Acne 101: Root Causes & Triggers

Today's Guest Post by Sofie Pavitt

Hi hi!

It’s wedding week and there’s no time to waste. So many of you found last week’s post informative, so go forth with confidence and get those facials!

Facials 201: Choosing the Right Type of Facial Studio

Last week’s guest post writer, Jessie, is an esthetician at Sofie Pavitt Skincare Studio in NYC and today, we have the honor of hearing from Sofie herself! I first went to Sofie sometime in 2017, shortly after she opened her original studio and I had moved to Brooklyn. My own journey with severe acne had begun the year before and I was desperate for help. I’ve been in awe of Sofie ever since and her approach to treating skin is one of the things that inspired me to want to be an esthetician myself. Sofie launched her own product line last year, which you probably know from your favorite skincare/skincare-adjacent influencer or if you’ve read this newsletter anytime before today since I mention her products quite frequently. In fact, Sofie Pavitt Face holds the distinct honor of being the only skincare brand whose entire line of products I actively use in my routine and the only products that I share with my very-soon-to-be husband. What can I say? When you find something that works, you hold on tight. 

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Hi from Sofie Pavitt HQ!

For those who don’t know, I’m Sofie. I’m a licensed esthetician and I own and operate Sofie Pavitt Skincare Studio in NYC––I opened my first location on Canal Street in early 2017. I also work for a dermatologist on more advanced acne scarring cases, once we have cleared a client in my facial studio. Most recently, I founded SOFIE PAVITT FACE, a skincare system designed for problematic skin. If the name sounds familiar, you may have come across the products on social media, or featured in outlets like Cosmopolitan, Essence, InStyle, The Zoe Report and more. We’ve won over 17 awards for the line so far (and counting!)

My studio is well known for its skin clearing transformations. I would say 80% of our clients initially come in with some type of problematic skin, such as acne, rosacea, perioral dermatitis, etc. I have an amazing team of 7 estheticians who work alongside me and it's truly all of our passion to help people get the best skin of their life.

A common theme we see at the studio is clients who are generally lost at how and why they are dealing with acne. There’s so much noise and information–whether right or wrong–around the subject online, and almost all of them come in confused and undecided on what type of treatment they should be seeking.

Photo Courtesy of Sofie Pavitt

I love to simplify the explanation of how acne forms and use the following points to educate my clients. 

There are three “events” that have to line up in order to have an acne formation. These events can exist at the same time or independently of each other, but all contribute to the chain of events that lead to acne formation. 

This is how I explain the ROOT CAUSE of acne in most of my clients:

1. An overshedding of skin cells. Genetic predisposition to acne can mean that your pores shed at a much faster rate than somebody who isn’t predisposed to acne. This creates build up and ‘stickiness’ both in the pores and on the surface of skin. Importantly, if you do naturally ‘overshed,’ your skin will always work like this. If you were considering this as a science experiment, this is your constant. (Check out this issue of Hotline Skin for an explanation about skin shedding.)

2. Oil production enters the chat. Oil production can be influenced environmentally — if you're stressed, on birth control, live somewhere very hot and humid, on certain medications, or eat a lot of peanut butter, to name a few. Consider this step in your experiment as your variable. All these things and more can increase your oil production. When your oil production is higher and enters a pore that has a sticky build up of dead skin cells, the combination forms a plug or congestion in the pore. Everyone produces oil, which helps lubricate and keep the skin happy. It only becomes an issue if you are producing too much, or if that oil is combining with the dead cell build up in that pore. It’s interesting to note that my clients on plant based diets, who don’t eat much fat/oil in their diet, have extremely waxy and hard oil in the pores. 

3. Bacteria food. C. Acnes bacteria is present on all skin and is usually relatively happy on the surface of our skin. It's only when it has a food source (see 1 and 2: dead skin and oil, aka it’s favorite all you can eat buffet) that it starts to cause issues. C. acnes bacteria flourishes in the pore, causes inflammation, infection, and ultimately, your pimple.

Photo Courtesy of Sofie Pavitt

Going a level deeper, I then explain ACNE TRIGGERS—things that can cause inflammation, increased oil production etc., such as:

• Diet. Diet is massively influential to our skin health and I recommend my clients to eat a varied diet, plants, animal products, and whole grains. Fiber is so important to have in the diet (see below more on gut health) but making sure there are enough oils and fats in the diet will also help soften and lubricate the skin too. 

• Gut health. The gut/skin axis is all too real. Aim for fiber daily (30g takes effort!), a probiotic, and fermented foods to keep your gut microbiome in check. Ironically, many clients are prescribed low dose long term antibiotics to clear acne and this is so detrimental to gut microbiome in general. 

• Stress. Stress raises cortisol levels and this can trigger your body to produce more oil. 

• Medications/supplements. Supplements such as b12, hair growth/biotin, and medications for thyroid, SSRIs, gender affirming meds such as testosterone and some birth controls can trigger acne. Many clients need to stay on these obviously, but please note to your provider if you are on any meds. 

• Sleep quality. None of us get enough sleep. Front load it: resting and active REM sleep is so important for skin correction and restoring.

Photo Courtesy of Sofie Pavitt

Last but not least, we talk about products. Most often, my clients come to me either using way too many products and/or the wrong active ingredients. The first thing I get them to do is to make sure they’re not using comedogenic ingredients by copy/pasting their products into our website’s pore clogging ingredients checker.

My hot take is that I always take my clients off retinols. They speed up cell turnover and are super irritating, and I want to work on barrier support and gentle exfoliation first.

It’s all so personalized and custom, but usually I will start by working on their barrier and taking them off all actives, before embarking on a gentle routine. Next comes the daily exfoliation routine to help them lightly push those excess skin cells away.

For example, I may treat inflamed acne with the following routine:

AM

1. Clean Clean Cleanser

2. Mandelic Clearing Serum

3. Non-comedogenic moisturizer/SPF

PM

1. Micellar Cleansing Pads to take off make up

2. Clean Clean Cleanser

3. Reset Benzoyl Peroxide Acne Treatment Mask

4. Nice Ice Frozen Toner Pod 

5. Non-comedogenic moisturizer

All this being said, I highly recommend anyone dealing with breakouts to seek professional help to determine what type of acne you have and what ingredients you should be choosing. 

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Thank you Sofie!! Our skin thanks you, too. Don’t forget, use the code JOLIE10 to get 10% off all Sofie Pavitt Face products.

Alrighty, off I go!!!!!! Have a great week. I plan to!

xx,

Jolie