Acne is a four-letter word. And is that a coincidence? It certainly sums up how most sufferers feel about it. Acne is the most common skin complaint of all – mostly prevalent among teenagers, and usually disappearing in the 20s. However, some types of acne may persist into adulthood – bringing considerable misery. (And actually, in the past few years – for reasons I don’t really understand – I’ve seen several friends who’ve previously been clear-skinned suddenly develop spots, in their 40s and beyond. Hugely confidence-draining it is, too.)

My professional observation as a professional, though (not just as a friend), is that spot control has to be a combined programme from inside out and outside in. Let’s sort the basics first – the internal bit. To be honest, there’s not much more I can add to the incredibly comprehensive in-depth look at acne which Shabir took in his editorial Take Control of Your Acne, here, in terms of the reasons for breakouts, and the supplements which can make a difference.

But as a beauty editor, I’m also interested in the ‘outside-in’ approach. Whatever you do, don’t run away with the idea that stripping away the excess oil from the surface of your skin – which often goes in tandem with spots – is going to solve your problems. This simply puts oil glands into overdrive: they just produce more, and set off a vicious circle.

In general I point people in the direction of really skin-friendly ranges like Spots & Stripes for younger skins, Derma E, and Green People. Whatever you do, don’t be tempted to use ultra-drying, cleansers; they can also send your skin into oil-overdrive and make the problem worse. Also avoid anything with sodium lauryl or laureth sulphate, a foaming agent which can irritate your skin. 

Above all, kiss goodbye to harsh cleansers and alcohol-based toners. (NB There is one Very Famous Name toner out there that’s so powerful, it can be used to remove nail polish. I kid you not.) By contrast, when it comes to skincare, your watchword really should be ‘gentle’ – and you must leave time for skin to get back into balance, as there are no overnight miracles here.

As for toner, ditch the paint-stripper and switch to super-gentle natural rosewater: for instance, Rosewater Spray just spritzes onto skin and can be swiped away with a couple of clean cotton pads (or simply spritz onto the pads themselves).

For many sufferers, spots do appear to be hormone-related – which is why we’re especially prone to them around puberty. At this vulnerable time – when self-esteem is often quite low – it is very tempting to give in and take medication (and this is probably what sufferers will be offered if they go to their GP, as it’s virtually the only weapon in the medical arsenal). However, beware – and also ask about side-effects, which can potentially be quite serious with some medication. (Mothers I know have been horrified to read the side-effect info – in teensy print – slipped inside a prescription packet of acne medication.) My personal observation is that drugs for acne should only be an absolute last resort after the problem has lingered for years and all other approaches have truly been exhausted. In some instances, the Pill may be prescribed to tackle acne – but according to top facialist Sarah Chapman, ‘A number of women who have come off it, having been on it for years, find their skin goes haywire.’ Phytotherapy (herbal medicine), however, has anecdotally been found helpful by many younger sufferers – without the nasty side-effects.

Later in life, it’s quite common to get an occasional flare-up – a big, deep-seated zit (or two) – that appears about once a month, just before your period. It’s a fact: premenstrual shifts in oestrogen and progesterone levels can prompt sebaceous glands to pump out more oil. Cortisol – secreted by the adrenal gland in response to stress – also stimulates sebum production, which is why it’s no illusion that the worst spots seem to erupt after a sleepless night or before a Big Date. Try to de-stress, in whatever (holistic) way you can. (And be aware that Acupuncture can effectively help to rebalance hormones, potentially eliminating that monthly break-out.)

Topically-applied products can also be blessedly effective – especially on the odd flare-up; Derma E Sulfur Spot Treatment targets the problem zone with a combination of known blemish-busting ingredients including tea tree, willow bark, lavender and rosewood, and can be applied as often as you like. And as for dealing with the red marks – which are often the legacy of a breakout (and can actually be even more distressing)? Well, that’s one of the key reasons iS Clinical Sheald was invented, and very effective they are, too.

And do bear these points in mind…

  • An often-overlooked cause of break-outs – especially on the forehead – can be hair products. Skin sometimes rebels against serums and leave-in conditioners that seep from the hair into the pores, especially after a sweaty workout.
  • Try where possible not to touch your face, except with totally clean hands. Carry an antibacterial hand product and use it regularly: Hydrating Hand Sanitizer comes in a really great-looking, handbag-friendly pump-action bottle. (If you’re a young spot sufferer, don’t be put off by the words ‘anti-ageing’ in the name: just enjoy the softening, smoothing properties of what’s actually a potent bug-zapper – a complete contrast to most hand sanitizers, which I find incredibly drying.)
  • Check, too, if acne around the chin area could be caused by habitual use of a phone underneath the chin – and it’s possible, too, to get spots from motorbike or cycling helmets, or around the nose area in people with glasses… So do make sure those things are really, really clean.
  • If you’re buying make-up, look for the words ‘non-comedogenic’ on the bottle, which means it does not contain pore-blocking ingredients that can give rise to spots and acne.
  • Alternatively, mineral make-up is worth trying: it doesn’t block pores at all and because of its ‘light-reflective’ properties, even a fairly light application can eliminate a huge amount of redness and give the illusion of smoother skin.
  • And last but not least, can you squeeze…? According to facialist Eve Lom, ‘On a daily basis, squeezing can damage and scar skin. But if you get an occasional spot, it’s okay to squeeze.’ Her technique? ‘You have to prepare skin first, by cleansing, then warming it. Ensure hands are spotlessly clean, too. Take a piece of cotton wool and soak it in hot water, then hold over the spot for around six seconds, repeating five or six times, before squeezing with the tips of your fingers, not your nails – which will mark skin. Never try to squeeze just a red lump; unless there’s a white “head”‘ on it, you’ll just spread the infection and make matters worse. And wipe with tea tree oil, afterwards.’


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