Adult acne: Dr Anjali Mahto answers the 12 most common questions
Overwhelmed with all the so-called advice on how to help adult acne?
Dr Anjali Mahto – who suffered from adult acne herself – answers some burning FAQs and her top tips to healthier skin.
Many people invest heaps of money in skincare products that claim they will help prevent our acne and breakouts.
But it can prove difficult to know exactly what products to use and what advice is truly trustworthy.
Dr Anjali Mahto’s new book, The Skincare Bible, was inspired by exactly this and the questions she’s asked everyday at her clinic, The Cadogan Clinic in London.
In a piece for Healthista, Dr Mahto – a consultant dermatologist – answered 12 common questions about adult acne, from causes of the condition to potential cures.
Many people invest heaps of money in skincare products that claim they will help prevent our acne and breakouts
Q. #1: Does what I eat effect my skin, or is it just a myth?
There is emerging scientific data that consumption of foods with a high glycaemic index (GI) (the naughty high sugar foods including white rice) and certain dairy products (in particular, low-fat milk) can aggravate acne.
These foods that are rapidly absorbed by the body, and result in raised blood sugar or glucose levels.
Raised circulating blood sugar or glucose levels promote the release of the hormone insulin and IGF-1 (insulin growth factor 1).
Both of these increase oil or sebum production and act on the body to produce more male hormones known as androgens (both men and women have androgens). All these factors together are thought to promote the development of acne.
Therefore, in some individuals, it may help to limit these types of food, and I would also suggest following a nutritional diet with plenty of whole grains, vegetables and pulses.
Stress can anecdotally also play a part in aggravating inflammatory skin conditions such as acne. Learn to de-stress and make sure you get enough sleep and exercise. Participate in activities such as yoga and meditation if this works for you.
Q. #2: Will drinking lots of water help my skin or is that a myth too?
I always recommend keeping yourself fully hydrated throughout the day, particularly during the warmer months or if you are suffering from sunburn, as this encourages fluid loss through the skin and can cause you to become very dehydrated.
The skin also loses more water content as we sleep compared to during the day which can be a problem for normal or dry skin types.
Always ensure you moisturise before bed as this is when your skin needs its extra moisture.
Drinking a lot of water will not help with fine lines and wrinkles, however and this is a common myth that often gets thrown about.
‘I always recommend keeping yourself fully hydrated throughout the day,’ Dr Mahto says
Q. #3: Are spots caused by hormones?
Yes absolutely. Skin concerns can often be attributed to hormonal changes that take place during the course of one’s life and particularly during certain periods including puberty, pregnancy and the menopause.
These hormones can wreak havoc on our skin in a rather predictable manner during these times.
Q. #4: If I treat my oily skin will it then dry my skin out and cause wrinkles?
I always recommend to follow the correct skincare regime for your skin type and those with oily skin should not worry about treating this if they use the correct products and ingredients.
Remember that good quality skincare need not be expensive or complicated. More often than not, it comes down to using products that contain the right ingredients.
Most people will have skin types that fall into one of the following categories: oily, dry, sensitive, normal/combination.
A person’s skin type can change over time and skincare will also need to change in response to this.
One of the most common errors in those with acne or oily skin is over- exfoliation in an attempt to unblock pores and remove oil.
This is not a good idea, as exfoliating frequently with harsh agents will cause irritation and potentially a worsening of break-outs.
I also suggest using cosmetic products that are non-comedogenic and contain ingredients such as Benzoyl peroxide, Alpha-hydroxy acids (AHAs), Salicylic acid, Retinols, Niacinamide and Tea Tree Oil.
HOW TO USE LED THERAPY TO CLEAR UP ACNE
Light treatment is increasingly popular for those looking to get rid of their acne.
In addition to Lorde, stars such as Kate Hudson, Kourtney Kardashian, Lena Dunham, and Jessica Alba, have all shared snaps of themselves using the technology as part of their own skincare regimen.
Two kinds of light can help in the battle against blemishes: blue and red.
Blue light works by destroying the bacteria that causes the zits to proliferate in the first place.
‘Blue light has been shown to penetrate the skin’s hair follicles and pores, which harbor bacteria and can cause inflammation, and therefore acne,’ dermatologist Marnie Nussbaum told Shape last year.
‘Bacteria are very sensitive to the blue light spectrum – it shuts down their metabolism and kills them.’
Red light has different virtues that complement those of blue light and help the overall aspect of the skin.
‘Red light has traditionally been used for anti-aging purposes because it helps stimulate collagen,’ dermatologist Joshua Zeichner told the magazine.
‘At the same time it helps reduce inflammation, which is why it is useful alongside blue-light in treating acne.’
Several devices are currently available for those looking to try the technology at home, ranging from just $35 to more than $150.
Treating oily skin however will not result in wrinkles as wrinkles occur due to the natural ageing process of the skin and sun exposure, not due to removal of skin oil as such.
Q. #5: Does an alkaline diet really work?
My recommendation is to follow a nutritional diet with plenty of whole grains, vegetables and pulses.
Stress can anecdotally also play a part in aggravating inflammatory skin conditions such as acne so activities to de-stress are important.
I would not personally recommend an alkaline diet and there is little scientific evidence to back its use.
Q. #6: What can you do for scarring post acne as an adult? Is it ever too late and how expensive is it?
‘My recommendation is to follow a nutritional diet with plenty of whole grains, vegetables and pulses,’ says Dr Mahto
Acne scarring typically occurs in association with spots that cause deep inflammation (nodules and cysts) and can either be elevated or depressed from the skin surface.
Whilst some acne scarring will improve over time, the skin contour does not usually completely normalize.
There are a number of methods that can be used to treat acne scarring if it is causing distress.
Sometimes a combination of treatments may be required to get the best result as one person may have several different types of scars.
What are the best ways to cover a spot?
Whiteheads Thick concealer applied with a precision brush, followed by finishing powder
Blackheads Matte foundation with a creamy concealer and powder foundation
Dry/ flaky Hydrating mist followed with moisturiser and a small amount of foundation
Oily Use a powder-based foundation and follow up with setting spray
Angry and red Green colour corrector followed by a yellow-based concealer
Picked Apply antibacterial gel and don’t apply makeup until it’s healed
Acne scar Conceal with full-coverage foundation and use fading products
Source: Francesca Neill
Common treatments include a mixture of micro-needling and laser depending on the scar types.
Misleading information results in much time, money, and effort being wasted on miracle cures without miracle results.
There are effective treatments available for managing acne and scarring. If you find your skin concerns are stopping you leading your life the way that you want, it is important to seek medical help.
Ensure your expert is a dermatologist on the GMC specialist register and can talk through the multiple options that are available.
It is important to have a discussion about which methods have been chosen and why.
And finally, it is vital that the acne process itself is switched off and treated before any scar treatments are started.
Q. #7: How can I help to prevent my acne?
Unfortunately, there is no way of preventing acne as it can be caused by a wide number of issues or periods in your life as mentioned above.
There are, however, many treatment and product options to help reduce the signs and symptoms of acne and an expert dermatologist will be able to determine the best treatment plan tailored to you.
How to treat pollution-induced acne if you live in the city
Many skincare experts have concluded that pollution in the city you live in can lead to breakouts.
The contaminated air surrounding you – full of dirt and debris – can build up on your skin ultimately leading to acne.
Skincare professionals shared different ways you can treat and prevent acne caused by pollution:
Use protective products that fight acne such as copper, rose extract, Vitamin-C niacinamide, ceramides and marine extracts.
Use a zinc-based sunscreen.
Add an air purifier to your home or office to cleanse the air you’re exposed to every day.
Take a resveratrol supplement for antioxidant protection.
Q. #8: Should I avoid face oils if I have acne?
Facial oils have gained much notoriety in recent years. They are touted as being good for all skin types– oily skin included.
The theory is that ‘like dissolves like’ and, therefore, oil will dissolve oil. I have seen little evidence to back up the claim that facial oil is good for those of us prone to spots and my advice would be to steer clear of these unless you have dry or very dry skin.
Oils on the skin can promote the formation of blackheads, leading to spots.
Facial oils have gained much notoriety in recent years. They are touted as being good for all skin types – oily skin included
Q. #9: After so long of not having acne, why has it started now I‘m in my 20s?
Acne can affect us throughout the different stages of our lives. Anecdotally, there seems to be data that suggests that acne is starting earlier and continuing for longer than previously noted.
Acne manifests itself in a variety of ways from blackheads and whiteheads to more severe and tender red spots, and it is estimated that 85 per cent of teenagers will suffer from acne at some point to varying degrees of severity.
During adolescence, acne is more common in males than females. However, women are much more likely to suffer with acne during adulthood than men, probably due to their complex hormonal cycles which fluctuate due to things like inflammation and stress.
Unfortunately, we don’t have a full understanding of the difference in the cause of acne in teens versus adults at this stage.
Skin concerns can often be attributed to hormonal changes that take place during the course of one’s life. There are certain periods, namely puberty, pregnancy and the menopause, where this holds particularly true.
Q. #10: At what age should I start keeping up a skin routine?
WHAT ARE THE FIVE BEST TIPS FOR SKINCARE?
According to Dr Anjahli Mahto, a London-based consultant dermatologist, there are five easy tips to protect your skin.
#1: ‘Wear sunscreen daily. Daily sunscreen use can help guard against skin cancer and premature skin ageing. Choose a broad-spectrum which offers protection against both UVA and UVB light. Sunscreen should be a minimum of SPF 15–30’.
#2: ‘Remember that good quality skincare need not be expensive or complicated. More often than not, it comes down to using products that contain the right ingredients’.
#3: ‘It is important to cleanse the skin twice a day – morning and evening. This can be in the form of a rinse of cleanser or micellar water. Air pollution (polycyclic aromatic hydrocarbons, volatile organic compounds, oxides) has been shown to contribute to premature skin ageing such as fine wrinkles and pigmentation spots. These should not be left in contact with the skin for any longer than necessary’.
#4: ‘It is really common to hear myths about pore size – for example – steam or hot water will open pores. This myth is propagated by glossy magazines, beauticians, and even some doctors! The truth is we can help improve the appearance of pore size but we cannot close them’.
#5: ‘Skin concerns such as acne scarring can have a profound psychological effect on the sufferer long after the acne itself has gone. Misleading information results in much time, money, and effort being wasted on miracle cures without miracle results. There are effective treatments available for managing acne and scarring. If you find your skin concerns are stopping you leading your life the way that you want, it is important to seek medical help’.
The correct skincare regime for your skin type should be used as early as possible, particularly from your teens when puberty has kicked in and you are more susceptible to hormonal changes.
Your skincare regime needn’t be complicated or expensive as long as you are using the correct ingredients to suit your skin type.
Q. #11: What should be my everyday skin routine?
As mentioned above, your skincare routine should reflect your skin type. I do recommend cleansing the skin twice a day – morning and evening.
This can be in the form of a cream cleanser or micellar water.
I also suggest exfoliating your skin as this helps to remove the upper layer of dead skin cells that sit on the skin – this improves the skin’s texture, age spots and uneven skin tone which ultimately allows for better penetration of skincare products such as moisturisers or serums.
Facial toners also have a number of positive roles in skincare. They can remove excess oil and make up and balance the pH of your skin.
Toners are useful for those with very oily or acne prone skin. They should be applied to a cotton pad and wiped over the skin surface.
Serums contain high concentrations of active ingredients and should be used before moisturisers. They are fast acting and lightweight.
A few drops of serum can be placed in the palms of the hands and pressed into the skin in a similar manner to using essence.
Using serums on damp skin may increase their penetration as damp skin is more permeable to products.
Q. #12: How can I help acne caused by hormones especially at that ‘time of the month’?
Acne is normally worse during your period and this is a very common issue for women and one 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 note worsening of their acne typically occurring anywhere from a week to a few days before the start of their period.
Though 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.
Such higher proportions of testosterone, in turn, are known to cause the changes in the skin’s complexion that bring about acne.
Unfortunately, us ladies are at the mercy of our hormonal cycles and there’s not much we can do about them, even if we can treat the resultant acne.
This piece originally appeared on and has been reproduced with the permission of Healthista.