Blemished Adulthood

Acne isn’t just for adolescents anymore—grownups get it, too.

By Lisa James

September 2007

It may not equal the heartbreak of young love turned sour, but it still hurts: The first morning you wake up to find your face marred by acne. (“Do I really have to go to school looking like this?”) But there is something that’s even worse: Being an adult who is battling those unsightly blemishes years after your peers have gone pimple-free. The only consolation is the fact that you’re not alone—at least 80% of all Americans will get acne at some point in their lives. What’s more, “the demographics of acne are changing,” says dermatologist Richard Fried, MD, author of Healing Adult Acne (New Harbinger). “Recent studies suggest that adult acne is becoming more common.”

Acne happens when male hormones called androgens (which are present in both sexes) incite keratinocytes, cells that line skin pores, to “become abnormally thick and sticky,” Fried says. These cells clog the pore, causing a whitehead (closed) or blackhead (open) to form; if a germ called Propionibacterium acnes is also trapped in the pore, inflammation turns the blemish red.

It’s easy to see how an adolescent’s raging hormones can cause facial havoc, but why should acne occur in adulthood? “Subtle hormonal changes that do not appear on standard blood tests” is one possibility, says Fried; women, whose hormones are constantly fluctuating, are especially acne-prone. Other potential causes—besides a family history of acne—include additives, such as hormones and antibiotics, that are now used in raising farm animals—and, not surprisingly, stress. Unfortunately, adult acne is often more severe and likely to cause scars.

Beyond Appearance
For some people, what makes adult acne difficult to deal with is the number it does on their self-confidence. “Acne has a uniquely strong potential to leave emotional scars, since it is an extremely visible affliction,” explains Fried, who adds that anxiety, depression, and body-image problems can accompany this disorder.

If your skin affects your emotions, Fried recommends taking stock of your psyche. For a week, note each negative emotion as it arises and ask, “What thoughts and perceptions led me to feel this way?” The idea: To become aware of the negative “self-talk” that leads you to obsess about every blemish—and to learn ways to break those conditioned responses.

One way to take control of your acne is to uncover the events that trigger it. Fried suggests thinking about when breakouts are most likely to occur: Are they tied to your menstrual cycle? To times when you feel stressed or angry, sleep deprived or ill? To the use of various types of cosmetics or hair products? To times when you load up on carbs or drink milk? To your exercise habits? Knowing your own patterns allows you to avoid triggers when possible or to take proactive steps if a flareup appears inevitable, which in turn can help you regain your self-assurance.

Smart Skin Management
Don’t try to scrub acne away. “Please recall that acne is rarely the result of poor hygiene,” urges Fried, who adds that overzealous “attempts to clean or even sterilize the skin often cause more problems than they solve.” Instead, he recommends alcohol-free toners, clarifiers or astringents for oily skin and low-alkaline cleansers for dry. One oily-skin cleanser suggestion comes from clinical skin care expert Jeanette Jacknin, MD, author of Smart Medicine for Your Skin (Avery/Penguin):

“Mix equal parts of liquid calendula extract and distilled witch hazel, and apply three times a day.” For stubborn spots, she suggests applying 1/2 teaspoon of goldenseal powder mixed with 12 drops of tea tree oil for 20 minutes twice daily. Green clay masques provide a deep-cleaning option.

Alpha hydroxy acids (AHAs) and beta hydroxy acids (BHAs) are two natural substances that exfoliate by helping to eliminate some of the dead cells that build up on the skin’s surface, which means that the pores are less likely to become clogged. (AHAs and BHAs also help improve the skin’s texture and reduce fine wrinkles.) These gentle exfoliants are available in both over-the-counter and professionally applied forms; discuss their possible use with your healthcare provider.

Various vitamins and minerals can help tame acne, both inside and out. Fried says that a form of vitamin B3 called niacinamide, available in both topical and oral preparations, fights inflammation and the pigmentation problems that can accompany acne. Vitamin C—already valued by practitioners for its ability to nourish and strengthen skin tissues—also eases inflammation because of its antioxidant properties according to Jacknin, as do the minerals zinc and selenium. Zinc and vitamins B5 and B6 can help alter the metabolic processes that often lead to breakouts. And Jacknin suggests taking flaxseed and evening primrose oils for their essential fatty acids along with beta-carotene, which the body uses to make skin-essential vitamin A.

Support your supplementation efforts with a proper diet. Eat “lots of raw yellow-orange and leafy green vegetables,” advises Jacknin. “Carrots, beets, celery, cucumber, lettuce and spinach are especially helpful.” Accompany all those colorful veggies with whole grains and lean proteins, along with plenty of pure, filtered water. Avoid the obvious stuff—fatty meats and fried junk, food additives of all sorts, alcohol and refined sugar (especially candy and soda), plus any foods that you may be particularly sensitive to. As for something you might not have thought of, too much iodine “can irritate pores and cause flare-ups,” says Jacknin. That means take it easy on iodized salt (and salty foods), milk and shellfish.

Don’t let acne send you into a bad high-school flashback. Treat it promptly so you can put on a happy face.

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