Ten Tips for Treating Acne on Asian Skin
Treating acne on Asian skin presents special challenges1 that are often overlooked by the manufacturers of the most popular acne care products. The products that work on other skin types can be harmful for Asian skin. Here are ten useful tips for treating acne on Asian skin.
- Products that work for other skin types often can be harmful to Asian skin.
- Many Asians have an enzyme deficiency that makes them very sensitive to hydroquinone. The products used to remove brown spots caused by acne can make them permanently black and blue.
- Any product to foams, fizzes, or tingles can damage Asian skin. Tiny bubbles in a thin lather are OK.
- Hydrating Asian skin is more likely to treat acne than drying Asian skin. Be sure to use alcohol-free moisturizers!
- Flushing on Asian skin is often misdiagnosed as rosacea. Usually, it is really not rosacea.
1. People of Asian heritage can be especially sensitive to detergent cleansers.
Any kind of soap or cleanser that makes big bubbles can break down the stratus corneum, the outermost layer of living skin. People who have Asian skin types, and especially people who have Japanese skin types, are especially sensitive to detergents2. Not only do sudsing, foaming, big-bubble soaps and cleaners not clear up the skin, they can even cause worse breakouts of tiny pimples almost immediately after contact. Most people who are of Asian descent should wear gloves when handling any kind of detergent. Any skin cleanser should make a thin, creamy lather with barely visible bubbles.
Onchronosis is a genetic condition causing lack of an enzyme the body needs to utilize the amino acids tyrosine and phenylalanine. It causes cumulative damage to bones and joints often misdiagnosed by Western doctors as osteoporosis. It can also cause a much more obvious symptom, black and blue discoloration of the skin, especially around the eyes and on the ears.
The dark discoloration of the skin can also occur as a reaction to exposure to industrial solvents, gasoline, benzene, or hydroquinone, which ironically is a product used to lighten the skin. The unfortunate reality is that when people with Asian skin tones use hydroquinone to remove brown spots on the skin left by acne, they often develop black and blue spots caused by onchronosis. Asian skin types must never be treated with products that contain hydroquinone, such as the Murad line of cosmetics.
3. Most Asians (and most people with tight, oily skin) are very sensitive to stinging and irritation from skin care products.
If you have an Asian skin type, chances are that any product that leaves your skin feeling “tingly”4 can cause irritation and even brown spotting of the skin. This means that products that contain alcohol, citrus extracts, lemon oil (although lemon juice is OK), eugenol, cinnamon, eucalyptus, hammamelis, calamine, benzoin, mint, peppermint, tea tree oil, wintergreen, or menthol have to be used with caution, as do all benzoyl peroxide products.
Overexposure to the sun can leave brown spots on the skin, and so can acne. To minimize the formation of brown spots after acne heals, always treat acne with products that cause the least possible inflammation, and treat pimples as soon you see them. One of the ways acne bacteria defend themselves is by making surrounding skin cells more susceptible to inflammation generated by the immune system. The sooner you treat a pimple, the less sensitizing chemicals they secrete.
5. Many Asian experience skin breakouts similar to rosacea after they drink. These usually are not actual rosacea.
Many Asians, especially Koreans, lack an enzyme that detoxifies alcohol6. Taking a shot or two of hard liquor can cause reddening of the skin, especially across the cheeks, around the eyes, and on the nose. This is not rosacea. It is a reaction to alcohol. Usually other symptoms are so unpleasant that the reaction is self-limiting.
6. Even though Asian skin looks light, it usually requires the same treatment as darker skin.
Asians tend to get spots from acne that can be made worse by some of the products used to lighten them. Higher concentrations of benzoyl peroxide (over 5%) and higher concentrations of alpha-hydroxy acid peels (over 10%) or beta-hydroxy acid peels (over 2%) also can cause permanent damage to Asian skin.
If you have Asian skin and you choose to use a mild facial peel, it is essential that you also use a neutralizing product to ensure that there is no damage to the skin. If you are getting a treatment at an aesthetician’s office or at a spa, make sure you get a “light” peel, just in case the provider is not familiar with Asian skin7. Or better yet, go to aestheticians and spas that specialize in treating Asian skin.
7. Asians need to wash their faces after they wash their hair.
Shampoo usually generates big bubbles to blast oil off hair. Unfortunately this can also damage to skin on the face. It is important to rinse the face after washing the hair to prevent redness and inflammation that can add to or cause brown spots, and it is also important to make sure the skin of the face does not come in contact with hair gels or leave-in conditioners.
8. Treating acne on Asian skin with a hydrating cleanser is more successful than treating acne with a drying cleanser.
Many Asians respond well to cleansers8 or cleansing pads that contain oil and respond poorly to cleansers or cleansing pads that contain alcohol. Oil in cleansers can dissolve excess oil on the skin, allowing it to be easily rinsed away. Alcohol in cleansers temporarily removes the “shine” from skin, but the skin responds to the drying effects of alcohol by producing even more oil later.
9. Certain ingredients in skin care products make acne (and any spots left after it heals) darker and more noticeable on Asian skin.
People who have Asian skin types need to avoid products that contain Achillea millefolium9 (yarrow), cedar, dandelion, geranium, jasmine, ylang-ylang (Cananga odorata), lemon grass, lemon oil (but not lemon juice), rose attar, rose otto, rosemary, and sandalwood.
10. Tea tree oil is usually not a good idea for treating acne on Asian skin.
Neither is Manuka honey, which is collected from hives of bees that feed on tea tree flowers. Tea tree oil is usually anti-inflammatory, but a surprisingly large number of people who have Asian skin types are allergic to it10. Allergies, like cuts, scrapes, infections, and overly aggressive acne treatments, can irritate and darken Asian skin.
- Ho SG, Chan HH. The Asian dermatologic patient: review of common pigmentary disorders and cutaneous diseases. Am J Clin Dermatol. 2009;10(3):153-68.
- Deguchi H, Aoyama R, Takahashi H, Isobe Y, Tsutsumi Y. Harmful Effects of Synthetic Surface-Active Detergents against Atopic Dermatitis. Case Rep Dermatol Med. 2015;2015:898262.
- Liu WC, Tey HL, Lee JS, Goh BK. Exogenous ochronosis in a Chinese patient: use of dermoscopy aids early diagnosis and selection of biopsy site. Singapore Med J. 2014 Jan;55(1):e1-3.
- Lev-Tov H, Maibach HI. The sensitive skin syndrome. Indian J Dermatol. 2012 Nov-Dec;57(6):419-23.
- Flament F, Bazin R, Qiu H, Ye C, Laquieze S, Rubert V, Decroux A, Simonpietri E, Piot B. Solar exposure(s) and facial clinical signs of aging in Chinese women: impacts upon age perception. Clin Cosmet Investig Dermatol. 2015 Feb 10;8:75-84
- Gross ER, Zambelli VO, Small BA, Ferreira JC, Chen CH, Mochly-Rosen D. A personalized medicine approach for Asian Americans with the aldehyde dehydrogenase 2*2 variant. Annu Rev Pharmacol Toxicol. 2015;55:107-27.
- Handog EB, Datuin MS, Singzon IA. Chemical peels for acne and acne scars in asians: evidence based review. J Cutan Aesthet Surg. 2012 Oct-Dec;5(4):239-46.
- Treating Asian skin requires a delicate balance between clearing the condition, preserving pigmentation | American Academy of Dermatology. Aad.org. 2019
- Peng HY, Lin CC, Wang HY, Shih Y, Chou ST. The melanogenesis alteration effects of Achillea millefolium L. essential oil and linalyl acetate: involvement of oxidative stress and the JNK and ERK signaling pathways in melanoma cells. PLoS One. 2014 Apr 17;9(4):e95186.
- Van der Valk PG, de Groot AC, Bruynzeel DP, Coenraads PJ, Weijland JW. Allergic contact eczema due to ‘tea tree’ oil. Ned Tijdschr Geneeskd. 1994 Apr 16;138(16):823-5.
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