enough with a cleanser that is especially labeled for oily skin something with low-neutral pH. I prescribe a cleanser with very low concentrations of AHA, Glycolic acid, 1 percent Salicylic acid, or a non-oily and non-drying cleanser that is the ideal. Try to avoid soaps as much as possible, as most strip away the natural fat barrier that our skin needs.
I favor suggesting a matting lotion or fluid to patients more than toners and astringents that can be too drying. They are available in some of the over the counter cosmetic products. Some are tinted to act as a base for makeup or as a foundation. Tints range from green that help to reduce the facial redness if present, and others are tinted with different skin color tones.
It can help control oil overproduction during the hot humid day. Apply twice daily and it doesn’t necessarily have to be used right after cleansing, it can be used later on in the day as needed. These help the T-zone area of the face that is the most oily and shiny. It removes excess oil, tightens pores and smoothes the appearance of the skin.
People with oily skin should minimize using topical moisturizers even if it is oil free. It should only be used if the person has combination skin and only to the areas that are dry. Because however light the moisturizer is, in my personal opinion and experience, it can cause clogging of pores and development of comedones (blackhead) in acne-prone skin types if used regularly. I suggest moisturizers when the topical treatment has gone a little too drying and only till the skin is re-hydrated again and then stop. I recommend using it as needed and only for dry rough patches till they resolve.
If you will not be exposed directly to the sun, use it as needed. Choose a fluid or liquid base sunscreen that is labeled specifically for oily skin; avoid the types that are excessively cream based.
The new makeup in the market for oily skin mostly has a matting effect and it addresses the shine problem. I recommend using a powder foundation with a SPF of at least 15-20 which has been integrated in many formulations of makeup. Use the new mineral base makeup.
Blotting powdered paper is a quick rescue a person can carry around even in their wallet. It can be used as a quick fix for that extra shiny nose, forehead, and chin.
Clay and mud masks can be done once to twice weekly as it helps with reducing oily skin by absorbing excessive oil and clearing out pores. There is also a new mask that contains sulfa, it can be helpful to patients that also have acne or rosacea.
Scrubs have to be really gentle or you will run the risk of damaging the skin. I never recommend harsh scrubs, only gentle dissoluble beads types that don’t damage the skin. It can be used once to twice weekly to clean up oily pores and decrease clogging.
Vitamin A derivative topical creams such as Adapalen, Tretinion cream or gel, Isotretinoin, even OTC creams with Retinol that can be suggested by a dermatologist can help. These are all off label uses that have shown to help in some practices by experience.
Another possible prescription is Tretinoin which has to be strictly prescribed and monitored during its use by a dermatologist, it can be given in small weekly doses and sometimes daily doses, but that can only be decided by the physician. You can discuss that option with them and they will explain the risks and benefits of its use.
AHA or Glycolic acid peels have helped in my own practice. Also Salicylic acid peels have been used in other practices. Peels removes dead skin, unclogs pores, and generates new skin production.
Sessions can be done by the beautician in which they can use a much lower concentration preparations of GA or AHA in small percentages. They can perform deep cleaning and toning of the skin with special techniques. Finish off with a proper mud or clay mask. This gives an instant satisfactory result to the patient of glowing skin after removal of the dead skin and cleaning up of the pores and absorbing the excessive oiliness on the skin.
There have been reports in the literature as well as discussions among dermatologist regarding the effectiveness of using laser or light treatments specifically for oily skin to shrink the sebaceous gland and thus decreasing sebum (oil) production. Two types have been mentioned ALA PDT treatment with a 1450nm diode laser that targets the dermis where the sebaceous glands lie causing its shrinkage. Other mentions are Pulsed light and heat energy therapy, and Photopneumatic therapy. Otherwise laser and PDT have been used most effectively to treat acne as it destroys the P. acneus organism that contributes to the flares of acne but not specifically to reduce oily skin by itself.
People with oily skin should be careful to avoid too much oil or fat in their diet as this can create excess sebum. I always recommend for healthy skin to increase the intake of green leafy vegetables, vitamin C rich fruits and lots of water at least 8 glasses a day, especially in hot weather because they supply vital nutrients and help flush toxins from the skin.
The list that you should take with you when go to over the counter pharmacy section:
Cleanser for oily skin low-neutral PH gel form (look for Salicylic acid 1% (Max 2%), AHA, Glycolic acid in the wash) avoid soaps. Wash twice daily.
Matting/ anti-shine gel, fluid or lotion in the morning after wash or mid day. Especially to the T-zone area.
Astringent/ toner for oily skin once-twice per day as needed.
Sunscreen for oily skin in liquid form for oily skin (SPF 30-50) if there is exposure to the sun.
Water base moisturizer noncomedogenic for oily skin only to rough patched and dry areas on the face as needed. Avoid the T-zone area.
Topical vitamin A derivative creams or gels, oral medications, peels, medical facial treatment sessions, lasers, and light therapy.
