~~I HANDBOOK
, my skin wasn't
that was OK. My friends
too, and there was
Ifln,m,,,r~ Hide The Blemish.
Isolace in the fact that
Except it wasn't.
is worse. At 38, I still
concealer. And I've spent
make-up, as well as hours
rt"rm"tnlm'i~t~ and facia lists, trying
I dreamed of.
to achieve the clear
Take today: my
a big spot on my chin,
Still, I know what it's like
embarrassment, expense
acne. Quite frankly, when
worrying about
spots and wrinkles,
is enough.
According to the
I'm one of a growing
number of adult acne
At last count, 54%
of women over 25 had some
study puts cases for those aged
with 5% finding their spots
Cosmetic dermatologist and 'lIrnc"/nc,,oI'
Sam Bunting says 60% of her
acne and 90% of those are
QAMO(JI237
HEALTH HANDBOOK .... away from your teens, and late-onset acne
that comes on after the age of 25," she explains.
" I'm definitely seeing more cases of the latter."
While teenage spots are most common on the oily
T-zone (and this pattern continues if you
have the persistent kind), adult-onset acne
is usually seen on the cheeks, chin, jawline
and neck, called the U-zone. "It tends to
be inflammatory, so while you may only
have three to four spots, they're likely to
be hard, stubborn nodules, and resolve
much more slowly," adds Dr Bunting.
By this point in your life, it feels as
though you shou Id have your hormones
under control, but women experience far greater
fluctuations throughout their life than men, making us
vulnerable for a longer period - because, whatever your
age, hormonal change is still the biggest acne trigger.
It causes excess sebum production and a tendency for
clogged pores. "It's wrong to think it's just puberty
that causes skin problems, it's also premenstrual days,
pregnancy, changes in hormone-based contraceptives,
such as coming off the Pill, and even the menopause,"
says Dr Bunting.
Acne is also a feature of
other female-only medical
conditions, such as polycystic
ovary syndrome (peDS)
- an increasingly common
condition, affecting up to
10% of UK women, which leads to unbalanced
hormones and overactive sebaceous glands.
Hormones aside, other factors are also responsible.
Your genes, for one. "Having a close relative with acne
increases your chance of suffering fourfold," says
Dr Bunting. And some people are simply unlucky
and have overactive oil-producing glands.
"Your glands may be more sensitive
to male hormones, such as androgens,"
explains dermatologist Nick Lowe.
"This sends them into overdrive, pumping
out too much oil. Then, dead skin cells
aren't shed properly and clog your pores,
and the excess oil creates the ideal
environment for acne bacteria to multiply,
often causing inflammation."
Of course, acne doesn't just affect how you look.
The British Skin Foundation recently surveyed over
2,000 adult sufferers and found 63% had lowered
self-confidence, while 20% felt a relationship had
ended due to their skin problems and a worrying 20%
said they had even contemplated or attempted suicide.
None of this is news to health psychologist
Dr Andrew Thompson, who studies the psychological
impact of skin disease at Sheffield University. "Having
visible acne really affects people's self-esteem, daily
functioning, work and relationships," he says. In a
study published in the British Journal of Dermatology,
sufferers recorded that it affected their quality of
life to the same level that patients with
conditions like epilepsy and diabetes had
reported. "It's a vicious cycle because
depression, anxiety and stress can impact
on immune function and affect the skin,
making the condition worse," he adds.
5% OF
WOMEN FIND THEIR SPOTS PERSIST INTO THEIR FORTIES
W
hen Jane, 35, an event
organiser from Middlesex,
has a bad bout, she can
hardly face leaving the house.
"I feel greasy and disgusting, and I can see people
trying not to look at the huge boils on my chin
and neck," she says. "What's the point in getting
dressed up to go out when I feel so unattractive?"
Dr Thompson says Jane's distress is typical.
"People with acne often worry they're seen as unclean
or unhealthy," he says. "If you're affected as an adult
it can be extra stressful, because of the apparent
age mismatch - you feel
you stand out more."
While I can't deny
it's comforting to know
that I'm not suffering
alone, it's puzzling that
we seem to be more
spot prone than ever before. The major reason,
according to experts, is a rise in stress levels.
"Women today are more likely to be high achievers
who end up internalising stress, rather than taking
measures to reduce it," says Dr Lowe. In short, while
you might not realise you're stressed, your body does,
and reacts. Male hormones - androgens
- that are normally converted to oestrogen
are instead converted to testosterone.
"This surge of male hormones contributes
to acne," says women's nutritional
health specialist Dr Marilyn Glenville.
But it's also true that we're hearing
more about spotty adults because we're
less prepared to put up with bad skin and
more likely to seek treatment. What helped
Jane was returning to her GP (again) and asking to try
another contraceptive pill. "I'd tried several, but finally
he gave me one called Yasmin and that stopped me
getting the really bad outbreaks," she says. "My skin's
not perfect, but I'm no longer embarrassed by it."
If something in your life is making you miserable,
taking action is always a good idea. So, over the
following pages, we bring you the latest treatment and
advice, to help give you hope for a spot-free future. ~
63<Ffo OF ADULT ACNE
SUFFERERS HAVE LOWERED
SELF-CONFIDENCE
54Ofo OF
WOMEN OVER
25 HAVE
SOME FACIAL
ACNE
238
QAMO(J!
...............~ HANDBOOK
rnnnpnlnn,'"-' these black or yellow follicles
cells . Whiteheads are closed
the blocked follicle.
i
says Dr Bunting.
, as they make your skin
off every other day,
and dry," she adds.
foundation, which
Look for the words
that are inflamed and may
the medieval-sounding
'pustules', have a white
often filled with pus,
which is produced in
to inflammation.
DO Consider the Pill.
types, such as Yasmin,
can help with outbreaks of
kind . A low-dose, long
course of antibiotics may
be prescribed. " Or, try
anti-inflammatory, topical Irp,>lrrIPn·r" containing benzoyl
c acid," says Dr Bunting.
peroxide, salicylic acid and
DON'T Squeeze them ,
tempting. You risk
scarring and worsening the
by pushing inflammation
deeper into the surrounding issue.
Known as nodules, these painful,
just under the skin's surface,
skin and often appear around the
and neck.
A classic sign of adult-onset acne, they're usually
caused by a hormone imbalance.
DO Speak to your GP. The rnn,t",,1pntIl/P
be effective. For severe cases, a n..,·m'lTo,o<"",
prescribe a hormonal treatment
which redUCeS your skin's oil nrrllili,rti(ln
DON'T "Use cleansing cloths,
says Dr Bunting. You can't exfol
and harsh treatment will make
worse.
Similar to boils, the biggest spots
pus-filled lurlps. They're the most
acne, distressing and the most .
DO Ask to be referred to a denmatqlo!~ist.
"The oral ret ;noid, Roaccutane, is
effective in severe cases, but can
be prescribed by denmatologists,"
Dr Bunting. "It reduces inll~",",~·hrln
sebum prodL ction-, completely
in 60% of CGses." The catch? It
effects such as dry skin, lips and
DON'T Use normal foundation - .
your pores. Try a range such as
Dermablend. It's lightweight, but
still hide spot s, acne cysts and
STARS AND THEIR SKIN
have (lcne scars.
·m self-r.onscious
about that, so
............. HANDBOOK 5 ways to zap the zits
- with its sugar and dairy
content - may cause spots
after all. "You don't have to
cut anything out completely.
I advise a balanced diet, with
lots of vegetables and low-GI
carbs," says Dr Bunting.
Find the
right expert
Your GP should be your first
stop. You'll discuss medication,
but you can also consider
whether a contraceptive pill will
help - certain types stabilise
hormones. "Make sure your GP
takes a full medical history to
rule out conditions such as
PCDS," says Dr Bunting. "It's
worth asking to be referred to
a dermatologist, but it's unusual
to get this on the NHS unless
your acne is severe." Even if
you can only afford one private
appointment after you've
seen your GP, it's worth it.
"A cosmetic dermatologist
will understand more how your
beauty regime, make-up and fitness habits might
be impacting on your acne," says Dr Bunting. To find
one, go to British Association of Dermatologists
(bad.org.uk). Consultations start from £50 .
• Rethink pampering
It may be relaxing, but a facial isn't
the best thing for an acne sufferer.
"Beauty therapists don't have specialist
knowledge and can end up causing
breakouts," says Dr Nick Lowe.
Your money would be better spent at
a dermatology clinic . "I use violet light
therapy, which kills and removes acne
bacteria and reduces inflammation.
Microdermabrasion can also unclog
blocked pores. And I've had good results
from controlled chemical peels, using salicylic and
lactic acid," says Dr Lowe. To find a practitioner, visit
the British Cosmetic Dermatology Group (bcdg.info).
e Take
supplements
"I recommend women take
nutrients such as magnesium,
vitamin B5, and the amino acid
L-theanine, which help combat
stress," says Dr Glenville. Take
a daily multivitamin including
vitamin C, which helps with
healing scars, and zinc, which
is good for skin health. "Also,
essential fatty acids can help
balance your skin's oil production, so look for an
omega-3 fish oil or flaxseed supplement," she adds.
Get support
If bad skin is making you unhappy, one effective
approach is cognitive behavioural therapy
(CBT) - your GP can refer you. "CBT
teaches you to challenge the way
you see yourself and how you think
others see you, addressing the
self-criticism that skin conditions
cause," says Dr Thompson. Find
a therapist at itsgoodtotalk.org.uk,
or try plusguidance.com for
online counselling.
A FACIAL ISN'T THE BEST THING FOR AN ACNE SUFFERER Eat well
"While there's no link between greasy foods and acne,
research suggests excessive consumption of dairy and
refined carbohydrates [anything sugary, and 'white'
versions of carbs] may contribute," says Dr Bunting.
"Research has shown that a protein called IGF-l
[insulin-like growth factor] stimulates oil production,
clogging follicles . And it's increased by milk and
high-GI refined foods ." Sadly, this means chocolate
242 aAMOIJI
• Try a mind trick
Making time for relaxation lowers your stress levels,
which will reduce hormone surges and have a positive
effect on your skin. "Spend five minutes every day
sitting or lying somewhere quiet with your eyes closed
- imagine you're somewhere you love, where you feel
safe. Notice everything about the place, in as much
detail as you can - how does it look, smell, sound,
feel?" says Dr Thompson. If you're in a social situation
and feel anxious that you're being judged, focus on
the external. "Really concentrate on the person you'r
talking to, what they're wearing and saying. Force
yourself to engage with them and ask questions,
which will tune out your inner critic," he adds. @