ACNE: The Dreaded 4-letter Word for Adults

Acne ranks as the most common skin condition in the world. It affects different groups at different times and in different ways, but one thing is clear, it is a globally pervasive issue.

Adult Acne

We are going to focus on females aged 25–55. Acne in this large group is termed ‘adult acne’ and is primarily hormonal, linked to the 5 Ps:

1. Periods

2. Pill or post-pill

3. Pregnancy

4. Post-pregnancy

5. Peri-menopause/menopause

These "5 Ps" can be a pain! For all women, hormonal change is normal, ranging from hours to years, but can also be profound. Reproductive hormones are not the only ones in play; stress hormones, for example, can have radical effects on our systems and skin.

Note here that fundamental chronic hormonal imbalance is different from normal hormonal change and requires medical attention.

Back to ‘everyday’ life with our hormones and the effect of changing levels on:

1. Mood

2. Weight

3. Stress

4. Libido

5. Hair

6. Fatigue

7. Skin

We've put skin last, but often your facial appearance will be top of the list when it comes to annoying hormonal issues. For some, there will be an actual acne problem.

Adult Acne Facts (for those over 25)

• Over 75% of cases are female

• Average age is 35

• Up to 80% have 'persistent' acne

• 80% of them have acne on their cheeks

• The pre-menstrual phase is worst in 70% of cases

• Lack of sleep worsens the condition in 70% of cases

• Stress is a worsening factor in 50% of cases

• Cosmetics/skin products trigger acne in over 20% of cases

What are the numbers for female acne by age?

• 45% of females aged 21 to 30

• 26% of females aged 31 to 40

• 12% of females aged 41 to 50

Among these very large groups, most will have the persistent type, but some will experience relapsing acne, meaning they had it in adolescence, and it returns later in adulthood. Alternatively, there is late-onset acne, which only affects females, often during peri-menopause.

Whatever the type, age, or stage, acne has certain characteristics and causes:

• Presence of changing levels of circulating hormones

• Elevated activity of the sebaceous glands

• Presence of C. acnes / P. acnes bacteria

What this means at the ‘coal face’ is:

• Increased oil production (sebum)

• Blocked hair follicles

• Bacterial activity (primarily c. Acnes)

• Skin inflammation

Hence, acne is described as a chronic inflammatory skin condition with distinct typical symptoms such as:

• Whiteheads/blackheads

• Pimples/pustules

• Skin bumps/lumps

• Under-skin cysts

• Redness

Occasional pimples or blackheads don't qualify as acne. They're just a temporary, easy-to-manage nuisance. Thankfully the way to deal with them is very similar to how we deal with acne, just on a smaller scale, meaning slightly different routines.

The basics for dealing with acne prone skin:

• Clean out the skin pores

• Reduce sebum/oiliness

• Deal with bacteria

• Calm the redness

• Protect the skin barrier

For acne and breakout prone skin, the best daily routine is:

1. Cleanse with antibacterial toner morning and night

2. Apply antibacterial gel/cream to affected areas

3. Use antibacterial moisturiser morning and night

4. Avoid all clogging products; make sure sunscreen is suitable

For occasional pimples, the best method is:

• Use antibacterial toner on the pimple

• Apply a spot treatment

• Avoid oily moisturiser on the area

• Prevent more pimples by using toner regularly on high risk areas

General Product Rules for Acne/Breakout/Blemish Prone Skin:

Ensure they are:

• Non-comedogenic, non-oily and non-clogging

• Naturally antibacterial to prevent resistance

• "Pore-patrol" – able to clean them out

• Microbiome-friendly to protect skin health

• pH balanced to support the skin barrier

• Calming to reduce redness

• Moisturising to nurture skin

• Non-irritant to avoid worsening the problem

Apart from the right Skin Care, what else will help?

• Healthy diet, low fat and low sugar

• Limited alcohol and no smoking

• Lots of water and fresh air

• Relaxation and ample sleep

• Probiotics for the microbiome

*Please note this is not medical advice and you should always seek such advice from medical professionals.

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