SEEING SPOTS

Eve Cameron reveals how she banished adult acne

House with garden. Kids. Dog. Walk-in wardrobe. Acne. Guess which of those wasn’t on my ‘things I’d like to have as a grown-up’ wish list? My skin troubles started in my mid-teens and have haunted me ever since. At school, I braved the casual cruelty: the word ‘pus’ whispered in corridors, followed by stifled laughter as I walked by and, a particular highlight etched pin sharp in my mind’s eye is the drawing on a sixth-form desk, clearly of me, in my favourite, distinctive black-and-white checked jumper, face dotted with marker pen, illustrating my distinguishing feature.

I felt so very ugly. And sad. The state of my skin consumed me. I spent hours on my make-up to conceal redness and lumps, styled my hair to cover half my forehead and cheeks and multi-masked before it was ever a ‘thing’. I was so self-conscious that I’d sit with my back to a window, if possible, angling myself so the light didn’t hit me directly in the face, illuminating my horrible skin.

My self-esteem continued to unravel and a period of self-destructive behaviour followed in my 20s. I partied hard and slept with men I didn’t really want to, but needed to, for validation. If they slept with me, I couldn’t be that hideous, I reasoned. Then I got pregnant, which called time on partying and, you’d assume, acne. But the much-anticipated bloom never came. Just more spots. Fast forward a decade and the breakouts were now jostling for position with laughter lines. Not so funny.

It’s easy to be very self-involved when you have a skin condition and although I often asked out loud, ‘Why me?’, I knew it wasn’t only me who was similarly afflicted. Over the years, I’d seen dozens of friends and colleagues made miserable by breakouts, minor and major. Dermatologists confirm that adult acne is indeed on the increase, whether it hangs around from teen years into adulthood or appears out of nowhere in the 20s, 30s and beyond. One survey of 92 private clinics found a 200% rise in cases.

There are a number of theories as to why acne is more common in grown-up women than ever before. Citing stress feels like a bit of a cliché, but it’s true that juggling work, kids and relationships can leave you strung out, flooding your system with the hormone cortisol, which can have an acne-forming effect on the sebaceous (oil) glands. Then there’s the pill, which dermatologists like Dr Anjali Mahto, who is a chronic acne sufferer, explain can delay or suppress acne until you come off it, to start a family, for example. Professor Nick Lowe goes as far as to say that if you were put on the pill at a younger age to treat acne and stay on it long term, you might have been better off not being on it and going through the cycle of acne earlier (and treating it differently) rather than containing it for years.

The role of diet is controversial. A high-glycaemic diet (sugar, refined carbs) is believed by many to contribute to breakouts and though the hard scientific evidence is

‘DERMATOLOGISTS CONFIRM ADULT ACNE IS ON THE INCREASE’

patchy, it’s an anecdotally persuasive link. Likewise dairy, which may be an acne trigger for some. Dr

Mahto suggests keeping a food diary for 12 weeks to see if there are any patterns to flare-ups. According to US dermatologist Dr Dennis Gross, hard water could also be making matters worse. We all naturally produce sebum or oil, but if you have blocked pores, your oil tends to be thicker. Wash your face in hard tap water and the calcium in it turns the already viscose oil into a waxier version, adding to the blockages, he explains.

So, what’s a woman to do? I tried facials, homeopathy, naturopathy, dapsone (an antibiotic used to treat leprosy), elimination diets and a truck load of skincare products that promised clear skin. But here’s what actually worked for me. I have to confess at this point that my acne did come and go, sometimes because I was on a course of antibiotics and, at other times, well, I don’t know why – maybe my stress levels and hormones were just in a good place. The game-changer, though, was Roaccutane, a daily pill of isotretinoin, closely related to vitamin A, that dries up your oil glands. Your hair and lips get pretty dry, too. Google it and you’ll see there were lawsuits in the US over its alleged side effects (depression, Crohn’s). All I can say is that I had three rounds and it cleared my skin up more or less completely.

I still have the odd breakout, so I take spironolactone, a diuretic that also has an anti-androgenic effect, knocking back the male hormones that increase oil production and spots. Alongside that, I keep my skincare simple and use an acid toner for the cell-renewing, pore-declogging benefits and a prescription retinoid or over-the-counter retinol (a topical vitamin A derivative) at night. These days, when people make comments about my skin, it’s always positive. All that vitamin A has kept it looking youthful, a welcome side effect. Now I just need to work on that walk-in wardrobe.

‘I USE ACID TONER AND A PRESCRIPTION RETINOID AT NIGHT’