Incidents of adults troubled by acne have jumped this past decade. According to The Academy of Dermatology (AAD), the average age of acne patients increased from 20.5 in 1997 to 26.5 in 2007.
As a beauty writer, I'm routinely besieged by desperate pleas for help via email, text and phone, from pals who are perplexed that their skin is looking more freshman year than fresh and clear. As a girlfriend recently complained, "What kind of sick joke is it that I'm dealing with wrinkles and breakouts at the same time?"
The adult acne epidemic is rooted in lifestyle factors, says Los Angeles dermatologist, Dr. Ava Shamban.
"There are two main reasons: changes in our diet and exercise patterns, as well as, the increased stress we endure everyday. By trading fresh food for easy-to-prepare processed foods, we ingest low-quality nutrients that don't support our skin. Our stress levels go through the roof as we try to juggle too many responsibilities -- parent, employee, spouse, caretaker -- all at once," says Shamban.
In the "Extreme Makeover" expert's new book, "Heal Your Skin," Shamban explains the unique mechanics behind adult acne, plus how to treat it.
Unlike teen acne, the adult version usually occurs with fewer, larger pustules, and along the hairline, chin and neck. Discoloration that lingers after the breakout tends to be a prime concern, especially among those who have deeper skin tones. And while hormones are at the heart of most complexion turbulence, it's more often demanding routines that triggers adult acne.
"To put it simply: as teenagers, acne gives us stress. As adults, stress gives us acne," says Shamban.
Here's some of Shamban's best advice to keep adult acne under control.
Don't over-cleanse. "Acne is not caused by grime, and your face is not a skillet that needs to be scrubbed clean," says Shamban. Harsh cleansers that strip the skin can actually make acne worse, by causing more inflammation and possibly opening and making breakouts susceptible to infection. Use tepid water to cleanse, in soft and gently sweeping movements across your face.
Trying cleansing with salicylic acid. "It's an ideal ingredient in an over-the-counter acne cleansing preparation because of its ability to clear away the buildup of dead skin cells and unclog pores," says Shamban. Anti-inflammatory properties also ensures the ingredient fights redness. Look for a product with an ideal balance of a two percent concentration. After applying it to the affected area -- which could also include your chest or back -- do something like brush your teeth, so that it can sit for a couple moments before you wash it off.
Kill bacteria. P. acnes (Propionibacterium acnes) is the enemy bacteria behind breakouts, and there is no better killer than benzoyl peroxide. Choose a product with a 2.5 to five percent strength, and be sure to touch only white towels after you apply, as the ingredient is known to bleach fabrics. It's important that you continue using the product after flare-ups have subsided, or else the bacteria may start propagating underneath the skin again.
Don't just spot-treat. Spot-treating does nothing for breakouts brewing beneath the surface of the skin. To truly break the acne cycle, Shamban advises you cover the surface of your face with your treatment of choice. Not only will that help clear up active acne, but the ingredients will fight the breakouts you don't see yet, and offer anti-aging benefits as well.
Know when it's time for a retinol. "If four weeks have passed and you don't see any improvement in your acne, or you have been left with discoloration, you need to try a retinol. Retinols will also address the wrinkles," advises Shamban. These vitamin A derivatives regulate your cell turnover so that sticky dead cells will slough off instead of clogging together. Be prepared for a flare-up a couple of weeks into treatment, as the active pushes buried debris to the surface, to clear the pores. There are both over-the-counter and prescription options available; the greatest advantage to taking this route is that it's also among the best ways to treat the signs of skin aging, too.
Zap at home. Expensive cortisone injections at the doctor's office used to be the only way to significantly speed up the demise of a zit. Now, handheld thermal devices have been cleared by the FDA to clear moderate acne by delivering a dose of heat to kill the bacteria in a pimple. Having tried the No!No! Skin version (Zeno and ThermaClear also make versions), I can personally attest to the fact that the lifesaver works. You can expect up to an 81 percent improvement in 24 hours, after twice-daily treatment.
Watch workplace triggers. Hours spent in front of the computer or on the phone can often result in pressing the phone to the chin, and resting our face into our hands. "Surveys show that we touch our faces 10 to 12 times an hour," says Shamban. Swipe surfaces with alcohol daily to prevent the passage of bacteria. Clothing that fits too tightly, particularly when seated for long periods of time, can be a culprit for back and chest breakouts.
Audit your beauty stash. Sometimes the products you use to look your best could be the very cause of your breakouts. Choose oil-free makeup and non-comedogenic skin care. Many acne-prone people are also sensitive to silicone-containing products, which you can spot on ingredient lists as ending in "ithicone" or "icate." For a list of the latest silicone-free beauty products, check out our feature.
Eat an anti-inflammatory diet. Drink water and green tea, which hydrates and astringes you from the inside out. Enjoy more fruits, vegetables, nuts, lean proteins and healthy oils. Limit processed foods, high sugar foods and drinks, and whole dairy -- all of which exacerbate acne by causing inflammation in the body. Grilling, baking and steaming foods also help, while frying can increase inflammation. And load up on the most power acne-fighting nutrients: vitamins A, B and C, zinc and omega-3 fatty acids.
Mind your medications. You may be hopelessly trying to treat a condition that is caused by a prescription you're taking. Common culprits are: steroids for asthma and other respiratory disorders, anti-seizure preventatives for epileptics, Lithium for bipolar disorder, Antabuse for alcoholism, discontinuing or switching oral contraceptives, and illegal Anabolic steroids, like those used by bodybuilders. If one of these pills may be a cause, talk to your doctor about how to temper or negate the side effects on your skin.
If your acne or discoloration concerns are more severe, dermatologists offer a range of laser treatments, chemical peels, light therapies and resurfacing options that can speed up the recovery and healing process along. Antiobiotics may help clear up an endless breakout cycle.
Yet, lifestyle changes made at home can help clear most adult acne cases. "One of my patients...has successfully treated her acne with topical skin care, adjusted her diet, and calmed her stress through acupuncture and an exercise program," says Shamban.
I skimmed other helpful chapters in Shamban's book that includes advice and detailed plans for skin going through pregnancy, menopause and cancer treatments -- all instances that not much skin care literature has delved into before. Shamban also offers extensive nutritional and at-home skin care recipes for your best-looking skin.
Now that's the kind of advice I can get behind.
And if a more holistic sense of wellness is your priority, check out our tips on how to "green" your beauty routine.