A Dermatologist’s Guide To Treating Adult Acne

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A Dermatologist’s Guide To Treating Adult Acne

Words by Ms Molly Isabella Smith

2 June 2020

For some, acne is a brief ordeal that’s over before you finish school. For others, it’s entirely normal for it to carry on well into maturity. “There are a significant number of men who continue to suffer with persistent acne into their twenties and beyond,” says Dr Sam Bunting, a leading dermatologist and acne specialist based on London’s Harley Street. As well as the aesthetic annoyance, living with acne can deeply affect our emotional and mental health.

It can have a huge impact not only on someone’s appearance, but also their self-esteem and quality of life. “It can also create a sense of isolation,” explains Dr Bunting. And for those who have spent years plagued by pimples, the path to clearer skin can feel like a particularly steep hill.

The bad news is there’s no one-size-fits-all secret formula that’ll banish your blemishes for good. Acne affects all of us differently. “We can classify it by severity: mild, moderate or severe,” says Dr Bunting. “Or we can classify it according to the presence of inflammatory and non-inflammatory skin lesions. Inflammatory lesions are red and angry, and can be papules, pustules or nodules. And non-inflammatory lesions are closed or open clogged pores or comedones.” On the plus side, there are some measures that’ll go a long way to combat acne – here’s a five-point plan that’ll help you on your quest for a spotless complexion.

01. Consult a dermatologist

Given the numerous types of acne out there, getting the right diagnosis is paramount. “If your acne is scarring your skin, it needs to be taken seriously and likely needs oral medication to treat it,” Dr Bunting says. Most of the time, the drugs used to treat acne are only available on prescription and a licensed professional will be able to tailor the remedy to your specific needs.

Even if you don’t require medication, consulting an expert can also take the guesswork out of a treatment plan and, crucially, render the process less daunting. “It can be really challenging to build an acne routine by yourself as the time for treatment to work is often in the order of weeks to months, so it can be a very uncertain time if you’re not sure you’re using the right things,” says Dr Bunting. “The guidance of a sympathetic and knowledgeable physician can make it so much easier, and at the same time help you address the more cosmetic aspects of your acne, such as pigmentation and uneven skin texture.”

02. Check the ingredients

This is the confusing part. The long list of ingredients on the back of the bottles in your bathroom cabinet can be enough to bewilder anyone into defeat. But it’s worth learning a few key names to identify exactly what will help or hinder your treatment.

“Breakouts are best treated with a combination of non-comedogenic skincare [products that won’t clog your pores] and a structured approach with chosen actives,” Dr Bunting says. “Actives” in this case refers to a collection of specialist and specifically, anti-inflammatory ingredients, such as azelaic acid or niacinamide. She also suggests introducing a retinol (vitamin A) product into your nighttime regimen.

“Retinoids normalise exfoliation of skin cells inside the pore, so they don’t clog,” she explains. But they also boast powerful anti-ageing properties, smoothing fine lines and refining skin tone and texture. Start slow, with a lower concentration, so you build a tolerance before moving on to more potent formulas, and always use sun protection afterwards.

03. Try an acid exfoliant

While a good scrub can feel immensely satisfying, especially if your breakouts cause dry or patchy areas of skin, it’s a big no-no for the acne-prone among us. “Friction is a known trigger for acne flares, so this is a bad idea,” says Dr Bunting.

There’s also a tendency to be overly thorough in your scouring, which can damage your skin’s delicate dermis. Instead, it’s advisable to switch to a chemical exfoliant, which will dissolve dead skin cells gently and just as effectively. Look for products containing a beta hydroxy acid, such as salicylic acid, which is oil-soluble and allows it to penetrate the pore deeper, or opting for the aforementioned bacteria-busting azelaic acid.

04. Wise up to the diet myth

In the olden days, you were probably lectured by a well-meaning parent that your penchant for chocolate bars or sweets was the prime culprit for your spots. While diet does play a part in overall wellbeing, people tend to put too much stock in the idea that it will clear your skin. “I think that while diet is an important aspect of skin health for all of us, it is very rare it makes as much impact on acne as we’d like to think,” Dr Bunting says.

However, there is a growing body of evidence that certain foods can make a difference, even if slight. “High glycaemic index foods seem to play a role,” Dr Bunting says. “Whereas foods that are rich in zinc, such as shellfish and nuts, may have an anti-inflammatory effect. Things I do suggest caution with are skimmed milk and sugary drinks. You should also choose protein shakes with some care.” If you don’t think you can forgo your post-workout fix, try to pick a powder that does not contain whey protein, which has been linked to breakouts.

05. Don’t shun sunscreen

Similar advice applies to SPF, which many acne sufferers tend to eschew out of fear that it will make their skin situation worse, leaving an unpleasant greasy residue behind, which in turn can cause clogged pores. There is some truth to the notion that cheaper, oily formulations can exacerbate acne, but choosing wisely will actually help matters in the long run, limiting the pigmentation and scarring that sun damage can aggravate.

“While the wrong sunscreen can cause issues, the right one is actually useful as it can help lessen the development of dark marks from blemishes,” Dr Bunting says. Look for broad-spectrum, lightweight and oil-free formulas in particular.

Illustrations by Mr Paul Hempstead

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