Have you ever had an acne breakout as an adult that you didn't try to explain yourself? In my experience, people who break out pretty regularly have read and watched enough on social media to have quite a few ideas on what's causing their problem. Sometimes they're right.
But many, many adult acne sufferers don't have that kind of experience. To them, their breakouts are just baffling. They have no idea what's causing them. Shockingly, at least 60% of my adult acne clientele never had acne as teens!
My job as a specialist in adult acne is to help my clients examine their daily habits, diet, hormonal history, medical history, and products, as well as have a visual picture of their breakouts by being sent photos, to determine and navigate through all possibilities for causes of their breakouts.
I'd like to share some of those possibilities.
Pressure and Friction
Skin absolutely hates being bothered. Pore linings can get irritated underneath friction and rubbing. To make matters worse, pore clogging ingredients can get pushed into pores leading to impactions of backed-up blackhead material.
Related : What does "Comedogenic" Mean?
Leaning on your hands, holding your phone to your cheek, sleeping on your arm, tossing and turning on your pillow, wearing a loose surgical mask all day, wearing bras and jeans/trousers that are too tight. And as much as you try your best not to touch your face, it's inevitable that you will at some point.
Using exclusively non-comedogenic and anti-inflammatory products will reduce these breakouts considerably, and help get rid of them for good. Inlcuded in this is using only non-comedogenic hand and body lotions, as well. Luckily, I have just come out with one!
Hormonal Shifts
Technically, all acne is hormonal, since testosterone is responsible for oil production in the skin. The ebb and flow of breakouts take place when oil production increases as testosterone in the body increases. As testosterone goes down, so do the breakouts. That is, unless other things get in the way.
There are factors that differentiate adult acne from teen acne that can affect levels of sensitivity in the body and on the skin that can mean the difference between a mild, short-lived hormonal breakout and a severe, long term one. On the skin, irritating dyes and stabilizers in makeup, and trying to extract blemishes at home, can really make a mess. Stress, birth control, pregnancy, and life cycle changes can adversely affect hormonal levels, and increase inflammation in the body as well, giving the skin's immune system a hard time. I have observed for many years that frequent changes in birth control prescriptions between adolescence and one's twenties seem to create a kind of sensitivity in the body that can make stubborn adult acne more of a possibility. I'll repeat - a significant number of my clients never had acne problems as teens.
Related : Skincare Q&A: Birth Control and Adult Acne
Sugar and white flour increase inflammation in the body, even moreso in the midst of insulin resistance. But even without insulin resistance, an insulin spike can create just the right hormonal fluctuation to affect oil production.
Eating soy can prompt shifts in hormone levels in some people, especially when consumed daily. Not everyone experiences improvement after I've suggested reducing soy consumption, but quite a few people have. In addition, there are supplements that can aggravate acne as well, such as biotin, high doses of B12, high doses of B6, and added iodine.
Most of the substances in skin care, hair care, body care, and makeup that clog up pore openings are ingredients that help with viscosity, penetration, and adherence. Almost all of them double as emollients (moisturizing agents), which is one of the chief reasons formulators love them. Most of them also happen to be very inexpensive, which is especially helpful when a skincare company wants production costs to go more toward what we call "performance" ingredients, like vitamins with sophisticated delivery systems, or anti-aging peptides. Others cloggers are natural oils and butters (a handful of oils are non-comedogenic, and are discussed in this blog post: "Kitchen Esthetician, or How To Navigate Acne DIY").
Several ingredients that can irritate pore linings when present in large amounts, are there to help give products desired consistency, distribute ingredients that don't normally mix together, and bind oils to water to take grime away. It's actually not common to have these in large amounts in a formula, but not that uncommon...
Strong detergents, artificial fragrances, most essential oils, and any extracts of botanicals that are similar to particular seasonal allergies you may have, can be just irritating enough to cause bits of swelling and irritation. When you get a breakout of small to medium bumps that turn red, never come to a head, and hurt just a little, it's very possible this breakout has an irritating product as a source - this does not mean you experience burning, itching, or immediate redness. The inside of your pores are the story here - you will not have any clue that a pore's lining is getting bothered like this.
Sometimes your skin just happens to unpredictably come across an ingredient it just doesn't like, whether other people experience breakouts from it or not. In the case of ingredients that are known to be a bit irritating, it's easier to identify what product is causing a potential problem. But when your skin just doesn't like something, this requires quite a bit of investigation, which is why all other possibilites should be eliminated first before such an undertaking.
Adult Acne Tip : It can take 3 months for a breakout to develop from its infancy! Whatever you're looking at in the mirror could easily be from something used 3 or 4 months ago. Never assume that it's from a new product you tried a week ago.
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