THERE'S Jessica Simpson and Proactiv. Dr. Perricone and his $75 "Nutritional Support." Sonya Dakar and her $50-an-ounce "Drying Potion."
And then there's Dan Kern -- the man who's taking the strange glamour out of acne treatment, and winning thousands of followers in the process.
Kern, 35, is the founder of Acne.org, a no-frills website built on a few simple concepts for clear skin. He isn't a celebrity or even a doctor. But he is out to change the way the world thinks about clogged pores or -- as he states with characteristic zeal on his home page -- to use "the power of the Internet to pool the intelligence and experience of people around the world to end the struggle of acne as we now know it."
In a little more than 10 years, Acne.org has gained 62,000 registered members and 20,000 unique visitors a day. The site is also a virtual town hall where sufferers commiserate, swap stories and solutions about bad skin, and keep message boards buzzing with makeup and grooming tips, product ratings, new research and scar treatment solutions.
"I'm looking for a gentle cleanser that doesn't have sodium laureth sulfate," writes deadbeat007. "Any suggestions?"
Acne_battle responds, "I've been using CeraVe cleanser and a Clinique cleanser also. Don't take my advice though; my face looks like crap."
One success story -- from Marie in Los Angeles -- reads, "My doctor had actually prescribed a 4% Brevoxyl Creamy Wash about three months prior, but I was using it all wrong . . . way too little for way too short of time. Using your method within two weeks, I saw a MAJOR improvement."
Kern's program is simple. He recommends washing with a mild cleanser, such as Basis Sensitive Skin bar or Acne.org's Gentle Cleanser. Allow the skin to completely dry. Then apply a dime-sized amount of benzoyl peroxide to the problem areas until all of the product has been absorbed. In time, this amount will increase to nearly a tablespoon. Allow it to completely dry, then follow with a fragrance-free moisturizer.
After about two weeks, the treated areas will start to peel and flake. Chances are they will turn red and itchy and burn, but, according to Kern, after the affected areas peel off and the skin becomes accustomed to the treatments, clearer skin will emerge.
"Follow the steps . . . precisely as outlined," he warns on his website. "I cannot make this point strongly enough. Maybe even print out this page or the checklist and take it into the bathroom with you."
Such passion is to be expected from someone who can talk endlessly about bacteria, skin irritation and specific dilutions of benzoyl peroxide. Kern also is quick to invoke the lessons of his mentors, self-help gurus such as Deepak Chopra. "Helping people is not about what I can get in return," Kern says, riffing on Chopra.
Born and raised in Westchester, Penn., Kern struggled with acne since he was 11. "I remember my first zit," he says. "It was right between my eyes. And I was obsessed right from the beginning."
When over-the-counter drugstore medications didn't work, he visited a dermatologist. Treatments such as Retin-A and antibiotics showed few results or worsened his acne. By the time Kern was in college, his condition was so severe that he would keep the light off in the bathroom to avoid seeing his face in the mirror. Eventually he developed a daily cleansing and treatment regimen with a mild benzoyl peroxide formula that worked. He thought it a fluke, but "what astonished me," he says, "was that it stayed clear."
Then in 1995, he was working as an office manager for a video game company in the Bay Area. He was reading Chopra's "The Seven Laws of Spiritual Success" and thinking about how he could help others. The answer seems obvious: "I should tell people how I cleared up my skin."
Kern took an Internet class and made a simple Web page that described his skin-care regimen. Word spread, and e-mails started coming in from people who, it could be said, had been converted. Kern knew he had to buy the domain name Acne.org.
Kern's regimen, according to Dr. Sonia Badreshia-Bansal, an adjunct clinical professor with the department of dermatology at Stanford University, would be useful for a person with mild acne. "However, in more severe cases," she says, "a combination approach using prescription medications will be required, and the regimen will need to be altered."
Dr. Ron Moy, director of dermatology for the California Health and Longevity Institute in Westlake Village, agrees. "Benzoyl peroxide is a fine ingredient. It hits bacteria," Moy says. "Some studies show it may be as effective as any of the topical or oral antibiotics. It's sort of the over-the-counter, cheap way for treating acne."
If the acne persists, however, it's probably time to see a dermatologist about other treatments, which may include Retin-A or an oral antibiotic. For people with acne aggravated by hormones -- which many women experience -- or cystic acne, benzoyl peroxide alone probably won't do the job, says Dr. Joyce Davis, a dermatologist in midtown Manhattan.
Benzoyl peroxide's major downside, too, is that it can irritate the skin, Davis says. That problem can be solved by using a moisturizer or cutting back on the strength of the solution. But a more annoying issue is that the chemical turns fabrics white. "It's a very good acne product, but it you just have to be careful, because it can bleach fabric," Davis says.
Kern's regimen remains largely unknown in the dermatology community. When Dr. A. David Rahimi, a fellow with the American Academy of Dermatology, visited Acne.org and read the claims, he was skeptical. "I think a lot of them are very exaggerated," he said. "Just to say that you can put 2.5% on the face in huge quantities and clear the skin is silly."
Kern's regimen notwithstanding, the site's information-rich content drives most of the traffic. Visitors interested in other treatments can search message boards for posts on retinoid medications, hormonal treatments and Accutane (isotretinoin, generically) from people who say they have used them.
They discuss folk remedies (such as dabbing a paste of aspirin and water on a cystic pimple to bring it to a head), and they ask which concealers and foundations help disguise an outbreak (Bobbi Brown, for one, has its fans and critics; Everyday Minerals has nearly a cult of 1,000 devotees). Collectively, they ponder holistic treatments and support each other emotionally through the self-esteem issues that accompany acne.
Kern isn't shy about posting videos of himself as he still performs a precise and methodical skin-care regimen -- "the thickness of the stratum corneum (the outermost layer of the skin) near the eyes is about one-tenth as thick as the rest of the face and can be very sensitive to benzoyl peroxide" -- and offers a chart of interchangeable products for his regimen, such as Basis sensitive skin bar soap, Neutrogena On-the-Spot and Cetaphil moisturizer.
His willingness to suggest alternatives and substitutes makes him different from the high priests of the skin-care trade. Dr. Perricone sells a 2-ounce tube of 5% benzoyl peroxide for $55. And Dakar's Drying Potion ("Hollywood's Secret Weapon") features ingredients such as peppermint and Dead Sea sulfur and sells for $25 for half an ounce.
Kern argues that a conscientious treatment regimen and the critical 2.5% benzoyl peroxide are all you need. And he'll sell you 4 ounces of benzoyl peroxide gel for $8.50.
Times staff writer Shari Roan contributed to this report.
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SIMPLE STEPS TO CLEAR SKIN
The acne.org regimen is built on the idea that a 2.5% benzoyl peroxide product -- and the discipline to wash your face twice a day -- are all you need to clear up your skin. Here's the plan:
Wash your face with a mild cleanser for 10 seconds. Kern prefers a face wash that is not scented, not a soap and not too expensive; he likes Purpose and Basis cleansers. Pat dry with a clean towel.
Allow face to dry completely. Using clean fingers, apply a gel or a cream containing 2.5% benzoyl peroxide. Proactiv, Neutrogena and acne.org offer products at that concentration. Massage very gently over problem areas and surrounding skin, taking care to avoid the eye area.
Let the medication absorb and completely dry. For the first week, the skin will turn red, irritated and itchy, but these symptoms will lessen by the third week.
Acne.org recommends gradually increasing the dosage, which, depending upon the individual and the acne, can be a tablespoon or more.
Wash your hands and apply a moisturizer labeled "non-comedogenic" and "fragrance-free" to lessen the dryness and flakiness.
Acne.org offers its own line of products, priced less than most department store brands.They are available at danielkern.com, where a 16-ounce bottle of cleanser costs $9.50; 4 ounces of benzoyl peroxide, $8.50; and 8 ounces of moisturizer, $10.50.
-- Serena Kim