You know how it goes… you’re getting ready for a big event – and then you notice it: a brand new pimple just trying to make its way to the surface of your skin, all shiny, red and inflamed.
But, I’m in my forties (or maybe fifties!) you gasp – why am I still getting acne?! Adult acne is certainly frustrating and often embarrassing to deal with, but you’re definitely NOT alone!
Let’s squeeze out the truth about this all-too-common skin issue and get to the bottom of why you’re still seeing those pesky pimples pop up — even at YOUR age!
What is Adult Acne, and what causes it?
Acne is generally thought of as an inflammatory skin condition that we see and experience most often during the teens years — yeah puberty!
Adult or Hormonal Acne is just a term used when breakouts occur during the adult years. “Acne” is the term used to describe prominent blackheads, whiteheads, pimples and cysts.
Whether you are 17 or 47, acne outbreaks have the same root cause: Changes in hormone levels affect the way your skin protects and regenerates itself, sometimes with unpleasant results. At the onset of menopause, or more accurately, the phase that leads into it, called perimenopause, levels of the female hormones, including estrogen, drop. But androgen levels, the male sex hormones that each woman has as well, remain constant. This situation in effect causes the body to experience a relative increase in the effect of these “male” hormones.
One of the strongest of the androgens, testosterone, often triggers skin conditions that result in menopausal acne. As testosterone levels rise, the skin’s sebaceous glands go into overdrive, producing excess sebum, an oily substance that can block pores. The problem is further exacerbated by the slowed-down cell regeneration in older skin. As excess skin cells build up, they block pores already clogged with sebum, resulting in inflammation and infection. The body’s immune response causes a buildup of white blood cells in the infected area, and the result is a blemish or zit.
While acne can affect any part of the skin, it more typically found on the face and neck, but can also occur on shoulders, back, chest, under the breasts and on the upper arms.
However, there are TWO MAJOR DIFFERENCES between acne in the adult years and the kind you experienced as a teen:
- Adult acne is usually on the lower half of the face (chin & jaw line), while teen acne is typically on the upper half (forehead, nose & cheeks)
- Adult acne is also deeper and can appear as ‘under the skin’ pimples (cysts), which usually can’t be drained
Experiencing ACNE in adulthood is usually attributed to a few key culprits:
- After starting or stopping hormonal birth control methods
- Hormonal shifts like around a woman’s period (‘cyclical acne’)
- During pregnancy, perimenopause, menopause
- Medical condition involving hormonal imbalances, like polycystic ovarian syndrome (PCOS)
One’s first dealings with acne may be in adulthood as well, having escaped it all together as a teenager! This “adult-onset acne” is most common in postmenopausal women due to pronounced hormonal shifts.
DIET & NUTRITION
While the link between diet and acne has been somewhat controversial over the years, more recent scientific evidence suggests that what you eat plays a great role in your skin health. Here are some of the best foods to eat to improve your acne and a list of those to avoid in order to support your healing.
BEST FOODS TO EAT:
- antioxidant rich fruits and vegetables – “When you’re healthier, your skin reflects that,” Antioxidants—found in spades in brightly colored produce—neutralize free radicals, which can wreak havoc on your skin by increasing inflammation. And inflammation is not only related to premature aging (think fine lines and wrinkles) but also acne.
- fatty fish – Salmon, sardines, and tuna are all good choices that help your body get the anti-inflammatory omega 3s it needs as these healthy fatty acids are the building blocks for our cells. By allowing your skin to build new, healthy cells, it will look better. In one small study in 2014, taking omega 3 supplements helped significantly decrease acne breakouts. If you’ve also got acne breakouts on your back, these other habits can help clear them.
- cucumbers and watermelon – high-water food will boost your body’s hydration, and that’s a very good thing for your skin. In general, maintaining skin’s hydration level is helpful for any skin condition. Drying out your skin in an effort to treat acne, then pile on rich moisturizers, which exacerbate acne, is a not so good strategy. It’s best if your skin doesn’t swing from one end of the spectrum to the other—and staying hydrated by chugging H20 and filling your diet with water-rich eats can maintain your complexion’s homeostasis.
- cashews -getting a little nutty for your skin pays off. A 1-ounce (oz) serving of cashews supplies a good source of zinc. In a 2014 study in BioMed Research International, researchers found that lower blood levels of zinc were associated with more severe acne, possibly because zinc may have anti-inflammatory and immune-boosting properties.
- probiotic rich foods – Yogurt is famous for its probiotics, but sauerkraut, miso, kimchi, and tempeh are all good non-dairy sources of the beneficial bacteria. A 2014 review of research in the Journal of the American Academy of Dermatology shows that consuming probiotics may stymie the release of inflammatory proteins and decrease sebum production, preventing plugged pores.
- spirulina – It’s blue-green algae and it’s bursting with nutrients—and gamma-linolenic acid. GLA is an essential fatty acid that has anti-inflammatory properties, which is why it may give blemishes the boot. In a 2014 study, acne sufferers who supplemented with either omega 3 fatty acids or GLA for 10 weeks saw fewer acne lesions. You can buy spirulina at health food stores and add it to your morning smoothie.
foods to avoid
- milk and most dairy products – If you have acne, you may want to rethink your glass of cow’s milk. It’s far from definitive, but some studies have suggested that acne may be worse for dairy eaters, particularly milk drinkers. It may be that dairy can cause a spike in testosterone that causes downstream effects leading to a breakout.
- saturated fat – burgers, fried chicken, and fast food meals are out if you want clear skin. That’s because they’re higher in saturated fat. A 2014 study in the Journal of the Academy of Nutrition and Dietetics looked at a range of diet habits and acne and found that people who had moderate to severe acne consumed more saturated fat than those with clear skin or mild acne. It’s not well understood, but saturated fat may increase certain growth factors that contribute to breakouts.
- refined carbohydrates (and sugar!) – foods like snack mixes, cookies, cakes, crackers, muffins, and white bread. These are highly processed eats that contain refined carbs, including added sugar. A 2016 study published in the Journal of the American Academy of Dermatology found a correlation between high glycemic index diets and increased incidence of acne.
STRESS & INFLAMMATION
Stress can cause a release of inflammatory chemicals called neuropeptides and a domino effect of hormonal shifts which can worsen acne.
Cortisol, the stress hormone, can affect all of your other hormones, too, causing them to be all out of whack.
Think about that huge pimple that invariably makes its appearance before a big date — because even “good” stress, like anticipating an important event, can trigger a breakout.
Stress also increases the severity of breakouts by making pore cells thicker, stickier and therefore, more clogged. The results are more inflamed, red and painful pimples.
“Researchers have found a relationship between stress and acne flare-ups. In response to stress, our bodies produce more androgens. These hormones stimulate the oil glands and hair follicles in the skin, which can lead to acne. This explains why acne can be an ongoing problem when we find ourselves under constant stress.” American Academy of Dermatology
Other factors that can also be to blame for Adult Acne, include:
- Family history/genetic predisposition
- Gut & digestive issues
- Commercially-made hair & skin products (including make-up remover & sunscreen)
- Facial hair removal (tweezing)
- Change of environment (including traveling)
- Side effects from certain medications
treatment for adult acne
While there are many, many treatments available (like topicals containing benzoyl peroxide, salicylic acid & sulfur) and some are even touted as the next miracle acne cure. Truthfully, there’s no magic bullet, and I am off the opinion that nothing beats trying something totally natural first!
Self-Care Strategies for Menopausal Acne
Maintaining a good self-care regimen is necessary for skin health throughout your life, but it is especially important for women experiencing the dual challenges of delicate skin and breakouts during menopause. Dermatologists recommend:
Daily cleansing. Wash your face twice a day with a gentle, nondrying cleanser followed by a light moisturizer.
Gentle approach. Harsh products and vigorous scrubbing are a definite no-no for mature skin that can be easily irritated or damaged.
No picking. Squeezing or picking at pimples must be avoided completely since skin, which becomes more fragile at menopause, may scar more easily
In addition to proper skin care, I encourages women to reevaluate their cosmetics collection. Oil-based cosmetics can exacerbate the problems for skin that is already clogged with excess oil. Look for water-based or mineral cosmetics to replace oily products and take extra care to remove all traces of makeup when you wash your face, are important steps in avoiding acne.
However, if you find that your acne is resistant to a more natural treatment approach or when using some of the over-the-counter remedies available, be sure to consult with a knowledgeable health practitioner for further investigation, and a more definitive diagnosis, plus appropriate course of action.
Out of my personal experience, I’ve put together a DIY natural beauty toner recipe with ingredients you may already have in your bathroom cupboard!
Blemish-Calming Natural Beauty Toner
½ cup purified water
¼ cup witch hazel, without added alcohol
¼ cup apple cider vinegar (ACV), unfiltered (with the “mother” in it)
2-3 drops tea tree oil (can sub with lavender or rosemary essential oil)
Pour all ingredients in a clean, sealable container – squeezable or misting bottle suggested.