What’s the key to clear skin?

If you’re prone to breakouts or have oily skin, don’t skimp on washing your face as part of your morning and evening skin care routine.

In a studyTrusted Source that focused specifically on face washing, participants were asked to wash their face one, two, or four times a day for a six-week period.

At the end of the study, there was a significant improvement in the acne lesions of those who washed their face twice a day. The participants who only washed their face once a day had the greatest increase in pimples.

The aisles at most drugstores are packed with all sorts of facial cleansers. Trying to figure out which one is right for you can be overwhelming.

When it comes to choosing the “best” cleanser, fancier may not necessarily be better.

A systematic reviewTrusted Source of 14 studies found that there really isn’t much difference in skin breakouts, no matter what type of cleanser you use.

The studies included everything from cleansing bars and antibacterial soaps to cleansers that contained alpha and beta hydroxy acids.

While this may be disappointing if you’ve spent a lot of money on an expensive cleanser, the takeaway here is that keeping it simple is probably best.

A mild cleanser without a lot of ingredients and fragrances can work just as well as more expensive options.

According to the American Academy of Dermatology (AAD), many topical therapies can help fight acne. The key to finding the most effective one for you is knowing what type of acne you have.

Depending on the type of acne you have, the AAD recommends the following:

• Comedonal acne (blackheads and similar bumps). Look for products that contain retinoids like adapalene gel (Differin).
• Mild acne. Topical benzoyl peroxide can help fight mild acne, either on its own or together with a topical retinoid.
• Inflammatory acne. Topical dapsone 5 percent gel is recommended, particularly in adult females.
• Acne with scarring. Azelaic acid preparations can help reduce acne and the risks of acne scarring.

If you want to simultaneously target different types of acne, the AAD recommends using a combination of benzoyl peroxide, tretinoin, or adapalene gel.

Using these treatments together may dry out your skin, so be sure to use a moisturizer to keep your skin hydrated.

How does a moisturizer help keep your skin clear? Well, if your skin is excessively dry, it may try to compensate for the dryness by overproducing oil. The result? Breakouts.

Like cleansers, moisturizers don’t have to be expensive or filled with fancy ingredients. More importantly, look for a moisturizer that’s noncomedogenic. This means it won’t clog your pores.

If you have oily skin, moisturizers labeled “lightweight” may be best to prevent a heavy, greasy feeling.

Some people find they have to switch to heavier moisturizers during the winter months when cold, dry air can leave skin feeling tight and dried out.

Exfoliation can help remove excess dead skin cells. If these cells stay on your skin for too long, they can clog your pores and lead to breakouts.

Having a buildup of dead cells on your face may also make your skin look dull, flaky, or prematurely aged.

The following exfoliation methods may help clear away dry and dead skin:

• a 2 percent salicylic acid mask
• a 10 percent or less glycolic acid mask or lotion
• a motorized facial brush

How often should you exfoliate? It really depends on the type of exfoliation you use.

For chemical exfoliants, like masks or lotions, aim for once or twice a week. For physical exfoliants, like scrubs or brushes, aim for three or four times a week.

Start with fewer exfoliating sessions and work your way up to prevent over-exfoliating.

If you have inflammatory acne (pustules and cysts), the AAD recommends that you talk to your dermatologist first, as some types of exfoliation may make inflammatory acne worse.

Not getting enough sleep may also cause your skin to break out more often.

According to a 2015 study, more than 65 percent of the study’s participants who said they felt tired also had acne.

The study’s authors theorized that a lack of sleep could, in some instances, cause the body to release inflammatory compounds. These compounds could cause the skin to break out or worsen acne.

To stay healthy both on the inside and out, aim for seven to nine hours of quality sleep each night.

A 2013 studyTrusted Source found people who use cosmetics seem to be more likely to have skin breakouts. To ensure your makeup routine is skin-friendly, be sure to:

• Use products labeled “noncomedogenic” or “oil-free.”
• Always wash your hands before applying makeup or skin care products.
• Always remove your makeup before going to sleep or exercising.
• Wash makeup brushes and sponges on a weekly basis.

Makeup can cause its own form of acne that doctors call acne cosmeticaTrusted Source. This condition causes small, raised bumps that usually appear on the chin, cheeks, or forehead.

It’s really, really hard not to pick at a zit. But, for the health of your skin, it’s important to resist.

Picking or popping a zit exposes the pore to even more bacteria, including those from your hands. It also increases the risk of infection or scarring.

If you have a pimple that really hurts, see a dermatologist. They can perform specialized treatments to safely get rid of the pimple while also minimizing the risk of infection.

Several studies, including one from 2017Trusted Source, have shown a connection between stress and acne. If you’re dealing with a stressful event or situation, look for healthy ways to de-stress. Some options include:

• exercising at a high to moderate intensity for at least 30 minutes
• doing breathing exercises
• doing yoga
• meditating for a few minutes
• writing it out
• practicing sound therapy, like playing a musical instrument or listening to your favorite music

Although there’s limited research on the connection between your diet and your skin, several studies have shown that foods with a high glycemic index may be linked with acne.

In a large study from 2009, more than 2,000 participants were placed on a low-glycemic diet. Not only did they lose weight, but 87 percent of the study’s participants also found they had less acne. Additionally, 91 percent said they needed less acne medication.

To cut back on foods with a high glycemic index try to:

• Limit processed carbs, like white bread and baked goods.
• Cut back on sugary sodas and sweets.
• Eat more fruits, vegetables, whole grains, and healthy sources of protein.
• Limit alcohol consumption.

There’s a good deal of scientific evidence that links smoking with a higher risk of acne.

One study included women from 25 to 50 years of age who had acne. The authors of this study found that almost 73 percent of the participants who smoked had acne, while only 29.4 percent of the women who didn’t smoke had pimples or some other form of acne.

If you need help with quitting tobacco, talk to your doctor about quit aids that may help.

When it comes to clear skin, pay attention to what you put on your face — like cleansers, moisturizers, and makeup — and what you don’t — like unwanted bacteria from your fingers or dirty brushes and sponges.

Focusing on certain lifestyle factors, like quality sleep, a healthy diet, and stress management, can make a difference to your skin, too.

If you’ve tried several types of treatments for your acne and nothing works, make an appointment with a dermatologist. They may prescribe treatments like antibiotics or prescription medications to help clear your skin.