HIT THE SPOT

With adult acne on the rise, Emma Strenner discovers the latest treatments to address the problem head on…

THREE WEEKS before I was due to get married, my skin literally combusted into cystic acne. It could have been the guest list, parents, juggling lots of travel for work, but let’s give it the umbrella title of ‘stress’. And there was no overnight ‘quick-fix’. Cystic acne is persistent and it took up camp all down my cheeks – the central point of stress-induced breakouts.

But I’m not the only one: The International Dermal Institute found that 40-55% of adults aged 20-40 are diagnosed with low-grade acne and oily skin, while the Journal Of The American Academy Of Dermatology claim 54% of women aged 25-plus now suffer from acne. Begging the question: why now?

‘Hormonal changes, rising pollution and increased levels of stress are all contributing to a surge in cases of adult acne,’ says Dr Barbara Kubicka, aesthetic medical physician. Consider it the insult of insults from life’s revolving door of karma: whether you managed to avoid an adolescence of breakouts or not, to then have to contend with them in later life feels incredibly unfair. So what can you do about it?

WHY, OH WHY?

‘Acne is driven mostly by clogging of pores and bacterial overgrowth,’ says Dr Robert Anolik, fellow of the American Academy of Dermatology. ‘ When overactive oil glands are combined with a clogged pore, this ultimately leads to swelling and a breakout.’ However, bad cleansing habits are not public enemy number one. ‘Genetic factors are the most influential, closely followed by particular medications and hormones.’ Or, more specifically, heightened levels of the male hormone testosterone, which rises in the system 

when faced with the fight-or-flight situations brought on by stress. ‘If male hormones are elevated in women, these oil glands can become particularly active and acne can strike.’

‘Adult acne skin tends to be less oily and with fewer comedones [the clogged hair follicle that manifests as blackheads or whiteheads], but is often more inflammatory compared to teenage acne,’ explains cosmetic dermatologist Dr Stefanie Williams. ‘Adults suffering with acne often report combination or even dry/sensitive skin, which makes treatment a little more challenging than that of teenage acne, where skin tends to be more “robust” and oily.’

PROBLEM SOLVER

‘A typical response of those suffering from adult acne is to tackle the surrounding dry, irritated skin, but applying skincare that’s too rich or oily around the area can easily aggravate the acne itself,’ warns Dr Williams. ‘By far the best way to deal with acne is to see a dermatologist for prescription creams (or tablets if needed). These are often a mix of anti-inflammatory, comedolytic (to prevent clogged pores) and antibacterial.’

Equally, it’s imperative to get your day-to-day routine down to a T. ‘ To prevent acne breakouts, opt for light but hydrating products and/or medical grade, oil-free serums with pollution prevention,’ suggests Dr Kubicka, who stresses that a thorough cleansing regime is absolutely key. ‘Seek out cleansers with active – but not abrasive – ingredients like polylactic acids.’ And remember the basic rule: if your skin feels ‘squeaky clean’ post-cleanse, the formula is probably too harsh for you, stripping your skin of its natural oils.

Speaking of which, consider facial oils a no-go for anybody with a tendency to breakout, warns Dr Williams. ‘ These clog up pores, “congest” skin and aggravate breakouts.’ As for that tea tree oil so loved in your teens? ‘It may have mild antiinflammatory effects, but its pore-clogging properties, in my professional experience, greatly outweigh the mild benefits.’

Post-basics, look for vitamin A derivatives such as retinol and retinaldehyde, alongside exfoliating acids like glycolic and salicylic to clarify the pores, prompt cell renewal and prevent further breakouts. Just be sure to keep an eye on the numbers. ‘ The ideal 

percentage of active ingredients depends very much on the individual’s skin type and condition as well as the overall formulation and co-ingredients of the product, so no general rules can be applied,’ explains Dr Williams. Remember that the percentage of active ingredients may change over the course of treatment, as many topicals – such as retinol and retinoids – need to be slowly integrated into your routine, as your skin learns to tolerate them. Start by applying a low percentage of over-the-counter retinol once a week, slowly working up to daily use and, finally, prescription formulas.

TECHY TREATMENTS

Topicals aside, Dr Anolik – like many other top derms – currently favours superficial chemical peels in combination with light and laser technologies. He opts for the Isolaz laser, which combines suction to unclog pores and uses an intense pulsed light (or IPL) to kill bacteria and even out skin tone ( ie, those pink and brown marks left behind from previous out breaks). Finally, for any remaining acne scars, he injects the area with a drop of cortisone to help bring them down faster.

For regular anti-spot maintenance, there’s LED Light Therapy, which uses a combination of different light spectrums to tackle flare-ups and – unlike other more invasive options – requires zero downtime. ‘Blue light has antibacterial properties and red helps with healing, making a combination of the two a very effective and safe treatment for acne sufferers,’ explains Dr Kubicka. ‘By gently heating up the skin, red light improves blood circulation and oxygen absorption while stimulating a release of cytokines – the body’s messengers that promote healing.’ But not all machines are made equal: look out for Dermalux Tri-wave, which combines red, blue and near infrared light.

As for the future of our spots? Still under development – but set to be groundbreaking alongside existing technologies – is the silver nanoparticle treatment co-developed by Sienna Biopharmaceuticals and Nano Composix. The topical photoparticle therapy sends silica-shelled silver nanoplates straight down the hair shaft within the oil gland to reach the base of the breakout. From here, infrared laser is used to target and damage the gland – halting acne-causing oil production at the source. Watch this space…