Corrective make-up and acne – Dr. P. Deshayes

We know that the quality of life of young adolescents is greatly affected by acne, but this impact is not proportional to the severity of the acne. We are also aware of the harmful effects of avoidable touching (abrasion or scratching). Every day we hear patients’ complaints about these lesions, “I’ve had them forever”, and about the treatments, ”they aren’t working”. When acne starts at age 11 patients find it difficult to understand why the situation has not been fixed once and for all after a year or two of treatment. This is when make-up starts to be used. Dubbed “Bridge therapy” by the team from the Mount Sinaï School of Medicine¹, who consider this as complementary to treatment during the wait for an improvement in the lesions or whilst waiting for a bout of inflammation to die down.

In practice - Not just talking but also demonstrating

Make-up often has a negative reputation amongst patients – we often hear mothers saying that their daughter’s acne “started when she started to use make-up” or we see the surprise “she’s got acne but she doesn’t use make-up!”. Calling make-up “camouflage” doesn’t help make this option seem attractive.
When I propose make-up as an option I prefer to describe its qualities during break-outs as “corrective”, I ask the patient to sit on my examination table and I do a demonstration straight away. The idea of make-up as a mask that will be obvious to others is often present amongst patients but successful make-up should not be clearly visible. This is important, especially when proposing make-up as an option to boys. When patients see the results of demonstrations their smiles and surprise lead to the conclusion that the “correction” is often successful. Then comes a quick lesson on how to use corrective make-up.

The features of corrective make-up

The main objective of corrective make-up is to make the lesions disappear, this means that a high concentration of pigment is required if a small amount of the make-up is to be used to cover the lesions. Corrective make-up contains 25-50% pigment whilst tinted cream contains just 5-8%, this means that it is thicker and it requires a specific technique to apply it - we’ll come back to this later.

Such products will often be applied on skin which has lesions on it, thus there is a significant risk of irritating or sensitizing the skin. These products should therefore not contain any ingredients that could lead to such issues. All the studies published on “make-up and quality of life” have shown a net improvement in quality of life with no worsening of pre-existing lesions, particularly in cases of acne.

Choice of colour

The shade of the corrective foundation should match the skin colour of the face - when applied to an area with no lesions it should be invisible. When hesitating between two shades of foundation we should always opt for the lighter of the two as we can always add a touch of powder to make it slightly darker but the opposite is impossible. The shade should vary to match the skin colour depending on exposure to the sun - it is best to have one product that matches the skin colour at its darkest and another that matches when the skin when it has not been exposed to the sun and to mix these two together.

Corrective brushes with lots of pigment are available and can help neutralise the redness or purple colour of the lesions. Green and yellow shades are rarely used in make-up for acne, but if necessary yellow is better than green, especially on golden skin. Green neutralises the redness and gives white - white like a piece of paper rather than skin-white - but the result is a pale grey colour which is difficult to change.
However, light and dark beige corrective brushes are available and these hide very visible lesions very well. The brushes are very helpful when used prior to applying foundation or when used without foundation in boys.

The corrective make-up routine

This make-up routine will include the local treatment of the acne, morning and evening, and will help improve adherence to the treatment. The use of a corrective foundation requires a base to be applied beforehand - this is the product prescribed to be used in the morning to compensate for the agression of the treatment applied in the evening (adapalene, tretinoin) or to complete the action of the evening treatment. A quick cleansing with purifying micellar water can also be carried out in advance of this. Before prescribing a base we must always check its compatibility with the corrective make-up - only if we choose products from different laboratories.
Make-up removal in the evening is compulsory and can be done in the shower with a foaming gel or, if the skin is irritated, with a derma-cleansing product applied using the fingers and then rinsed off. Once the skin has dried it is ready for the local treatment.

Technique for applying the corrective make-up

Corrective foundation is not applied in the same way as a tinted cream. It is important to show the patient the technique, this takes just a couple of minutes:

1. The product must be warmed up on the back of the hand using a finger, this helps make it more fluid.
2. Next it must be applied little by little using the finger, only a small amount of product should be used.
3. It is by dabbing with a brush, that the product is set in place. The product will thus flow into the imperfections on the surface of the skin - onto the domes of “spots” and into the holes of dilated pores or scars - in order to ensure the face is all one shade.

Applying a mineral powder will help create a matte finish, ensuring the make-up lasts and making it possible to apply blusher. Powder should not be used on boys in order to ensure the make-up is not visible.
With very visible lesions we can either use the beige corrective brush, either before or after applying powder, and then come back to lesions that are still visible and use the corrective foundation and then powder. A delicate touch is required to ensure this is not overdone.

Compliments about the make-up

The “mask” effect of excessive use must be avoided - the objective of the correction is not to make the lesions disappear completely but to reduce the visibility of the lesions as much as possible so they no longer attract the eye. The final result is better when the make-up highlights the eyes or the mouth. The dermatologist can remind the patient that they have a beautiful mouth or eyes at this point. We are thus moving away from the “camouflage” approach and towards an approach where the qualities of the face are highlighted. Lesions such as those caused by acne can lead to poor well-being or even depressive states as well as a dislike amongst patients for their own physique, especially in cases where the lesions last for a long period of time.

Corrective make-up can be a solution, complementary to treatment, a “bridge therapy”. This option becomes valuable when patients are taught how to use it at make-up workshops within dermatology departments².

This article has been written by Dr. P. Deshayes, dermatologist (Caen, France)