I have had acne most of my life. It had gone away, but now that I am in my forties, it has come back with a vengeance. What can I do?
I chose this question for the first post since it is very close to my heart. I have struggled with acne most of my life and still have to manage it on a daily basis, now at 38. It is one of the main reasons that I became a skin care therapist. I wanted to know more about how I could resolve my own skin issues and help other people resolve theirs, too. Acne is one of the skin care issues that affects people deeply, both physically and emotionally. It sucks.
In my skin care practice, probably over half of the clients I see are managing acne. While some of them are in their teens, most of them are in their late 30s and 40s. Some of these clients had acne when they were younger and it has returned. Many of them are getting acne for the first time in their lives as an adult.
It is frustrating.
There are many reasons acne can return (or appear) as an adult. A likely reason is due to hormonal shifts (such as pregnancy, perimenopause and menopause) that are taking place that cause changes in how skin regenerates itself. Sebum, the substance produced by the sebaceous glands that keeps skin from drying out, can increase. The skin cells that shed mix with the increased sebum, clogging the pore with an oily sludge. Changes in hormones can also cause an increase in the likelihood of bacteria that cause acne on the skin.
Shifts in hormone levels can also contribute to increased inflammation in the body, which is a known contributor to acne, as well as other inflammatory skin conditions (and aging - boooo!). Inflammation in the body can also be caused by a diet that contributes to inflammation - things like processed foods, sugar, alcohol, red meat and refined grains.
Stress is another major offender that can lead to breakouts in adults. Managing the root of things that are stressing you out can help a great deal in relieving acne and other chronic skin conditions. Our emotions are reflected in our skin. It is important to connect with them and explore how they could be contributing to skin issues.
While no one skin care approach works for everyone, here are some things to consider trying if you are experiencing acne flareups as an adult. It may take some experimenting and time to find the approach that works best for your skin. And, please, always keep in mind any known allergies, contraindications or sensitivities that you may have when making any changes in your skin care routine (both internal and external)...
- Remove all processed foods, food additives (artificial flavors, dyes, etc.), caffeine, alcohol, sugar, red meat and refined grains from your diet. You may also want to seriously consider removing or decreasing your dairy intake, as this is often a major culprit.
- Incorporate a green smoothie into your daily diet. Smoothies containing fresh fruits, vegetables and greens (like kale and spinach) help your body to naturally cleanse itself. To jump start your green smoothie routine, try Tera Warner's 3-Day Green Smoothie Challenge, a free service that guides you through 3 days of smoothie recipe planning and preparation. It is really fun!
- Drinking fresh juices containing beets, burdock root, celery, grapefruit, carrot, parsley and nettles are also wonderful for helping to clear skin. You can also drink skin-clearing teas such as burdock root, red clover, dandelion root and milk thistle.
- Consider adding an internal supplement containing skin-clearing herbs, such as Herb Pharm's Dermal Health™ Compound. I use this tincture whenever I'm going through periods of acne flareups and it has been helpful.
- Eat plenty of salmon and natural, whole fat yogurt. The omega-3s in salmon help to reduce inflammation in the body. Yogurt helps to keep healthy bacteria in the gut, balancing the intestinal system, which promotes clear skin. If you don't like fish or yogurt, you can take fish (or flax) oil and a probiotic supplement.
- Consider getting tested for food allergies. I have had several clients that were able to link their acne to an allergy they had developed as adults. Dairy was often the allergy.
- Consult a qualified naturopath or herbalist who could customize a plan of herbal supplements to help manage hormonal fluctuations. I'm not at all suggesting that you don't see a doctor or dermatologist (please, do if you have a chronic or severe skin condition that isn't responding to other treatments), but it is likely that they would address any hormonal issues with synthetic hormones, like birth control, which I don't feel is really a solution. An herbal care plan customized to you can offer a more gently effective approach.
- Remove makeup every night and follow a consistent daily skin care routine.
- Care for skin gently, using a cleanser twice daily that will provide thorough cleansing without stripping skin. Look for ingredients like glycolic acid (derived from cane sugar) and willow bark, which will help to effectively exfoliate dead skin cells and keep pores from clogging in the first place. A great one to try is dermaE's Vitamin A Glycolic Cleanser.
- Look for products with ingredients such as tea tree oil, that offer antibacterial properties and chamomile, calendula or kelp, which help to soothe irritation and inflammation from breakouts.
- Avoid products containing benzoyl peroxide. This chemical is harsh on all ages of skin and can excessively irritate and dry out skin. While it may begin to clear blemishes, you are left with raw, red, itchy, scaly skin. :(
- Do not use physical or granular scrubs on active breakouts. These irritate skin that is broken out and can actually make acne worse. Also avoid scrubbing skin harshly with a washcloth or any other tool. For gentle exfoliation, use an enzymatic mask such as dermaE's Cleansing Enzyme Mask. These types of masks exfoliate skin by unsticking the "glue" that holds on to dead skin cells. This allows the dead skin to be removed, revealing fresh new cells below, rather than clogging pores.
- Just like mom always said - avoid picking, as it can lead to infection and scarring.
- Be sure to wear sun protection regularly, as the sun can cause red marks from breakouts to remain long after the breakout is gone.
- After cleansing, use a gentle toner, such as rosewater and glycerin or orange flower water to add a boost of hydration and keep your skin at the proper ph level.
- Use a moisturizer regularly on clean skin to keep skin hydrated. Adult acne can be unique in that the skin tends to be drier overall to start with. When skin is stripped from cleansing and not properly nourished and moisturized afterward it can easily dry out further. When the skin dries out, it begins to freak out and pump out more sebum (oil) to compensate. This increase in sebum, mixed with dry flaky skin is a recipe for a breakout.
- Don't obsess over non-comedogenic or oil free products. These have been hyped all over the place. All types of skin need a protective moisturizer and even those with acne can use a product with oil in it. Preposterous, you say!?! Yes. I know. It sounds crazy. But for some (not all), a little bit of oil can actually keep skins oil production in check, helping to decrease breakouts. Just stick to lighter moisture formulas that contain oils like hazelnut or grapeseed, which are lovely for oily or acne skins. If you just can't go there or you feel that a product is causing you to break out, try a gel formula like dermaE's Pycnogenol Moisture Gel.
- Use a night treatment to keep pores clean 3-4 nights a week. Look for formulas, again, with glycolic or willow bark. A good one to try is dermaE's Vitamin A Pore Refining Gel. ***Please note: I am not trying to promote dermaE in this post, but they do have a really solid, affordable and extensive natural product line that I have seen results from. There are many other products out there to explore for acne - including those you can make yourself. I just know that these have worked for real-life, actual people and they are readily available, which is important for busy folks. :)***
- Consider getting regular professional facials and/or natural facial peels. It can make a big difference in improving acne. Even getting facials at the change of each season can help.
- If you are unable to get a professional treatment, perform a weekly at home mini-facial with a thorough cleansing, followed by a face mask using fruits containing beneficial acids and enzymes that will help remove dead skin and sebum - any combination of pineapple, papaya, cherries, kiwi, lemons, limes and grapes (and more!) can be blended together. Leave the mask on for 20 minutes, remove with a warm, damp cloth, rinse with lukewarm water and finish with a toner and moisturizer.
- Find a personal, meditative or spiritual practice that helps you to unwind and let go of the issues you are holding on to emotionally. This could be a regular yoga practice, exercise, journaling, walks in the woods, taking long, cleansing baths, energy work, massage, spending more time for yourself - whatever feels right to you to connect with those emotions that can be showing up as acne on your skin's surface.
- Drink plenty of water, get plenty of rest and exercise, spend lots of time outdoors in fresh air and surround yourself with love and loving people.
- Be good to yourself. You are a good person. :)
Phew! That was a lot of bullet points! I hope this information is helpful! Looking forward to another Ask the Esty soon!
To submit a question, click the Ask the Esty logo on the right of this blog (or on the tab at the top!) and complete the form. I will only include the question/answer -never any of your information - to keep things confidential, so please feel free to ask your most burning skin and natural body care questions!