June is Acne Awareness Month. And s anyone who’s ever suffered with the condition knows, as well as being sore and uncomfortable, it can have a hugely negative impact on mental health too. If you’re struggling with your skin, don’t feel alone. Acne is one of the most common skin conditions in the UK. It accounts for around 3.5 million visits to GPs every year. And adult women are more likely to be affected than their male counterparts.
When it comes to treatment there’s a lot of misinformation out there. That’s why consultant dermatologist and acne expert, Dr Anjali Mahto, has shared the most frequently asked questions she gets at the Self London clinic about acne. Read on to find out what they are.
- Why is my acne worse during my period?
This is one of the most common acne questions I get from women in my clinic. It’s an issue that many have simply come to accept as part and parcel of that time of the month.
About two-thirds of acne-prone women will notice the worsening of their acne typically occurring anywhere from a week to a few days before the start of their period. Women have female hormones circulating through their bodies throughout their menstrual cycle (oestrogen predominating in the first half of the month and progesterone in the second half). The androgen testosterone is also present – albeit in smaller quantities – at all times.
Shortly before the onset of menstrual bleeding, female hormones reach their lowest levels. The level of testosterone, however, remains fairly constant at all times and so its proportion is relatively higher at these points. In turn, these higher proportions of testosterone are known to cause the changes in the skin’s complexion that bring about acne.
2. Is it true that acne on my lower face is due to hormones?
Fundamentally, all acne is hormonal. But in adult women it has often been reported – anecdotally – that it occurs more commonly on the lower half of the face, jawline, chin and neck. Actually, this is something I have noted from personal experience in my clinics. However, the scientific evidence is inconclusive on this point as we haven’t yet determined the precise causes of such distribution.
Similarly, some observations have suggested that acne type also varies by age in women, with adults usually suffering from tender, inflammatory (cystic) spots. They also seem to have fewer numbers of blackheads or whiteheads compared to teenagers. Again, however, not all scientific studies have confirmed this observation.
3. Will I ever ‘grow out’ of my acne?
Acne is probably best regarded as a chronic problem. Some individuals will grow out of their skin problems, but for many others, acne can cause much distress and recur over the years. Female adults with acne or those with underlying PCOS may exhibit higher treatment failure or relapse rates despite the use of standard therapies.
Speaking from my own personal experience, having suffered from acne for over twenty-five years, I think much of the distress that it causes stems from the belief that you should have grown out of it by the time you reach a certain age.
It can be incredibly frustrating when it’s back yet again after a round of what you thought was a successful treatment. The reality is that it is often a condition that requires control rather than being amenable to a permanent cure.
Acne is much easier to come to terms with when we realise that our real goal should be to minimise its impacts so that we can get on with life. If it comes back, worry not; there are ways we can deal with it, and we needn’t let it hold us back.
3. Why am I suddenly breaking out during the menopause?
Acne breakouts can occur as we approach menopause due to hormonal fluctuations during this period. Overall, falling levels of oestrogen lead to a relatively high ratio of androgen hormones to oestrogen which can drive acne.
Managing acne during the menopause requires the same general measures as acne during other times of life, e.g. puberty. The main difference is being aware that the skin may also be dry and sensitive. So, using gentle, fragrance-free cleansers and moisturisers can help alongside active treatments.
4. How can you prevent your pores from clogging?
Ensure you’re cleansing properly. Cleanse once in the morning to remove any sweat or sebum that’s built up overnight. And cleanse in the evening to remove sunscreen, pollution, make up and so on. Introducing an exfoliating acid can also help. I like the Paula’s Choice 2% BHA Liquid Exfoliant which contains salicylic acid.
5. Should I still wear foundation if I have acne?
Those with acne-prone skin (myself included) need to be careful about the types of base makeup and foundation they use. We don’t want to cause further issues with our skin.
Look for products labelled as non-comedogenic as these are less likely to clog your pores.
Light, mattifying formulas are also likely to be better for acne-prone skin – as opposed to foundations and base makeup that is very thick or creamy. Opting for a mineral-based foundation, containing zinc, silica or titanium, can also be very useful as they help absorb excess oil, as well as helping to camouflage redness.
6. What foods should I avoid if I want to get rid of my acne?
The acne and diet story is controversial and interesting in equal measures. Before the 1960s, dietary advice to acne sufferers was a standard part of care. Dermatologists recommended avoiding sugary foods, carbonated drinks, chocolate and fat.
The turning point in the acne and diet story was in the late 1960s and early 1970s. This was after two pivotal scientific studies, which reported the two were not connected.
Diet was long forgotten by dermatologists until the turn of the 21st century, with new research and a thorough critical analysis of the old data.
The total number of studies carried out over the past forty years is relatively small. Yet, there appears to be a growing body of support for the idea that certain types of food may aggravate acne.
Emerging data suggests that high glycaemic index diets may have a role to play in how acne develops. There is also limited evidence that some dairy (in particular skimmed milk) may also have some influence.
