How to deal with adult acne

By Michelle Bateman

If you're plagued by spots you hoped to leave behind with your teenage years, good news: adult acne is more common than you think. It's also easier to treat than you suspected.

Adult acne starts with hormones that trigger a mass of sebum; then is exacerbated by the abnormal growth of the hair-follicle lining; from here, plugs form, making it harder for the sebum to naturally drain; add a bacteria called Propionibacterium acnes to the mix and bam! – you’ll see spots…

Understanding what goes on beneath the surface only goes part of the way towards explaining why some of us get acne and others don’t.

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This goes especially when we’re talking about hormonal acne – the type that develops in our 20s and 30s. While teen acne targets the T-zone, hormonal acne is more prominent on the lower half of the face, including the jawline, chin and neck.

“There’s an increasing prevalence of hormonal acne (not just in western countries) and we need to do more work to understand why,” says Professor Kurt Gebauer, a dermatologist and co-chair of the advisory group All About Acne.

“It is linked to the way hormones interact with each other and stress appears to be one of the triggers.”

Other triggers may include illness, weight gain and pregnancy, and it’s a common side effect of polycystic ovary syndrome.


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In treatment

About 85 per cent of Australians will develop acne at some point in their lives, according to All About Acne. With odds like that, it’s no wonder so many resources are being invested in treating it.

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Mild acne can often respond to something as simple as twice-daily washing with a soap-free cleanser or one containing salicylic acid, says Professor Gebauer. He recommends using Cetaphil or Neutrogena. If it’s more severe, he suggests visiting a GP or dermatologist “for topical or oral therapies such as antibiotics, retinoids, fixed-combination treatments or specific oral contraceptive pills”.

There are also a host of mid-range treatment options for those with mild to moderate acne.

Research published in the International Journal of Dermatology suggests nicotinamide (a form of vitamin B), may be as effective in reducing acne lesions as the common topical antibiotic clindamycin.

Alternatively, glycolic peels – done either in a derm’s office or in a salon – have been used effectively for years, though studies in the journal Dermatologic Surgery suggest salicylic acid may have similar short-term benefits, as well as being more effective in the long run, with fewer side effects.

Blue-light therapy has got the research tick, offering effective and fast treatment of mild to moderate acne. One study in the Journal of Drugs in Dermatology trialled the twice-daily use of a blue-light device along with a cleanser with a blend of salicylic acid. It found 82 per cent of participants were happy with the results after eight weeks.

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Food for thought

After years of research suggesting that specific foods (ahem, chocolate) doesn’t give you pimples it’s now looking more likely that the opposite is true.

“There have been good quality studies to show that diet can have an effect on acne,” says Professor Gebauer. “That doesn’t mean simply eating a healthy, balanced diet will prevent or cure acne, especially if you have the more severe forms, but we’re finding that a low-GI diet in combination with acne treatment can be beneficial.”

You know the drill for low-GI foods – look for nuts and seeds, avocados, whole grains like quinoa and buckwheat, a variety of legumes and vegetables. Skip foods that are highly refined or high in sugar, such as white bread and pasta, cakes and biscuits.


Under cover

When you’re breaking out it can be tempting to cover up the offending spots with truckloads of make-up. Step away from the Spakfilla! “Many commercial make-up brands contain comedogenic ingredients, which means they congest the skin, further exacerbating the condition,” says Leslie Graham, national educator at Jane Iredale.

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She suggests looking for make-up labelled non-comedogenic (All About Acne also advises using mineral make-up). When covering up, Graham says using a brush helps avoid transferring oils from fingertips to face – just clean brushes daily with a mild detergent. Easy.


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