At any age, the underlying cause of acne is an over-sensitivity to the male hormone testosterone.
'In response, skin glands produce excessive amounts of oil that,
along with dead skin cells, clog up in hair follicles, trapping bacteria
and triggering superficial pimples and blackheads, as well as bumps
beneath the skin's surface,' says Susan Mayou, a consultant
dermatologist at the Cadogan Clinic and Cromwell Hospital.
Mayou says it has always been known that some women are more prone to spots at times when hormones fluctuate, such as adolescence, pregnancy and during the menopause. Many more also experience monthly breakouts triggered by the menstrual cycle.
But our lifestyles are being added to the list of factors that can spark the hormonal imbalances that cause acne in people who are in their 30s and 40s.
For years, the medical field was divided on whether stress affected the complexion, but several clinical studies in recent years have proven that it can induce flare-ups. In one small trial at Stanford University involving 22 students with acne, exam pressures were proven to make their skin condition worse.
When someone is stressed, the adrenal glands secrete more androgens (male hormones) that stimulate the production of oil, which can result in pimples.
But psychological stress has also been shown to lower the body's wound-healing capacity by up to 40 per cent, meaning that stress-induced acne is also likely to be more stubborn.
GROWING PAINS
Around 80% of 11-to-30-year olds are affected by acne to some degree
Two years ago, Australian nutritionists asked a group of young adults with acne to follow either their regular diet, which included plenty of processed and sugary foods, or to switch to a low glycaemic index (GI) diet of wholegrains, fruit and vegetables, lean meat and fish.
After 12 weeks, their results, published in the American Journal of Clinical Nutrition, showed that the healthier eating group had a measurable drop in the severity of their acne, with 51 per cent fewer pimples than when they started.
'That's a better result than you would see from topical acne products,' said Professor Neil Mann, who led the study.
Mann suspects it is the fact that processed foods spark a rise in insulin that, in turn, increases the production of testosterone that is to blame.
Even too much time at the gym is causing acne in some women who have never previously suffered.
A report in the latest issue of Women's Running magazine reveals that sometimes sweat can play havoc with the skin, creating a moist environment for micro- organism growth and the emergence of a skin problem dubbed 'exercise acne'.
It can also be exacerbated by the overgrowth of a yeast germ called pityrosporum, which reacts with sweat to cause pimples. 'Overall, exercise is good for the skin,' says Bevis Man of the British Skin Foundation. 'But it can cause problems for some.'
So what, if anything, is the cure for adult acne? Mayou says that GPs will usually prescribe topical creams or ointments containing anti-acne agents such as benzoyl peroxide, antibiotics, retinoids or azelaic acid as the first stage of treatment.
'They work for some people, but can cause irritation for others.'
If that fails, a course of oral antibiotics might be recommended. In severe cases, the powerful drug Roaccutane can stem sebum production, leading to improvements for sufferers.
Aside from prescribed medication, cleansing the body and face as soon after exercise as possible, preferably with a tea tree-based soap containing natural anti-microbrial properties that slow yeast growth, can help to prevent exercise acne.
It can take time to control, 'but the good news is that adult acne is treatable,' says Bevis Man.
By Peta Bee
