Male skin 101

Much of the information and advice surrounding skincare is aimed at women — so what's a guy to do in the battle against blemishes? First, it's essential to consider the differences between male and female skin.

Dermatologist Lisa Kellett, M.D., tells Cosmetics Magazine, "In general, men have a slightly thicker epidermis and dermis than women, as well as significantly more terminal (coarse) hair on the face and body." Having thicker skin means that men's skin can better tolerate higher concentrations of acne ingredients, such as benzoyl peroxide and salicylic acid.

In addition, dermatologist Jeffrey Benabio, M.D., explains in The Dermatology Blog that male skin has larger pores and a higher density of sebaceous glands. This means that male skin is more prone to sweating and tends to be oilier, so deep cleansing is a must for men in maintaining a clear complexion.

Identifying the enemy

Acne occurs when the dead skin cells, sebum and bacteria naturally present in the skin become trapped inside the pore. Because the bacteria responsible for acne, P. acnes, is anaerobic and doesn't need oxygen to survive, it flourishes in blocked pores, leading to either non-inflammatory or inflammatory breakouts. Non-inflammatory lesions include:

• Blackheads (open comedones): If what you see looks like tiny flecks of pepper, then it's most likely a blackhead. These are plugs of dead skin and sebum that block the pore opening and are most often seen around the nose, on the chin and sometimes even on the cheeks. Blackheads rarely turn into inflammatory acne.
• Whiteheads (closed comedones): These blockages are too large for the pore opening, resulting in a raised plug of white blood cells, often called pus. Unlike blackheads, whiteheads can easily turn into inflammatory acne.

Inflammatory acne is more serious and manifests as much larger, deeply impacted blemishes that appear red and inflamed. Healthline, an online medical resource, explains the differences among the common types of inflammatory acne:

• Papules: Small skin lesions which appear solid and raised.

• Pustules: Small, pus-filled, blister-like lesions on the surface of skin.

• Nodules: Solid, raised bumps on the skin, greater than 10 millimeters in diameter.

• Cysts: Closed pocket of tissue that can be filled with air, fluid or pus.

Inflammatory acne is often painful and feels like hard bumps deep within the skin. These infections can be extremely difficult to treat with over-the-counter products.

The triggers

Multiple factors can cause an outbreak of acne, wreaking havoc on skin. These include:

• Oil production: During puberty, sebaceous glands begin churning out sebum (oil), the body's natural moisturizer. Unfortunately, oily skin can lead to acne. Because men tend to have a higher density of sebaceous glands, oily skin is a common culprit of male acne.

• Dead skin cells: As skin cells die, they're sloughed off and replaced by new ones. When too many dead skin cells build up along the lining of the pore, they "stick" together with the excess sebum and block the pore opening, leading to whiteheads and blackheads.

• Bacterial growth: The P. acnes bacteria thrives and multiples rapidly in the dark, warm confines of a pore. When the contents of the pore swell past normal, a small eruption can occur in the cell wall, releasing the dead skin cells and bacteria into surrounding tissues. When this happens, white blood cells are sent to investigate, leading to redness and inflammation.

• Hormones: In addition to being linked to all things manly, testosterone can also contribute to acne. Not only does testosterone signal the skin to increase oil production, it starts raging in early teen years, which can kickoff a long battle with blemishes. Beyond the teen years, certain glandular disorders may also boost testosterone production, leading to acneic skin conditions.

Effective ingredients

Several active ingredients, such as salicylic acid and benzoyl peroxide, are all-stars in helping to clear up skin. But be patient — most treatments take several weeks or more to work.

• Salicylic acid: Exfoliates away the dead skin cells that block the pore opening and encourages cell turnover.

  • Deep cleanser: Because men are more prone to oily skin, deep cleansing is a must. For overall clarity, use a cleanser with salicylic acid twice a day such as Anthony Logistics Anti-Acne Cleanser.

  • Spot treatment: To target individual blemishes, consider a spot treatment. Anthony Logistics Anti-Acne Spot Therapy features salicylic acid and alpha hydroxy acids to clear up new blemishes and exfoliate dead skin cells.

• Benzoyl peroxide: Kills the P. acnes bacteria by releasing oxygen into the pore. Look for it in concentrations ranging from two to 10 percent. Because men have naturally thicker skin, they can tolerate higher concentrations. However, higher concentrations of benzoyl peroxide can leave skin overly dry and flakey, so you may want to start with a lower percentage and work up from there.

  • Deep cleanser: PCA Skin pHaze 31 BPO 5% Cleanser is especially formulated for the face and contains 5 percent benzoyl peroxide.

  • Spot treatment: Menscience Acne Spot Repair includes 10 percent benzoyl peroxide along with soothing ingredients like green tea and vitamin E.

  Both ingredients make skin more vulnerable to UV rays, which can lead to sunburn and skin cancer, so be sure to use sunscreen every day. A moisturizer with sun protection is ideal to both lock in hydration and protect the skin: Jack Black Sun Guard Oil-Free Very Water/Sweat Resistant Sunscreen SPF 30+ is perfect for daily use as well as outdoor activities and sports.

Prescription treatments

If you've tried over-the-counter products and still aren't seeing a reduction in breakouts, it's time for a trip to the dermatologist for clinical strength, prescription treatments.

• Retin-A (Tretinoin): A topical retinoid derived from vitamin A that clears out clogged pores and reduces oil production by the sebaceous glands. Results may take several months and side effects such as drying, peeling or flaking are possible. Because Retin-A makes skin more sensitive to UV rays, wear sunscreen daily.

• Antibiotics: Oral or topical treatments — lotions, creams or gels — that kill acne-causing bacteria. Results may take several months to appear and, as with Retin-A, be especially diligent about wearing sunscreen daily.

• Accutane (isotretinoin): An oral medication that wages war on acne in several ways: It shrinks sebaceous glands, lowers oil production, stops bacterial growth and calms inflammation.

  Unfortunately, Accutane can cause severe side effects including dry, irritated skin, headaches, nausea, stomach pain, diarrhea, joint and muscle pains, hair loss, vision problems and mood changes. Talk to your dermatologist about the likelihood of these side effects and inform your doctor immediately if you notice any of these reactions.

Learn everything you need to know about acne-fighting skincare in our Complete Acne Handbook.