Once through adolescence we would have thought acne and pimples were behind us, but that may not be entirely true. For many adults, particularly women (it was the boys ‘back when’) acne resurrects later in adulthood, even into their fifties. For some people, they never went away.
Acne is pretty much what you remember it to be. It starts out when the glands at the base of hair follicles secrete too much ‘sebum’ an oily substance that lubricates the skin. If that was it, you would just have oily skin. But an excess of sebum combining with dead skin cells can clog the pore. Then, if bacteria is present on the skin, it can invade the clogged follicles which leads to the follicle wall to rupture. The result: redness and inflammation — that is a pimple.
After all those years clear of pimples, why would they return in adulthood? Blame is shared among several factors. Genetics, climate (both very dry and very humid), cosmetics and skin care products, some medications, emotional stress and lack of sleep can all contribute to acne.
Blame can also be laid on hormones triggering oil glands going wild as in adolescence may resurface in adulthood, particularly in pre-menopausal women. Hormones also explain why many women experience acne flare-ups during pregnancy and prior to their menstrual periods.
Diet may also be a contributing factor, though the research is inconsistent. There is some indication that a diet of lower glycemic foods (such as whole-grain bread and certain fruits) can lead to less acne. Conversely, high glycemic foods and heavy consumption of dairy, especially milk, have been associated with acne; association does not mean causation, just that it could influence acne. In addition, there is evidence that omega-3 fats are protective (fatty fish, flax). If you limit your dairy intake be sure to get enough calcium from other sources.
Guarding against acne as an adult is not much different from what it was in adolescence. Start by keeping your face clean, washing with a mild cleanser and soft pad or your hands, then patting the face dry. The goal is to avoid irritating the skin so stay away from gritty cleansers.
Some cosmetics include salicylic acid, which fights acne. When shopping for skin care products, look for those what won’t clog pores (non-comedogenic). You might also consider topical over-the-counter acne medications but keep in mind that they may cause excess dryness. Products containing benzoyl peroxide can fight acne, but use it only occasionally as it will dry out your skin.
Now, if you do get a whitehead or blackhead, no matter how much it is calling out to you, don’t squeeze or pop it. That will just encourage infection and make things worse.
If you are still having problems with acne after trying these self-help steps, it might be time to see a dermatologist.
While adult onset acne is not especially welcome, we would like to think that with age also comes a level of awareness and confidence that may not have been present during adolescence, in which case a pimple could be much less ‘serious’ than it once was.
Dr. Paul Martiquet is the Medical Health Officer for Rural Vancouver Coastal Health including Powell River, the Sunshine Coast, Sea-to-Sky, Bella Bella and Bella Coola.