Acne and the quest for clear skin
In the spirit of keeping things “real” I’m writing this because I want you all to understand that even I, a skin specialist of over 20 years still get acne!
I have struggled with my skin from time to time all of my adult life whilst some women are lucky enough not to have had any issues. However most people I see daily, regardless of age do, and that is the norm.
Those perfect selfies
We are being constantly bombarded by “perfect” images every day – and skin is no exception to that. I am always amazed by the radiant selfies that adorn our social media pages and wonder how it is possible for all these women to look effortlessly fresh faced, with clear complexions and not a eye bag in sight at 7am?
That “I woke up like this” image probably took at least 100 shots to perfect, along with a team of professionals. And the images of women are usually young, attractive, and have what seems to be “perfect” skin. Not women that have hectic lives – with jobs, looking after families, laundry, late nights, traffic jams and generally just running from one task to the next.
How stress affects your skin
All of the daily stresses we put ourselves through lead to some of the problems we see reflected in our skin. Of course there are many reasons why our skin can go through breakouts or dryness even pigmentation, but for most of us it can often be as a result of our busy lifestyle. It is widely (but not recognised by mainstream medical professionals) believed that adrenal malfunction could be affecting up to 80% of women today.
It’s no coincidence that acne breakouts tend to happen before or during a stressful event. With acne it’s all about the hormones, particularly cortisol. When you’re stressed your body releases more cortisol. This triggers glands under your skin to produce more oil, which leads to the growth of the Propion P-acnes bacteria within the sebaceous follicles. This along with dead skin cells leads to papules, pustules and cysts. In adults, acne is typically a sign of hormonal imbalance and is becoming more common in the over 30’s.
I know myself that when I am feeling particularly stressed it has a direct on my skin, and the painful red lumps appear particularly around the chin and jawline. This is because not only is my cortisol high, but in turn when the production of cortisol stops, the metabolic rate drops (causing tiredness, sugar cravings, and weight gain) and hypoglycemia and insulin resistance are the result. When we give into the cravings we then we are in danger of further hormone disruption. In the past those with acne were discouraged from eating sugar and refined carbohydrate foods like sweets, chocolates, biscuits,cakes, etc. and recent research has revisited this idea and is again showing a strong correlation between a person with acne and their refined food intake, any changes in insulin handling (insulin resistance) and hormonal disruption, which is also strongly associated with acne.
Diets rich in processed and sugary foods stimulate more insulin production, and it is these higher than average levels of insulin which negatively affect the liver’s ability to produce SHBG (Sex Hormone Binding Globulin), resulting in more active testosterone circulating in the blood. More testosterone equals higher sebum production in the skin, and increased sebum means more oil in the skin pores. This leads to clogged pores, which helps provide a rich food supply for the bacteria (Propionibacterium acnes).
Diet & lifestyle
So when we are looking for solutions to these types of skin problems we cannot solely rely on topical products or treatments. We need to consider our whole diet and lifestyle to truly gain control of our skin issues. As a therapist with years of experience both personal and professional dealing with acne there are many schools of thought out there as the best way to tackle the issue.Here are a few of my personal recommendations from the information I have learned over the years and from the success I have seen with my own skin and my clients.
Diet – if you want to try and control and conquer acne a diet rich in Omega 3 fatty acids, zinc, vitamin A and folates will have a huge effect. Of course cutting out as much refined sugars and carbohydrates will also be highly beneficial. Eat walnuts, almonds, ground flaxseed, plenty of fresh fruits and vegetables, oily fish and other good quality proteins which all have been shown to improve the hormonal causes of acne within weeks.
Adrenal Health and reducing stress – this can be the holy grail for some of us and there are many ways to approach this but I find one of the best ways is exercise, whatever you like to do run,walk, go to a gym make time at least 3-5 times a week.
Sleep – getting enough and listening to your bodies needs, without sufficient good quality sleep your back on that stress- cortisol- insulin resistance cycle which as we have said all contributes to acne.
Dairy – this is a controversial one! My belief is that as human beings our bodies are not equipped to deal with dairy products. I personally believe that we all have a tolerance to dairy, and it is when we over do it it can cause issues, of which there are many but when we are talking about the skin and acne it’s all about the hormones. Dairy products all contain growth hormone, and cows that are milked for for human consumption are pregnant or technically nursing. This milk is full of pregnancy hormones and added to that some farmers inject their cattle with bovine somatotropin, another hormone to increase milk production. When we ingest these hormones it only adds to our own, causing more imbalance. Too much dairy in our diet can also cause excess production of mucus and the glue like substances that stick our skin cells together leading to congested skins, and once that happens acne can develop much more rapidly.
Treating acne
Cleansing
Firstly we need to keep the skin clean and clear of any unnecessary oils and that means religiously taking off make -up and any pollution and natural cells debris at the end of the day, but also in the morning. We don’t want to strip the skin as this can lead to further oil production to compensate but a cleanser that will leave our skin balanced.
Wipes are not the answer! They are alkaline and dehydrate the skin leaving it vulnerable and then causes more oil to be produced to raise the natural ph level back to acidic. So a cleanser containing ingredients like Lactic Acid, Salyclic Acid, Vitamin A and gentle cleansing agents will help to reduce congestion, reduce inflammation and regulate oil production.
Treatment Products
There are many to choose from but I prefer to take the more clinical approach here with tried and tested ingredients. Again Salyclic Acid to reduce inflammation and unblock pores. Vitamin A to regulate oil and sebum production. AHA’s like Glycolic, Lactic, L-Mandelic acids can all help long term to increase natural exfoliation within the follicles to prevent cell build up and keep the skin looking clear.
One of the old school ingredients that can also be effective is Benzoyl Peroxide. The danger with this ingredient is that if used incorrectly or if it’s overused can lead to dryness and dehydration which then triggers more oil production and were back where we started! Typically ones purchased from a pharmacy are the better options like Acnecide gel, this works by targeting the bacteria that causes the redness and inflammation (P-acnes) and persistence is the key, use it every day and the reduction in breakouts will lessen.
Hydration
Yes we all know drinking water helps but topically we are afraid that using a moisturizer will cause more problems. And yes this can be true – especially if the cream you apply is full of mineral oils, silicones and thick emollients.
What an acne skin needs is water, not oil. I prefer to opt for light, water based serums or creams that are rich in Hyaluronic Acid. This naturally occurring substance acts a magnate to water. It increases hydration whilst promoting healing. Products containing Omega 3 (alpha-linolenic acid) and Omega 6 (linoleic acid) can naturally restore the skin’s barrier reducing inflammation and strengthening our skin’s immune system and preventing cell damage.
UV or Not to UV?
Many acne sufferers say the sun helps their skin to improve and to a certain extent we all know sunlight can have many positive effects on our body and sense of well being. The reason UV light helps with acne is the blue part of the light spectrum causes the release of a substance called porphyrin which destroys the P-acnes bacteria. But UV light reduces our skins langerhans cells which gobble up all the nastys that cause infection, plus exposure to uv light can increase post inflammatory hyperpigmentation so you may have less actual spots but more scarring and pigmentation. Opt for non UV light treatments that with still aid in the fight against the problem but won’t harm or damage your skin in the process.
There are several available in salons and clinics but I personally use LightFusion from SkinBrands as a treatment in my business.
Beta Peel before and after
Treatments – as I have said Light Therapy can be very beneficial but one of the most effective ways to treat acne is with skin resurfacing treatments or skin peels. These are my treatment of choice when tackling an acne skin as they work within the skin to clear the excess cellular build up, reduce inflammation and oxygenate where bacteria thrive. A course of AHA treatments can be very successful in the treatment of acne and reduce the re-occurrence of breakouts.
AHA Peel before and after
To Squeeze or not To Squeeze
Squeezing, shall i or shan’t I?
I find it virtually impossible not to squeeze a spot but most people go about it the wrong way. I say “you really shouldn’t” but it’s just all to tempting not to and before you know it it looks worse than before!
If you really must then follow these basic guidelines:
- wait- don’t keep prodding and poking a hard lump- you’ll just make it bigger by forcing and the build up inside to disperse deeper and end up with a much bigger spot or even worse cause a cyst. When, and if you can see an obvious amount of sebum ready to discharge then approach with care.
- the best time to tackle a spot is after a shower or bath when the heat has softened the skin and the heat and steam with relax the pores. Ensure the skin it totally clean too.
- with the sides of the finger tips covered with tissue or cotton wool gently wiggle the spot, try and get under it with either side of your fingers and ease the contents to the surface. Don’t go on the attack with fingernails drawn pushing down, you’ll just push it deeper and increase risk of scarring.
- don’t keep squeezing, if it doesn’t come out easily don’t force it, you can try again tomorrow but for the meantime ice it, make a compress with a few cubes and apply to the area (wrap in clean cotton, do not apply ice directly to the skin as it may cause a burn) for 10 minutes. If it still looks red wait 10 minutes then repeat with the ice.
- apply an antibacterial healing product as mentioned before or make a paste with a soluble aspirin and apply that to the area. Leave the are free from any other product and make-up if possible and allow to heal.
Take action – and persevere
This is the information I give to my clients and follow myself, I still get spots and don’t always manage to control my breakouts when hormones take over but with these guidelines you really are doing everything you can do. Persistence and perseverance are what pays off, jumping from product to product and treatment to treatment isn’t the solution you need on average 3-6 months to see real improvement and long term gain.
Your stress levels, hormones, medication, environment and heredity traits all play a part in how our skin behaves through our lives but in reality no one has a totally perfect skin, no matter what you see. To quote Cindy Crawford the original and in my opinion still the most beautiful Supermodel “Even I don’t wake up looking like Cindy Crawford”
So there is hope for us all! And don’t be too disheartened there are always solutions to problems you just have to find the right one for you.
Here is a list of products I both use and recommend.
Cleansers
Elizabeth Arden Pro Clarifying Cleanser
Medik8 Betacleanse
Medik8 Pore Cleanse
Treatment
Elizabeth Arden Pro Skin Perfection serum
Elizabeth Arden Pro Age Defense Serum
Medik8 Betagel
Medik8 Beta Aox
Acnecide Cream (benzoyl peroxide)
Zoderm (benzoyl peroxide)
Dermalogica Overnight Clearing Gel
Hydration and SPF
Medik8 Hydrate B5 Serum
Medik8 Hydrate B5 Day 360 SPF 30
Elizabeth Arden Pro Barrier Repair
Vitage Skin Defense SPF30
Dermalogica Active Moist
Don’t forget your GP
While sometimes over looked your GP can prescribe topical and oral medication that can be highly effective. Ask your GP how prescription medication can work in combination with all the methods and treatments in this blog.
Always seek medical advice if condition becomes unmanageable or if you are experiencing sever symptoms.
