This happened to me all the time when I struggled with deep, painful cystic chin breakouts. I would find a new ‘holy grail’ acne treatment, my skin would get less oily (the relief at this alone was huge) and the large painful bumps on my chin would vanish (I was dancing with joy)… for a few months. It felt like any acne treatments I used stopped working after a while.
I felt utter frustration, scream-shouting inside – why is my acne treatment not working anymore? Why does my acne keep getting better and then worse?
This is the blog I wish I could have read 10 years ago. Take my hand, I’m about to guide you through the number one reason why acne products stop working.
And it’s not because they’re expired or because your skin builds a tolerance to them over time.
Why Is My Acne Treatment Not Working Anymore?
One of the first acne treatments to give me sweet relief was completely unexpected. It wasn’t even prescribed by a doctor (the opposite in fact 😂). I was watching The Only Way to Essex when Chloe Sims pounced on fellow castmate Diags with a pot full of Sudocrem.[It’s a nappy rash cream]
Diags was struggling with breakouts so Chloe let him in on the Sudocrem secret – it works for acne too (well kind of – more about why it only ‘kind of works’ soon).
This is how I went to bed every night for years.[my partner Rich jokingly got photo evidence one night 🙈)
I remember opening the door to a neighbour, forgetting I looked like a Geisha 😂 can you imagine?
Sudocrem was the first acne treatment that felt like it worked. I was so excited, so happy, so relieved.
My skin felt balanced and I didn’t see a bad breakout in months… until I did again.
It felt like my skin was getting used to Sudocrem and it stopped working. I was devastated, hopeless and so unhappy in my skin.
Why Do Acne Products Stop Working?
Why is my acne treatment not working anymore? I’m going to break down why Sudocrem stopped getting rid of my acne – and then I’m going to show you why common acne treatments like DUAC become way less effective with time.
Ok, so Sudocrem. The simple, grey pot of white claggy cream.
I remember the first time I use it, I don’t understand – how am I supposed to rub it in? It’s that thick.
Sudocrem’s a ‘healing antiseptic cream’ – mostly designed for babies bottoms.
It contains two actives which help make acne better (at least in the beginning);
- Zinc oxide – us scientists call zinc oxide an astringent – in human all that means is it dries up your skin – makes your skin less oily
- Benzyl alcohol – an antiseptic that can help kill off acne bacteria on your skin
This is awesome (at face value) because Sudocrem as an acne treatment confronts two root changes in your skin biology.
Firstly, zinc oxide in Sudocrem’s helping mop up excess sebum your skin’s making – this also reduces the rate of acne bacteria growing on your skin because acne bacteria love oil. Wahoo.
Secondly, Sudocrem has a direct antiseptic effect meaning it helps kill off the overgrowth of acne bacteria that cause your skin’s immune function to get all red, hot and angry.
Why Does My Acne Keep Getting Better and Then Worse?
At the start acne treatments like Sudocrem work but then they make your acne worse. Sometimes way worse than before. That’s because treatments like Sudocrem (and DUAC – which we’ll talk more about soon) work against your skin’s natural biology.
Zinc oxide for example is an astingent which dries up your skin. When your skin gets dry, your skin’s pH level changes – your skin pH should be naturally slightly acidic (about pH 4.2-5) – this helps stop acne bacteria from overgrowing – yay. However, when you use drying treatments like zinc oxide – this raises your skin pH. Your skin pH becomes less alkaline and a happier place for acne bacteria.
This science quote says it all;
Psst – flora just means microbiome which means the kinds of bacteria living on your skin.
An acidic pH environment is conducive to normal flora growth, so, as pH increases, pathogenic bacteria proliferate. In particular, P. acnes grows well in an environment with a pH range of 6.0~6.5, but when pH drops to 5.5, its growth noticeably decreases.Ann Dermatol. 2016 Apr; 28(2): 216–221.
This is a massive challenge with what I now call ‘Blitz-It’ skincare like Sudocrem (or DUAC) – they dry out your skin and when your skin is dry your skin’s pH level rises.
It rises easily to the pH range (6-6.5) that acne bacteria love.
Once your skin pH level’s strayed (which can take a few months to happen permanently) – it feels like your acne treatment has stopped working.
Psst, my science-proven acne diet helps to reduce the pH levels of your skin – if you’re serious about getting clear, download your free copy of my one-page acne diet cheatsheet here.
Why Did My Acne Routine Stop Working?
A high pH level of skin is the number one reason why acne routines stop working. Here’s the number two reason why acne routines stop working – your acne treatment’s killing off good skin bacteria too.
Do you remember how Sudocrem contains an antiseptic called benzyl alcohol?
You’re doing so amazingly taking in all of this science – just look at you go 🙂
Well, whenever you use an antibacterial on your skin, you’re not just killing off acne bacteria, you’re also killing off good skin bacteria. Bacteria that help your skin resist breakouts.
What science tells us;
The presence of Gram-positive bacteria on the skin (Streptococcus, Lactococcus, and Streptomyces) restrains the spread of other pathogenic bacteria.Life (Basel). 2022 Mar; 12(3): 422.
Translation 🙂 good bacteria help stop bacteria with pathogenic potential, like acne bacteria from overgrowing.
Yay – this is how your skin naturally resists acne. This is how you get rid of acne for good.
But acne treatments like Sudocrem kill off these awesome good bacteria. Your skin no longer has the acne bacteria ‘criminals’ but it also no longer has the acne bacteria police.
In this condition, your acne will get worse again once you stop using your acne treatment. But don’t worry, there is another way – hold tight while I explain why DUAC treatments can work for a few months and then make acne worse, way worse.
DUAC – Why Is My Acne Treatment Not Working Anymore?
DUAC is a prescription acne treatment that contains two acne-fighting actives;
- Benzoyl peroxide (3%) – an antiseptic – it kills off acne bacteria, plus also has mild exfoliating benefits which can help prevent clogged pores
- Clindamycin (1%) – an antibiotic that kills off acne bacteria
I bet it’s all starting to make sense now eh? 😀 Why your DUAC acne treatment’s not working anymore?
DUAC’s main mode of action is to kill off bacteria on your skin.
That means DUAC’s killing off good bacteria too.
Psst – good bacteria do other awesome things like helping to keep your skin hydrated and calm.
The biggest side effect of any treatment containing benzoyl peroxide is its ability to make your skin really dry, red and irritated.
That’s because benzoyl peroxide dries out your skin.
And you’ve guessed it – that causes your skin’s pH level to rise, which causes acne bacteria to overgrow.
Why is my acne treatment not working anymore? Good bacteria prevent acne bacteria from overgrowing and because your acne treatments kill off the good bacteria on your skin, eventually acne treatments like DUAC or benzoyl peroxide stop working.
Can Skin Become Immune to Acne Products?
It’s not the case that your skin’s becoming immune to acne products instead, what’s happening is the acne product has unnaturally changed your skin biology. Acne treatments like benzoyl peroxide or DUAC or antibiotics work against your skin biology to get you rapid results. You see a wonderful clearing of your acne.
…but then acne comes back worse than before.
Why? Because your skin health is majorly reduced. For example, there are way fewer good skin bacteria to stop the acne bacteria from growing.
But there is a better way 🙂 you can use natural changes to your skincare, diet and lifestyle to prevent acne bacteria from overgrowing and to cause good skin bacteria to thrive.
It’s how you’re going to heal from acne for good and get healthy, happy, glowing, calm skin you feel like awesomesauce in.
And it’s what I show you how to do in my online, science-supported video course, Acne Warrior. Check out Acne Warrior and see my amazing client transformations here.
Cheryl Woodman is a scientist, skin health expert & award-winning skincare formulator who’s more friend next door than bow tie wearing professor. Through her 1-2-1 services and video courses she’s here helping you get healthier, happier skin you feel comfortable, confident and like the freakin’ awesomesauce you are in. Select the option which best describes your skin health here to see and hear the amazing transformations you could be getting.