Adult Acne

Those of us who suffered from acne as teens dreamed of when we’d grow up and our acne would vanish. For a growing number of us, that day never arrived.

A grown-up problem

Approximately 50 percent of women and 40 percent of men aged 20 to 29 suffer from acne. Those percentages decrease with age: by age 50 and over, 15 percent of women and 7 percent of men are affected.

Although acne peaks among teenagers, particularly males, women are more likely than men to suffer from adult acne. For some, this condition is a continuation from adolescence. For others, it is late onset (starting after age 25). Adult sufferers are more likely to have an inflammatory form: deep-seated, inflamed pimples and subcutaneous nodules and cysts on the lower part of the face.

Causes and triggers

Acne occurs when our bodies produce too much sebum (oil). Dead skin cells, which usually get dry and flake off, stick together with the sebum inside pores and clog them. If P. acnes, a type of skin bacteria, gets inside the clogged pore, the bacteria can multiply quickly and cause inflamed pores, cysts, or nodules.

Researchers have identified a variety of factors that can trigger or worsen this condition:

• hormonal changes (44 to 65 percent of women report flare-ups around menstruation)
• medications
• genetics
• diet
• stress
• smoking

Diet and acne

While sweets and fat have long been suspected of aggravating acne, today’s research emphasizes milk, chocolate, and foods with a high glycemic index (foods that increase blood sugar levels more than others).

Studies in 2005 and 2012 showed positive associations between acne and the quantity of milk drunk, particularly skim milk. The 2012 study also investigated other foods: pasta and bread, meat, cheese, sweets (including chocolate), fruits, and vegetables. None of these foods appeared to increase the risk of acne, though fish consumption seemed to provide some protection.

A small 2014 study of acne-prone males disagreed, showing a statistically significant correlation between the amount of chocolate consumed and exacerbation of acne.

Several studies from 2012 onward point to the relationship between acne and high glycemic foods such as refined carbohydrates, with study subjects who cut out these foods showing a significant reduction in acne.

This research indicates we should

• watch for specific food triggers
• keep a food diary, noting new, increased, or decreased breakouts
• try eliminating a particular food, keeping in mind it can take up to 12 weeks for dietary changes to have an effect

Stress and acne

While many people believe stress plays a part in acne flare-ups, the exact mechanism remains unknown. One theory is that stress causes our bodies to produce more androgens (hormones that stimulate oil glands), leading to acne. However, in a 2007 study of young males, increased stress correlated with acne severity but not increased sebum production.

Studies published between 2010 and 2013 suggest the role of oxidative stress, an imbalance between the production of free radicals and our body’s ability to counteract their harmful effects. According to researchers, oxidative stress changes our antioxidant defence system at both the skin and systemic level, causing acne. The greater the body’s chemical stress markers, the more severe the acne.

Other researchers have looked at a gut-brain-skin theory, proposing that heightened emotional states can change intestinal microflora, increase intestinal permeability, and contribute to systemic inflammation, which might trigger acne.

Natural treatments available

While over-the-counter acne products abound in drugstores, such products are generally not backed by well-designed clinical studies. Researchers are now turning to botanicals and other natural products to treat this skin condition.

Lavender essential oil and bergamot

Studies have validated the antimicrobial, anti-inflammatory, and antiseptic properties of these botanicals.

Rosemary

A 2007 in vitro study confirmed the antibacterial properties of rosemary essential oil against P. acnes.

Tea tree oil

In a 2007 double-blind study, a topical application of 5 percent tea tree oil effectively treated mild to moderate acne. A 2010 evidence-based review pointed to tea tree oil as having the potential to become a standard treatment for acne.

Fish oil

In a 2012 study, fish oil supplements reduced moderate to severe acne.

Aloe vera gel

In a 2014 study, aloe vera gel improved the effectiveness of standard topical retinoids in combating mild to moderate acne.

Green tea extract

In a 2009 study, a 2 percent green tea lotion proved effective against mild to moderate acne, and a 2012 review of studies stated such treatment “should be potentially effective.”

Zinc

A 2013 review of studies suggested oral and topical zinc may decrease sebum production.

Always work with a knowledgeable health care professional when using these or other products.

Supplements for healthy skin

Researchers are also looking at vitamins, minerals, and probiotics for their antioxidant and/or anti-inflammatory properties, which fight acne and improve overall skin health.

Numerous studies have shown that oral supplements have a beneficial effect on skin, including increased skin density, thickness, and elasticity; decreased roughness and scaling; fewer wrinkles; and better moisture retention. Supplements that show promise include

• vitamin A
• vitamin B
• vitamin C
• linoleic acid
• dietary aloe gel
• probiotics
• flaxseed and borage oil

Tips for glowing, healthy skin

• Use mild skin products free of fragrances, chemicals, and alcohol.
• Clean your face before bedtime to remove makeup, sunscreen, bacteria, dead skin, dirt, and oil buildup that can inflame pores. Rinse thoroughly with warm or cool water and pat dry.
• Avoid rough scrub pads or astringents that irritate skin.
• Choose cosmetics and moisturizers that are noncomedogenic (don’t promote closed pores) and are free of oil.
• Drink water to detox, improve blood flow, and help cells absorb nutrients.
• Drink green tea to help stop inflammation and slow DNA damage.
• Eat plenty of fruits, vegetables, lean protein, and whole grains.
• Exercise daily to increase blood flow and sweat dirt out.
• Use a broad-spectrum SPF 30 sunscreen even if it doesn’t seem sunny.
• Avoid smoking.