Acne can be incredibly debilitating to those suffering from it. Having been an acne sufferer before, I understand the struggle. It can make some people feel like they can’t be seen past the bumpiness of their skin even though to everyone else it looks like they have barely noticeable blemishes. Regardless of how the acne actually looks on the skin, it can stop people leaving the house on some days.
Acne is one of those skin conditions that has a lot of myths surrounding it. For example, I’ve heard people say that you get acne from not washing your face enough, acne is a result of eating too many oily, fatty and sugary foods, acne will go away after your teenage years/your early twenties, acne happens because you wear makeup or because you are not using skincare products. If you are currently under the wrath of chronic adult acne, you will know these may have inklings of truth but are not the cold hard facts and plenty of people still have acne even though they follow specific regimes, eat healthily and don’t wear makeup.
What is adult acne?
If you have adult acne, it’s one of two types: it could be continuing acne, meaning that it has carried on from acne that you had in your teenage years without going away, or adult-onset acne, meaning that it begins suddenly when you are an Official Honest-to-God Adult AKA past the age of 25 (in terms of adult acne, as we are all still teens at heart). Technically, even getting blackheads, bumpiness or the odd two or three spots means that you have acne – it doesn’t have to be severe to be chronic.
Why do adults have or get acne?
- Hormones: It’s nearly misleading to separate acne from hormonal acne as in our experience, the majority of our clients tend to relate their breakouts to hormonal changes. Hormonal imbalances of any scale can cause breakouts, meaning that you may be more likely to have spots during your period, while you are pregnant, while you are on birth control or during the menopause. Clients we’ve had with polycystic ovaries seem to be more likely to suffer with congestion. If you believe your acne to be hormonal, visit your GP where they can run tests and prescribe you with what they think will help you.
- Genetic predisposition: You are more likely to be an acne sufferer if it runs in your family. However, there’s not a lot known about why. There are definitely correlations when it comes to adult acne but nobody is quite certain on a lot of things.
- Stress: I personally believe stress to play a huge role in why adults get acne. Your body responds to stress by bumping up the production of a type of hormone called androgens in the body. These androgens stimulate oil glands, leading to extra oil being produced and thus more blackheads, papules and pustules form on the skin.
- Products: It doesn’t matter if products are expensive or cheap – what matters is that the products being used are non-comedogenic. This means that they do not clog the pore, and this goes for makeup AND skincare too. If you are using products without antibacterial ingredients, they probably are not doing a lot for your skin.
- Dietary intolerances: I recently had a client who was trying everything for acne, they had even had hormone and blood tests and they had been on all the products and medications that should help it at some point. This person was particular about what they ate and everyday for lunch they had the same thing: cucumber, brown bread and chicken. People don’t have a lot of faith in having intolerance tests done but they had no other option at this point and so they gave it a go. Their results came back that saying that they had intolerances to chicken, cucumber and some of the ingredients of brown bread and within two weeks, their skin went from grade 4 acne (ie. cystic acne) to grade 2/3 (ie. papules and pustules). So don’t count it out!!
- Sugar: Technically, the jury is still out on this one. Sugar raises insulin levels, triggering male hormones and thus increases oil production. However, many dermatologists believe that sugar has no effect on acne.
How does acne form?
When oil (sebum) is over-produced, it becomes trapped in the pore behind dead skin cells, debris and comedogenic makeup and skincare products. This can result in a whitehead, when the clogged pore closes over, or a blackhead, when the clogged pore is exposed and changes colour.
The acne bacteria, Propionibacterium Acnes (or P. Acnes, for those who type it a lot) moves in to the clogged pore and creates infection, which causes the inflammation, redness and pain associated with grade 2, 3 and 4 acne.
What does each grade of acne look and feel like?
Grade 1: Mild
- Grade 1 acne can be called flat acne or non-inflammatory acne as it usually means no redness and no bumps. Blackheads and open comedones are a sign of grade 1 acne and occur due to excess oiliness.
- Grade 1 acne usually doesn’t require intense treatment as it may never progress past this point. However, it can also be a sign of the condition worsening. Grade 1 acne is most commonly found in the T-Zone (nose and forehead).
Grade 2: Moderate
- With moderate acne, you will have more blemishes like whiteheads (closed comedones) with some inflammation (AKA redness and rise). This is where you may see papules, the type of spot that is small and headless, and even some pustules, the type that are larger and will usually grow a yellow or white head. The whitehead of pustules is made up of white blood cells and sebum mixed with debris.
- Grade 2 usually affects the T-Zone and the cheeks, chin and the jaw.
Grade 3: Severe
- Grade 3 means that the papules and pustules occur in larger numbers and are more visibly inflamed (ie. larger, redder and more painful).
- Spots may join together. Because of this, an area of the skin is infected rather than a single pore. The structure of the skin is compromised due to the collapsing pores and scarring can occur.
- The infection has spread deeper into the skin.
Grade 4: Cystic
- Cystic acne is very angry, severe acne. An acne cyst is deep, very painful and usually over 5mm in diameter.
- They usually have a smooth texture and are very tender. You may also have nodules, which are solid and sore bumps that do not contains pus.
- They can last for absolutely ages and even when they do go away, they can lie dormant before returning.
According to information from the International Dermal Institute website, between 40 – 55% of adults in the age bracket of 20 to 40 are suffering from low grade acne (ie. grade 1 and grade 2 acne). If you ask people what percentage of adults have acne, I can nearly guarantee the figure they’d say would be nowhere near 55%!!
Keep an eye out, the next articles will be on scarring and marking, prevention and common treatments as well as dealing with emergency breakouts…