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 New York City–based, 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 New York City-based, 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.
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 New York City-based, board-certified dermatologist Dr. 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 New York City-based, 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.
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.”
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.
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.
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 New York City-based 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.
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.”
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
- 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.
- 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.
- 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.
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