What's the best way to take care of your combination or oily skin?

Chat led by Doctor Wafa OUAZZANI, Dermatologist, Attachée des hôpitaux (associated with hospitals), member of the SFDP (French Society of Paediatric Dermatology).


Transcript of Chat :


Question 1
Internet user: What causes the appearance of oily skin?
Doctor Wafa OUAZZANI: Oily skin is due to seborrhoea, which is excess sebum. This sebum is secreted by the sebaceous glands which are situated in certain areas of the body (face, trunk, etc.) and their activity is influenced by hormones. There may be a family history of this.
You can have oily skin without having acne but you cannot have acne without having oily skin.

Question 2
Internet user: I would like to know what to avoid if you have combination skin.
Doctor Wafa OUAZZANI: The best thing to do from the outset is to apply creams for oily skin because cream for dry skin is going to be too rich, and therefore comedogenic. Apply a suitable dermatological foaming gel in the evening and a micellar water in the morning.

Question 3
Internet user: Is it good to only wash your face with a micellar solution?
Doctor Wafa OUAZZANI: For discrete acne, yes. But for the most significant kinds of acne, use a combination of a micellar water in the morning and a special anti-acne foaming gel in the evening..

Question 4
Internet user: Are anti-shine face powders harmful in the long term?
Doctor Wafa OUAZZANI: Not at all. A loose powder, no problem. Just be sure to use a good quality loose powder. However, pressed powder and foundation should both be avoided. And most importantly, remove your make-up properly each evening!

Question 5
Internet user: What can you do to prevent shiny facial skin?
Doctor Wafa OUAZZANI: You need to use an anti-shine cream in the morning after thoroughly cleansing your face (micellar water), then you finish off with a dash of loose powder applied with a large brush.

Question 6
Internet user: Hello, I'm 41, oily skin, no wrinkles but what's worrying me are several acne pimples, some of which appeared a few days after I used a new cream, others appear now and again. What can I do? This is really bothering me.
Doctor Wafa OUAZZANI: Don't panic, your skin is oily which means that you will have a lot less wrinkles than a person with dry skin. So this is an advantage.
As to your acne problem, you will need to consult a dermatologist so that he can prescribe a comprehensive treatment program for your acne. In the meantime, use products that are suitable for oily skin recommended by your chemist and go to a good beautician to have your skin thoroughly cleansed.

Question 7
Internet user: During my period I get quite oily pimples which, when they fade, leave scars!! Is this normal?
Doctor Wafa OUAZZANI: This appearance of pimples is quite normal. Acne during a period is called menstrual acne. There are effective treatments, but the most important thing is not to touch your pimples! Acne, even inflammatory acne, does not leave scars if you don't touch the pimples. Crescent shapes are left.

Question 8
Internet user: I have blackheads mainly around my nose and on my chin. Should I use a particular product for those areas?
Doctor Wafa OUAZZANI: Yes indeed. You need to use an effective exfoliation treatment for several minutes once or twice a week and rinse your face with cold water in order to tighten the pores. There are keratolytic (anti-acne) creams specifically for oily skin recommended by the chemist or prescribed by the dermatologist to be applied every evening over the course of many weeks.

Question 9
Internet user: What can I do to get rid of cystic hormonal acne situated just on the jaw area (little raised bumps, hard to the touch, but no red pimples)? Is dermatological treatment necessary at 35?
Doctor Wafa OUAZZANI: Yes. Your dermatologist will prescribe you hormonal treatment which also acts as a contraceptive, but which will treat your macrocystic acne from within after 3 months (end of the 3rd blister pack).
Internet user: I'm not taking any contraception! So what can I do?
Doctor Wafa OUAZZANI: The other option is to take an antibiotic, i.e. a treatment that keeps the acne at bay, but which does not act definitively on it; there is a risk of recurrence when treatment is stopped.

Question 10
Internet user: Can I wash my face in the evenings with a superfatted soap?
Doctor Wafa OUAZZANI: A superfatted soap may be suitable because it's non-irritant and there's no risk of triggering reactive seborrhoea. However, I prefer an anti-acne foaming gel.

Question 11
Internet user: What's the difference between combination skin and oily skin?
Doctor Wafa OUAZZANI: Combination skin is characterised by facial areas that are both dry and oily (the T-zone). However, oily skin is skin that is oily everywhere and the whole facial surface is shiny.

Question 12
Internet user: How can I conceal a pimple?
Doctor Wafa OUAZZANI: You should avoid putting make-up on when you have acne. Foundations clog up the pores. Instead use a special cover stick that you can buy in a chemist. If you wear make-up every day and your pores are clogged, you'll suffer from acne; it's a never-ending cycle.

Question 13
Internet user: I've suffered from acne for many years. Shiny skin, blackheads, red pimples, dilated pores are all part of my daily life. Is it possible to truly cure my acne?
Doctor Wafa OUAZZANI: Of course. By consulting a dermatologist, and by diligently following the course of treatment, the acne should not persist.

Question 14
Internet user: Will oily skin stay that way forever????
Doctor Wafa OUAZZANI: You cannot change your skin type. You won't have wrinkles, but you'll always have oily skin. Therefore you need to dry out your oily skin just as someone with dry skin would need to hydrate it.

Question 15
Internet user: Can combination skin become oily skin and conversely can oily skin develop into combination skin?
Doctor Wafa OUAZZANI: Combination skin cannot become oily skin, but you need to use treatments for oily skin. However, oily skin can develop into combination skin if you use local drying treatments.

Question 16
Internet user: I moisturise my oily skin a lot, how can I dry it???
Doctor Wafa OUAZZANI: If you have oily skin, you shouldn't need to moisturise it too much. You need to always be attentive to your skin's needs. Use a moisturising cream that's not too rich when your skin feels taut, but otherwise avoid using this type of cream.

Question 17
Internet user: My husband has blackheads on his back, I remove them every day, but this only makes it worse and besides it leaves ugly marks, should I stop fiddling with them?
Doctor Wafa OUAZZANI: Stop immediately! You're running the risk of causing an abscess one day that could become the size of an orange. Use a special antibacterial body soap and scrub the affected area with an abrasive glove.
Internet user: How do you explain this? Is it sweat, or clothing, or what?
Doctor Wafa OUAZZANI: The trunk and back are acne-prone areas; many sebaceous glands are found there.

Question 18
Internet user: Does acne affect girls as much as it does boys?
Doctor Wafa OUAZZANI: Yes. With boys, acne disappears quicker; around 18-20 years of age. With girls, acne may persist longer due to make-up.

Question 19
Internet user: I take steam baths with water and thyme for my face, then I continue with an exfoliation, then I finish with a face-pack. Is this good for getting rid of blackheads, as much as it's possible to do so?
Doctor Wafa OUAZZANI: How many times a week do you do this?
Internet user: Once a week.
Doctor Wafa OUAZZANI: That's ok, it's perfect. Continue at this pace with the steam bath and the exfoliating. However, it's important not to use the face-pack on the same day because that will re-clog the pores.

Question 20
Internet user: Is it dangerous to take Diane-35 for many years taking into account that the treatment was started at the age of 15 for roaccutane. I had to start taking Diane-35 again a short time ago because I once again developed acne, I am afraid that I won't be able to have children due to the fact that I started with a very strong pill at a very young age...
Doctor Wafa OUAZZANI: No, as long as you are monitored by your gynaecologist and you don't have cholesterol. This doesn't decrease your fertility, on the contrary, this regulates your cycle and as soon as you stop you can immediately fall pregnant (don't listen to the rumours). However, you should certainly not smoke.

Question 21
Internet user: My 11-year-old daughter has started getting small pimples all over her forehead, can I consult a professional about this or is she too young?
Doctor Wafa OUAZZANI: This is pre-puberty acne. Start by going to the chemist to buy a good foaming gel for the evenings and an anti-acne cream for the forehead in the mornings.

Question 22
Internet user: I have very slightly shiny skin and very occasionally blackheads and red pimples. I'm hesitant to use products specifically for oily skin, I'm afraid of attacking my skin with active ingredients that are too powerful. What do you think?
Doctor Wafa OUAZZANI: Apply a cream that's not too rich that claims to act on acne and has slight hydrating effects. To cleanse your skin in the evenings, use a micellar water especially for oily skin instead of soap..

Question 23
Internet user: If I don't put cream on my face, will it be less shiny?
Doctor Wafa OUAZZANI: It's very simple, you need to either apply an anti-shine cream, or not apply anything.

Question 24
Internet user: How can I get rid of blackheads!!!
Doctor Wafa OUAZZANI: A blackhead is a comedo. Acne always starts with a comedo which is the initial acne lesion. A comedo that has not been drained causes the chain of events that leads to all acne lesions. It's the job of the dermatologist to get rid of blackheads. It's very important not to try to touch them yourself.
No acne in 2009 is resistant to treatment prescribed by dermatologists. However, you can expect a long and restrictive course of treatment: There is no miracle, you must expect to wait 3 to 6 months in order to be able to get rid of the acne.

Question 25
Internet user: Does diet have an influence on oily skin? If so, what advice should be followed? Can I eat chocolate??
Doctor Wafa OUAZZANI: Very good question. Again, diet is involved in acne. It's very important to leave out chocolate, it's fat and sugar. You can test it, eat lots of chocolate, you will have lots of acne, they are directly linked.
Eat lots of fruit and vegetables, avoid fat, sugar and cow's milk too. Food hygiene is vital.

Question 26
Internet user: I’ve read that you can apply layers of up to 3 different creams to intensify the effects, is this possible? Is there not a risk of suffocating the skin?
Doctor Wafa OUAZZANI: This should definitely be avoided. You only need to use one cream.

Question 27
Internet user: I have combination skin and greasy hair, I have to wash it every 2 days. It's impossible to wait any longer than that, I've tried everything, is it normal to have such greasy hair?
Doctor Wafa OUAZZANI: You should continue to wash it every two days with a frequent use shampoo. Make sure that you finish the process with cold water. A tip: tell your hairdresser to give you some highlights, it's pretty and dries out the hair somewhat.
Internet user: I've used an astringent lotion a few times, but that burnt my skin. So I stopped. What do you think?
Doctor Wafa OUAZZANI: If it burns you, the lotion is too irritant for you. You've done the right thing in stopping.

Question 28
Internet user: Do you know of any solutions for making acne scars disappear apart from laser treatment (which hurts too much)?
Doctor Wafa OUAZZANI: Nowadays laser treatment is really effective in making acne scars disappear. There's no effective alternative solution. Pulsed light helps in the treatment of acne flare-ups, but not for scars. Laser treatment carried out properly is not painful and proves very effective on the facial area. You may need 2 or 3 sessions to get rid of the scars, depending on their intensity. On the neck and shoulders, and on the back, the results are more unpredictable, you should need a few more sessions.

Question 29
Internet user: I had my first spots at 14, I'm 17 now and I still have spots and blackheads. How long is this going to last?
Doctor Wafa OUAZZANI: Don't think that this will go away all on its own, you need a proper course of treatment suited to your everyday life. This could last until you're 45, so you should consult a dermatologist!

Question 30
Internet user: Are anti-shine products effective all day long?
Doctor Wafa OUAZZANI: Yes, applying an anti-shine product in the morning enables you to avoid the 11am seborrhoea peak. Anti-shine products act as sponges and absorb sebum. They may be tinted, but they are different from a foundation which will clog the pores.

Question 31
Internet user: How can I tighten my pores and make my skin less dull?
Doctor Wafa OUAZZANI: These are 2 different issues. To tighten the pores, you need to use acid-based creams which tighten the pores and finish your facial cleansing with cold water. In order to make your skin less dull, you should not smoke and you should apply vitamin C-based creams for radiance of the complexion.

Question 32
Internet user: Is there a link between sexual activity and the disappearance of acne?
Doctor Wafa OUAZZANI: There is no link between acne and sexual activity. Acne occurs during a period of hormonal activity, but it's not going to disappear when you first become sexually active.


^{This transcription does not necessarily represent all the discussions that occurred during the chat..}