A blackhead-prone T-zone, a maskne cyst on your chin, a smattering of PMS-related pimples—we’ve all experienced acne in one way or another. Almost 20 per cent of Canadians suffer from breakouts, with up to 22 per cent of women suffering from adult acne, according to the Acne and Rosacea Society of Canada. In its simplest explanation, acne occurs when a hair follicle becomes clogged with oil and dead skin cells. It can show up in the skin in different equally unpleasant forms, including cysts, pustules, blackheads and whiteheads. The reasons for breakouts vary from person to person, with hormones, stress and genetics being just a few of the most common factors. 

For a long time, acne was treated with the same tried and true therapeutics—many of which are still used today. But innovation has come a long way from the Noxzemas and Proactivs of the past (no shade to them, they helped minimize my teenage acne significantly in the ’90s). Between oil-zapping lasers, new topical medications and a plethora of gentle yet effective skincare ingredients, having clear skin is now more possible than ever. 

Between oil-zapping lasers, new topical medications and a plethora of gentle yet effective skincare ingredients, having clear skin is now more possible than ever. 

Dr. Sonya Abdulla, a dermatologist at Dermatology on Bloor in Toronto, sees a lot of acne in patients of all ages come through her doors but has noticed an uptick of the skin condition among women over the age of 25. “This may be due to increased incidence but could also be due to a better understanding that acne is not just a teenage phenomenon and that effective treatments are available for this demographic,” she says.

Thanks to progress in the industry, acne is no longer a one-approach-for-all condition. Combinations of treatments—including skincare, medication, and in-office procedures—are often recommended to help tackle the complexity of breakouts and the different ways in which they’re triggered. “The ultimate goal is to reduce the burden of acne from a look and feel perspective to improve a patient’s quality of life and ultimately prevent long-term consequences like hyperpigmentation and scarring,” says Abdulla.  

To get a better sense of what’s new out there in acne care, we’re taking a closer look at three advancements that are helping to put an end to stubborn pimples (*crosses fingers*).

The innovative new acne laser

In-office laser treatments have been used for decades to treat a variety of skin concerns, including wrinkles and sunspots, and in 2022 a new device arrived in Canada that specifically addresses oily and blemish-prone skin. AviClear is a laser that treats acne by targeting the source of oil production deep within the skin. It’s being touted as the first alternative to Accutane (an oral medication that’s often prescribed for deep, cystic acne), without many of the unwanted side effects, such as super-dry skin and chapped lips. “AviClear is the first FDA-cleared, energy-based device that treats mild to severe acne,” says Dr. Dominique Babin-Muise, aesthetic physician and owner of Luma Clinic in Halifax. The machine uses a 1,726-nanometer-wavelength laser to tackle acne at its source by shutting down the active oil glands. “Oil is one of the main driving forces of acne, so by targeting that, it can suppress the formation of blemishes,” explains Babin-Muise. 

The laser penetrates below the surface of the skin, leaving the surface of the face untouched, which means that the AviClear can be used on all skin tones without the risk of causing hyperpigmentation. One treatment typically takes around 30 to 45 minutes and three sessions, spaced four to six weeks apart, are required. While prices will vary across clinics in Canada, three treatments will typically run you around $4,000. Depending on the type of laser, a session can be uncomfortable to sit through (just ask anyone who’s has a resurfacing treatment!). Babin-Muise describes the discomfort from each AviClear procedure as anywhere from a one to a six on the pain scale, with levels varying between patients. “We find that a lot of people tolerate the treatment quite well,” she says, and the laser can be adjusted in intensity for a customizable result and feel. As for downtime post-procedure, unlike ablative lasers that remove the surface level of the skin and require days to weeks to recover, the AviClear is relatively downtime-free. Babin-Muise has noticed mild redness and swelling in some patients for as little as an hour after treatment while lasting for a few days in others. The most common side effects are itchiness and dryness, which she says can last for a week or so after each session. While temporary, purging is also common after treatments as the glands become disrupted by the laser and the skin rids itself of whatever was housed inside, causing a breakout.

As for results, Babin-Muise says that it varies from person to person, and much of it depends on the severity of the acne. Some people may see an improvement in their skin two weeks after their first session, while others need longer to see a marked difference (such as weeks after their third session). 

The groundbreaking topical acne treatment

Hormonal acne has been a long-time frustration for many people, especially women. This type of breakout occurs when hormone fluctuations in the body increase the amount of oil your skin produces (puberty and menopause are two common culprits). One family of hormones called androgens play a large role in regulating sebum production, so when those hormones go into overdrive, more oil is produced, which leads to more breakouts. In the past, hormonal acne has been tricky to treat, aside from a few oral medication options. “Most topical therapies will look to address inflammation, occlusion of the skin and bacterial triggers, but there’s no other direct target for the hormonal part,” says Abdulla. That was until the introduction of Winlevi, a new prescription cream that gets to the root of the problem. The first medication to target hormonal acne in 40 years, Winlevi aims to minimize the effects of androgen hormones on the skin by reducing oil production.

Approved by Health Canada this summer, the active ingredient in the cream is a topical androgen receptor inhibitor called clascoterone. “Winlevi blocks the effect of androgens that drive acne in the skin and also has an anti-inflammatory effect,” says Abdulla. Applied twice daily, the treatment can be used by anyone 12 years of age and older with breakouts on the face or body. Unlike many of the oral medications used to treat acne (such as Accutane or Doxycycline), Winlevi is relatively mild when it comes to side effects, which can vary from patient to patient. Abdulla explains that clascoterone is well-tolerated, with skin redness, peeling, dryness and itching occurring in some users. “Overall, clascoterone cream may be less irritating to a patient’s skin when compared to some of our other prescription topical acne treatments,” she says. When taking Winlevi, clinical studies show an improvement in the skin around the 12-week mark with continued improvement over six to 12 months of consistent use. As for the cost of this new cream, it will vary for each person depending on health coverage and where you fill your prescription. 

The new lineup of acne-clearing ingredients

From glycolic acid to benzoyl peroxide, topical skincare ingredients have always been a first line of defense against acne. And while both are still used today to minimize breakouts, the arsenal of ingredients has expanded, including options that aren’t as drying. “Skincare will always play a role in acne management, including ingredients to soothe the skin, to promote tolerability and to give an additional boost for acne reduction,” says Abdulla. Unlike old-school spot treatments, most products these days are formulated with zit-zapping actives along with barrier-replenishing ingredients to help soothe irritated, compromised skin. 

Need-to-know blemish blasters to help curb breakouts

 

Hydrocolloid patches

Made of hydrocolloid—a moisture-wicking material that’s been used in medicine for years—these handy little stickers work like mini sponges on the skin. Pop one on a pimple, wait a few hours and watch as it ‘sucks up’ and absorbs the gunk and moisture that sits below the surface of the zit, effectively drying it out. Not only do pimple patches deflate angry whiteheads, but they also help to stop idle fingers from picking away at the skin. “[They] keep hands away from an inflamed lesion, reducing the temptation to squeeze it, which can trigger rupture and scarring,” says Abdulla. If you’re looking to zap an especially stubborn zit, try a patch formulated with an extra anti-acne boost, like tea tree oil or salicylic acid.

Hero Cosmetics Mighty Patch Original, $23 for 36 patches, shop.shoppersdrugmart.ca Photo: Hero Cosmetics

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Starface Hydro-Stars + Big Blue with 1% Salicylic Acid, $22, starfaceworld.ca

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Azelaic acid

A new player in the acne game, azelaic acid is renowned for its soothing and anti-redness properties. Antimicrobial and anti-inflammatory, azelaic acid boosts cell turnover and targets inflammation, which means it’s a one-two punch in treating active blemishes while minimizing scarring. “It helps with both acne and rosacea and can also target secondary hyperpigmentation,” says Abdulla. Because azelaic acid isn’t as potent a treatment for acne as others in the toolbox, it’s often recommended alongside other ingredients like salicylic acid and benzoyl peroxide. 

Dermalogica Liquid Peel, $42, dermalogica.ca. Photo: Dermalogica

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Drunk Elephant Bouncy Brightfacial, $89, sephora.ca. Photo: Drunk Elephant

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Salicylic acid

This BHA (beta hydroxy acid) is a gold standard ingredient to treat acne, and it recently got a makeover, appearing in everything from cleansers and toners to serums and masks. Salicylic acid and its derivatives directly target the oil gland, unclog pores and reduce the bacteria that drives acne, says Abdulla. Its unique ability to exfoliate the skin and dissolve dead skin cells and grime in pores is what makes this acid such an acne-fighting superstar. Its unclogging abilities make it especially helpful in treating blackheads and whiteheads while helping to prevent further breakouts.

Vichy Normaderm BHA Peeling Serum, $50, vichy.ca Photo: Vichy

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Peace Out Salicylic Acid Acne Treatment Serum, $46, sephora.ca

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