Adult acne sucks. Just when you feel like you've finally started to get your sh*t together, the bad skin and spots you thought you'd saw the back of in college swoop in ready to kill your vibe once more.
The thing is (and it's a biggie) that adult acne and teenage acne aren't actually the same thing, and in lieu of puberty, there are plenty of other potential triggers ready to set your skin off into a frenzy—we'll cover this in just a minute.
But this also means that it's probably not wise to simply start dousing your skin with litres of harsh cleansers or sever spot-drying lotions (you know, the ones you depended on in your teens). Just like you, acne-fighting skincare has grown up, and thankfully, the new guard of sophisticated formulas makes fighting it a hell of a lot easier. We asked Justine Hextall, MD, consultant dermatologist at The Harley Medical Group, to share everything you need to know about adult acne and to give her expert guidance as to the ultimate game plan to ditch it once and for all.
Okay, so what's to blame?
"In teens, the triggers are puberty and oily teenage skin, whereas adult acne is usually caused by hormonal fluctuations," explains Hextall. "Irregular monthly fluctuations in hormones produce excess oil that flows into clogged pores—a result of decreased cell turnover due to ageing." Depressing stuff.
These hormonal fluctuations could be down to stress, which increases the body's levels of cortisone (the fight-or-flight hormone), which can irritate the skin. But it could also be genetic: "Thick, oily skin could be part of your genetic makeup, which in turn, could increase your chances of developing acne," says Hextall. And pollutants (yes, that old chestnut) can also trap dirt in pores and encourage inflammation.
Your diet plays its own part too. "For some people, dairy produce is known to aggravate acne," reveals Hextall. "Milk is a direct source of hormones and a number of growth factors, which can stimulate sebaceous glands, promote more insulin in the body and alter skin cell production." We've got the 411 on some great milk alternatives here. And gluten grains, like wheat, barley and rye, are known to cause the production of insulin and promote inflammation too. So experimenting with removing these triggers can help you recognise exactly what's causing havoc on your skin.
Finally, "a high toxic load can clog up the liver, putting extra pressure on the detoxification function of the skin," which Hextall believes could explain why there appears to be a link between a healthy gut and good skin. For this, she recommends adding in fermented foods like kefir, sauerkraut and kimchi into your diet, which are all rich in beneficial bacteria.
So where do we go from here? Is medication an option?
"A GP or dermatologist will prescribe antibiotics for acne if they feel it is necessary and results can take at least six weeks to show, and some courses last up to six months," explains Hextall. "And side effects, though uncommon, can include minor skin irritation, redness and peeling of the skin."
While she's always hesitant to prescribe courses of systemic treatments for acne, Hextall is a massive advocate for the use of physical therapies, such as LED light and IPL lasers, which she has experienced to be really beneficial for her acne-suffering patients.
To pop or not to pop—that is the question.
Never say never is the line from Hextall. "If a spot really has peaked with a visible yellow head, a gentle squeeze may help. Unfortunately, squeezing can exacerbate the inflammation, which can encourage scarring, so caution is advised."
Okay, so what can be done about it?
For starters, there are a few golden rules that Hextall recommends for the treatment of adult acne:
- Wash acne-prone skin only twice a day—over-washing may irritate the skin and increase inflammation.
- Use a gentle cleanser, lukewarm water and fragrance-free products.
- Avoid oil-based makeup, which increases oil production in the skin and, in turn, blocks hair follicles, which increases inflammation.
- Keeping hair out of your face will help to prevent the buildup of oil, as will regular washing.
And are there any ingredients that are particularly good at treating adult acne?
"Benzoyl peroxide and topical retinoids can help to reduce the number of bacteria on the skin," and thankfully, you can find these ingredients in plenty of readily available skincare formulas. "Applying these regularly can stop outbreaks or at least minimize the outbreak of spots."
Using a gentle wash is also key and Hextall recommends Cetaphil or La Roche-Posay Effaclar Purifying Cleansing Gel (£9). "They both remove dirt and oil without harming the delicate balance of the skin barrier, keeping skin calm and hydrated."
Below we've laid out our favourite tried-and-tested products that are perfect for treating adult acne.
This cleanser counts dermatologists the world over within its fan base, including Hextall, thanks to its ultra-gentle formula that cleans away enough of the acne-exasperating sebum without completely stripping the skin dry.
The newest addition to Glossier's skincare cohort, this skin treatment contains a mixture of potent AHAs, BHAs and PHAs that nibble away at the dead skin cells at the surface and sebum-clogging pores further down. As the impressive trial results show, it does one heck of a job at clearing skin and imparting that elusive glow.
As Hextall suggests, retinols are great at limiting potentially acne-causing bacteria on the skin and Zelens' serum is as efficient as they get, and it'll also fade away any areas of hyperpigmentation.
As Hextall recommends, light therapy can be really efficacious at treating adult acne, and although treatments carried out by a dermatologist's office will be higher intensity, Neutrogena's clever mask can replicate some of the effects at home. It utilises blue light (which kills the acne-causing bacteria) and red light (to reduce inflammation). Used for 10 minutes every day for 12 weeks, it will clear skin dramatically.
Looking for something containing benzoyl peroxide as Hextall suggested? You'll find it in this lightweight milky lotion by Mario Badescu. It's great at seeping into skin and clearing up those irritating under-the-skin spots.