Seven ways to zap those zits

Stop disregarding those breakouts as isolated incidents and start taking notice. Adult acne is far more common than you might think,  and the effects can be serious, says Tracey Strange.

The fact that adult acne exists is unlikely to surprise you. What you may be interested to learn is how prolific it is. Fifty percent of adults over 25 suffer from it, sometimes chronically. Acne can be a serious, life-altering skin condition, and the psychological outcomes - from loss of self-esteem to deep depression - can be extreme.

All this is made even more sobering by the fact that acne can only be managed, not cured, says leading cosmetic physician Dr Teresa Cattin. There's no physiological difference between adult acne and that occurring in puberty, so how it's treated is generally the same whether you're 14 or 40.

What causes it is unknown. But it's certainly associated with hormonal fluctuations, which can make pregnancy a prime culprit (along with menopause and the Pill). Other links include genetics, vitamin deficiencies (see our story on supplements), stress, and certain medicines. It also pays to be careful with thick makeup, which can clog the pores.

Acne can be a bit of a changeling - appearing as anything from a red rash or bumpy skin, to distinctive pimples or boils. This means tackling it is often multi-handed.

1. Over-the-counter solutions usually involve ingredients such as benzoyl peroxide and salicylic acid (generally considered safe to use during pregnancy), which help to kill off bacteria, break down blackheads and minimise the shedding of cells. Benzoyl peroxide may also have an effect on oil production but, as a consequence, can also dry out the skin.
2. Tea tree oil, neem, and juniper berry are often used in natural anti-acne skincare.
3. Prescription drugs are another obvious solution. Accutane, which inhibits sebum production, is still considered the "gold standard", but it will never be prescribed for women who are pregnant or wanting to be. Other medications include Retin-A, antibiotics, and the Pill, all of which have potential side-effects.
4. Natural options have varying results. But then most naturopaths would regard acne as a symptom of a generally unhealthy body, choosing to prescribe a variety of holistic treatments including drinking lots of water (to support the kidneys), eating plenty of fresh fruit and vegetables, taking a vitamin C supplement, avoiding stress where possible and exercising regularly.
5. When it comes to skincare, avoiding harsh exfoliants and cleansers is also recommended since these actually work to speed up sebum production, rather than guard against it.
6. In terms of salon and appearance medicine treatments, regular facials, glycolic peels (to help with exfoliation) and light therapy, including the bacteria-reducing "blue-light", and CO2 and Erbium Yag lasers, have all proven helpful. Corisone can also be injected directly into lesions to help reduce swelling and pain.
7. At the cutting-edge end of the spectrum are photodynamic therapy, or PDT, which combines a photosensitive chemical with light to destroy the sebaceous unit, effectively eliminating the acne. Botox can also be used to reduce sebum production by blocking the chemicals it needs.

Not-so-quick fixes
No case of acne should be taken lightly. Professional help should always be sought if you feel your breakouts are getting “out of control”.  But while your skin is being treated, there are a few things you can do to minimise acne’s appearance.

First, treat your skin gently. Avoid scrubs and toners containing alcohol.

Second, avoid products that can potentially clog the pores, particularly those containing petroleum.

Third, gentle clay masks can help soothe the skin but avoid any preparations that involve tingling or cooling ingredients such as menthol, camphor or eucalyptus as these can cause further irritation.

Fourth, use an exfoliant containing salicylic acid, or BHA. BHA has antibacterial properties and is also an anti-inflammatory.

Fifth, consider mineral-based or powder foundations since these can be less irritating to the skin.