How to treat acne with dry skin

The changing of seasons can wreak havoc on acne-prone skin, and winter is no different. If you're struggling with dryness on top of acne this season, these dermatologists have the answers for you.

Can dry skin lead to acne?

Dry skin may lead to acne if you aren't using the right skincare routine, says Diane Berson, MD, a board-certified dermatologist in private practice in New York City and faculty member in the department of dermatology at Weill Cornell Medical College. 

Here's why:

Your cleanser may be too harsh for winter. If you are acne-prone, your skin may benefit from stronger cleansers in the summertime to combat sweat and oil, Berson says. But once winter hits, the effects of cold air outside and dry heat indoors might be too much for your skin to bear — leading to dry, flaky, and inflamed skin. 

If you're breaking out on top of that dryness, you might think increased oil production is to blame. But that's a myth, says Berson. "When you dry out the skin, it's not necessarily that your oil glands work harder to lubricate the skin," she says. The production of sebum, the oil produced by our sebaceous (oil) glands, is caused by hormones, stress, diet, and genetics — not the moisture level of your skin. 

Harsh cleansers can disrupt your skin's barrier function, the complex set of mechanisms that allow our skin to keep moisture in and keep germs out. This can cause inflammation of the sebaceous follicles, aka your pores, which then leads to acne. 

Your moisturizer is too heavy and clogging your skin. Winter weather might make you want to reach for more intense moisturizers, Berson says, but those heavier products can be a no-no for oily skin, even when you're experiencing dryness in winter.

"As a result of using a heavier moisturizer to combat the dryness of the skin, they might find that they're more likely to get clogging and breakouts," says Berson.

How to treat dry skin and acne

Since your skincare routine may be at the root of what is causing your acne and dry skin, it's important to pick the right products. 

Which cleanser to choose: You should make sure you're using a gentle cleanser, says Sonya Kenkare, MD, a board-certified dermatologist and assistant professor of dermatology at Rush Medical College in Chicago. Kenkare recommends a hydrating cleanser from drugstore brands like CeraVe and Cetaphil. 

Avoid foaming cleansers, she says, because they have more detergents that can cause further dryness. Aim to cleanse and moisturize your skin twice a day. And make sure you get a cleanser with the right ingredients for your skin type. 

Which moisturizer to choose: Pick a moisturizer that is oil-free and noncomedogenic, which means it won't clog your pores, says Kenkare. Timing is important, too. You should moisturize while your skin is still damp, says Berson, and when you're drying off, pat gently, don't rub. 

"You're actually going to help seal in the moisture and make the skin feel better hydrated. If you just dry off and walk away, every time you do that, you're drying out your skin more because the moisture evaporates from the skin and takes more moisture with it," Berson says.

Add a serum: If an oil-free moisturizer isn't cutting it, Berson has another recommendation: "When I have patients who need hydration, but not necessarily greasy moisturization, I recommend they choose a hydrating serum." 

She says to look for serums with ingredients like hyaluronic acid and glycerin, which help hydrate the skin, and niacinamide and ceramides, which can calm down inflamed skin and help repair barrier function.

Wear sunscreen: Finally, Kenkare recommends sunscreen for those dealing with acne and dry skin. Acne can lead to post-inflammatory hyperpigmentation (dark spots) for people with darker skin and post-inflammatory erythema (red spots) for people with lighter skin, and those effects become exaggerated with dry skin and sun exposure.

Both doctors agree that it's always a good idea to see a dermatologist if your skin is in distress, especially because your skin has different needs in different seasons. A dermatologist can also recommend appropriate prescription treatments for your acne, like topical or oral retinoids or hormonal medications.

"I don't recommend purchasing products simply because they are popular at that moment," says Berson. "[A dermatologist] is going to tailor the recommendations to your skin type and to what's going on with your skin."

Insider's takeaway

Switching up your skincare routine with gentle cleansers, oil-free moisturizers, and hydrating serums can help get your skin in check when acne and dryness strike at the same time. But when in doubt, consult with a board-certified dermatologist, who can customize a skincare regimen just for you.

Although acne is commonly associated with oily skin, let it be known that dry skin can break out too. And while these breakouts on drier skin are certainly manageable, they can be a little harder to deal with because so many standard acne treatments are targeted specifically to oily skin types. “But sometimes acne can occur on certain parts of the face, while other parts are unusually dry (what we call combination skin or T-zone oily skin),” explains board-certified dermatologist Morgan Rabach, MD.

“I like to compare the skin with brick and mortar, where the skin cells are bricks and the mortar is what holds the cells together: ceramides, lipids, and cholesterol. Dryness occurs when there is not enough mortar to keep the bricks together,” explains board-certified dermatologist Dendy Engelman, MD. “Moisture keeps the skin pliable and supple, whereas the lack of it causes skin to crack, flake, and peel. Cracked skin is more vulnerable to infection from microorganisms—such as bacteria and fungus—because the skin barrier is not strong enough to protect itself, which can lead to increased breakouts,” she explains.

So treating acne with dry skin can require a delicate balance. But first, a bit more on the basics from leading board-certified dermatologists. 

Meet the Expert

• Morgan Rabach, MD, is a board-certified dermatologist based in New York City. She is the co-founder of LM Medical PLLC.
• Dendy Engelman, MD, is a board-certified dermatologist and Mohs surgeon based in New York City.
• Dr. Rachel Nazarian, MD, is a board-certified dermatologist with Schweiger Dermatology in New York City. 
• Joshua Zeichner, MD, is a New York City-based board-certified dermatologist.
• Charlotte Birnbaum, MD, is a board-certified dermatologist based with Spring Street Dermatology in New York City.

Why Breakouts Happen

Acne—no matter what type of skin you have—results from a relatively simple formula. "The skin produces sebum or oil, and if the substance is too thick and sticky it can combine with dead skin cells in the pores and create a plug," says board-certified dermatologist Rachel Nazarian, MD. "This blackhead or whitehead can combine with bacteria and become inflamed, making a red or tender pimple."

As we get older, “our skin loses sebaceous output and moisture,” says Engelman. “Unfortunately, acne can start to increase as we age due to hormonal imbalance, stress, dietary, environmental factors, genetics. So, increased breakouts can start when skin is becoming drier—it’s a tough combo!” she says. 

These breakouts are treatable—it just takes a certain amount of knowledge to make sure you don’t worsen the skin’s dryness in an effort to banish zits! “It is a challenge to treat acne if you have dry skin, because acne treatments can actually dry you out more,” explains board-certified dermatologist Joshua Zeichner, MD. “So it is important to use appropriate cleansers and moisturizers to address dry skin and minimize the risk of medication-related irritation.” 

How to Prevent Breakouts When You Have Dry Skin

Below, dermatologist-recommended tips on how to prevent breakouts when you have dry skin.

01 of 06

Stick to a Regular Skincare Routine

Find what works—and stick with it. “Keep a regular skin routine,” Rabach recommends. “Introducing a new product can throw off a good routine and cause a setback in a cycle of breaking out and then being too dry.”

02 of 06

Cleanse Twice a Day

Wash your face twice a day, but don’t strip it. Rabach recommends choosing a milky-textured cleanser, as it won’t strip the skin of its natural oils.

03 of 06

Try a Retinol (in Moderation)

Retinol (aka every dermatologist’s favorite ingredient) works to unclog pores by sloughing away dead skin cells, helping pores stay clear. Of course, retinol is equally famous for being potentially irritating and causing dryness (!) and flaking for some users. So, for dry skin, Rabach recommends using them sparingly—“maybe once or twice a week instead of nightly.” If you find you’re still sensitive to retinol, try sandwiching it between moisturizer.

04 of 06

Alternate Your Actives

Be careful not to overwhelm your skin with stronger, active ingredients. “It is important to start with one treatment at a time,” explains board-certified dermatologist Charlotte Birnbaum, MD. “Hold off on using products with alpha-hydroxy acids (like glycolic or lactic acid) or beta-hydroxy acids (salicylic acid) while starting retinoids, and add them in once a week only when your skin is already tolerating retinoids,” she suggests. 

05 of 06

Moisturize (and Don't Be Afraid of Oils)

It’s common for people with acne-prone skin to be afraid of moisture, but the fact is all skin types need moisture. “Those with acne tend to be afraid of oils, when in fact, they are a great way to add moisture back into the skin,” Engelman says. She explains that “for acneic skin, face oils help to reduce inflammation. This effect helps reduce breakouts and minimize post-inflammatory hyperpigmentation that can occur after acne flares.”

06 of 06

Beware of Stripping/Over-Exfoliating the Skin

Treat your skin gently. “Avoid loofah-type face scrubbers and handheld mechanical face washers,” Rabach says, "as these may increase dryness and irritation.” Another tip: Stay away from drying, astringent products. “Avoid alcohol-based toners as they often do little to treat acne, and they make it that much harder to tolerate more efficacious treatments like retinoids,” Birnbaum says.

How to Treat Breakouts When You Have Dry Skin

1. Spot Treat: For dry skin, address pimples with a targeted treatment so as not to dry out the rest of the skin. “Spot treatments deliver a powerful dose of active ingredients (typically salicylic acid or benzoyl peroxide) to the pesky pimple, but won’t dry out the surrounding area,” Engelman says. She recommends using a spot treatment as needed, but keeping the rest of your routine consistent and making sure to always cleanse, treat, and moisturize. If you use a benzoyl peroxide–based spot treatment, look for one with a concentration of 1%–2.5%, Rabach advises. “Research shows that higher-strength benzoyl peroxide creates more dryness and irritation and doesn’t help reduce acne with any greater effectiveness,” she says.
2. Spironolactone: The plus-side about treating dry skin with acne with oral medication is that you can avoid using potentially drying topical treatments altogether. Spironolactone is an oral medication that “works best in females with hormone-induced acne (usually cystic pimples around the jawline,” Rabach explains.  
3. Antibiotics: Medications like “doxycycline or minocycline work on P. acne (the main bacteria that causes acne) and also reduce inflammation in red painful acne,” Rabach explains. Like Spironolactone, they help reduce the need for topical treatments.

FAQ

• Why Am I Suddenly Breaking Out?

  A number of factors can cause sudden breakouts when you're an adult, including fluctuating hormone levels, stress, and products in your skincare, haircare, or makeup routine. If you recently added a new product to your rotation, you could also be experiencing purging. This is when your skin temporarily reacts to an ingredient that is triggering cell turnover (often a retinol or acid) with a flare-up. How can you tell the difference? Purging will typically be caused by ingredients that exfoliate the skin, and the spots will heal quicker than your standard breakouts.

• Does Moisturizing Skin Help Acne?

  Moisturizer can definitely help reduce your breakouts—so long as you pick one with the right ingredients. Look for an option that contains both acne-fighting ingredients, like salicylic acid, and soothing ingredients like aloe vera.
  

A Dermatologist-Approved Skincare Routine for Adult Acne

Article Sources

Byrdie takes every opportunity to use high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial guidelines to learn more about how we keep our content accurate, reliable and trustworthy.

1. Leyden J, Stein-Gold L, Weiss J. Why Topical Retinoids Are Mainstay of Therapy for Acne. Dermatol Ther (Heidelb). 2017;7(3):293-304. doi:10.1007/s13555-017-0185-2

2. American Academy of Dermatology Association. Adult acne.

3. Retinoid-induced flaring in patients with acne vulgaris: does it really exist? J Clin Aesthet Dermatol. 2008;1(1):41-43.

4. Chularojanamontri L, Tuchinda P, Kulthanan K, Pongparit K. Moisturizers for acne. J Clin Aesthet Dermatol. 2014;7(5):36-44.

   What causes acne on dry skin?

   Why can dry skin cause acne? Since the clogging of hair follicles causes acne, dry skin can cause an excess buildup of dead skin cells. This, in turn, can clog your pores. In addition, dry skin makes your pores more likely to break open, allowing acne causing bacteria deeper into the skin.

   Can you still get acne with dry skin?

   For those few with dry skin and acne breakouts, it's an infuriating struggle. Trying to find a moisturizer that addresses the needs of dry skin without clogging pores and causing more breakouts is hard enough. Then there's the issue that products that control breakouts often make dry skin even drier.