Do you ever imagine that you could go back in time and relive your youth? Those teenage years where time seemed irrelevant, emotions were so potent, the possibilities endless, and acne – oh so present. Life as a teenager goes hand-in-hand with raging hormones and unpredictable acne. For adults, it does not – or, so we thought. Up to 50% of people in their twenties to forties experience adult acne, according to the International Dermal Institute. From a pimple to a painful boil that lurks under the skin, only acne can make the thought of wrinkles more pleasant.
Understanding how to prevent, treat, and care for acne, is the key to arming yourself against a surprise onslaught. No matter your gender, age, or ethnicity, acne doesn’t discriminate. “It is more common among women than men,” explains Rebecca Treston, founder and manager of Rebecca Treston Aesthetics at the Clinic Center in Dubai. The reason? Hormones. When estrogen levels in your body dip around your period, testosterone levels fluctuate. This increases the skin’s oil production, which can lead to clogged pores. Adult acne is also kickstarted when hormones affect the pilosebaceous unit – consisting of a hair follicle, sebaceous gland, and hair. If the follicle becomes blocked, it leads to an accumulation of sebum and the overgrowth of otherwise normal bacteria. Infection sets in, leading to white blood cells being sent to the area, forming a pus-filled pimple.
Other causes are also at play. “Diet is the number-one problem,” says Los Angeles-based celebrity dermatologist Dr Harold Lancer. “Caffeine, dairy, and sugar trigger perversion of function with testosterone. You will never see a celebrity eat products containing dairy when they are getting ready for a red carpet event,” he says. Dr Lancer also notes that stress, which increases cortisol levels and inflammation, is the second leading cause of adult acne. “Physical, mental, and emotional stress can trigger a testosterone imbalance.” Even if you are emotionally OK but have been ill, you are at risk – and vice versa. Other factors can include your living conditions. “Urban pollution is proven to make acne worse. Middle Eastern cities such as Dubai are no different,” Treston explains.
How to mitigate the damage, then? “Hygiene is paramount,” explains Dr Marwa Ali, resident doctor at The Wellness Clinic at Harrods in London. Although removing impurities from the dermis is essential, it must be done correctly. Washing your face too often and with the wrong formulas can cause flare-ups and irritate acne lesions. Treatments used during the teen years can become ineffective for adults and even make acne worse, while some creams and serums can also be too rich for certain skin types, leading to breakouts. Combination or oily skins should look to products labeled as water-based, oil-free, and non-comedogenic.
Severe breakouts and hormonal acne require a visit to the dermatologist. “A good skincare specialist or dermatologist will spend time with you to go through a thorough examination, as well as provide evidence-based treatments and advice,” says Treston. She focuses on lifestyle and diet changes, before exploring a routine that combines topical treatments with laser facials. Blue and red light treatments can also be used, with blue killing certain bacteria and red reducing inflammation.
For many, topical treatments offer a solution. “A good skincare regime is essential for maintaining skin health, to treat active acne, and improve the appearance of scars,” explains Ali. Common acne-busting ingredients include benzoyl peroxide or salicylic acid, which can be used alongside oral or topical antibiotics. Prescription topical retinoids are also particularly effective. They not only prevent acne but also stimulate collagen, which can help reduce the appearance of fine lines and wrinkles, too.
If, after trying topical retinoids and antibiotics, the acne persists, your dermatologist will prescribe stronger medication. Treston suggests Roaccutane for cystic acne. “If over-the-counter acne treatments are like gentle exfoliates, Roaccutane is like a full acid peel. It’s intense, it’s extreme, and it’s not for everyone. It should only be used as a last resort,” she states. In most cases, the oral treatment can garner results within four to five months. As with any medication, it has possible side effects, which can include low moods and depression, dry skin, itching, red rashes, and sensitivity to the sun.
Apart from being physically trying, flare-ups are emotionally draining. A new movement championing the reality of adult acne aims to empower those afflicted by it to embrace the skin they are in. #FreeThePimple is redefining beauty standards across social media, with people posting images of their affected areas sans foundation and concealer to help boost the confidence of others. Whether you are in a constant battle with your skin or only experience the occasional flare-up, the first tools to combat acne are patience and self-acceptance.