Askanesthetician's Blog

An esthetician explores skincare issues and concerns

Psoriasis Information March 13, 2013

Filed under: Skin Conditions — askanesthetician @ 7:30 am
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Lately I have come across a few articles about the skin disease psoriasis so I thought I would share the information here.  I’ve addressed the issue of psoriasis before in this blog (see my post August is Psoriasis Awareness Month), but I wanted to go into greater detail here about this disease.

Just what is psoriasis and how many people does it affect?  In the article The Biology Behind Eczema and Psoriasis in Skin Inc. Dr. Claudia Aguirre explains:

Psoriasis has been confused with eczema, lupus, boils, vitiligo and leprosy. Because of the confusing connection with leprosy in ancient times, psoriasis sufferers were even made to wear special suits and carry a rattle or bell, like lepers, announcing their presence. Only in the 19th century was a distinction made between psoriasis and leprosy, alleviating some of the psychosocial impact of this highly visible and distressing skin disease.9 As with eczema, it presents as itchy, red skin and involves altered immunity. However, its complexities reach far beyond the surface of the skin. People with psoriasis have an increased risk of cardiovascular disease, metabolic syndrome, obesity and other immune-related inflammatory diseases—even cancer. The mysteries behind this complicated and debilitating skin disease are only beginning to be unraveled. Psoriasis is a chronic, inflammatory multisystem disease affecting 1–3% of the world’s population.3 Whereas the rashes on eczematous skin can have irregular edges and texture, psoriatic lesions tend to be more uniform and distinct. Red or pink areas of thickened, raised and dry skin typically present on the elbows, knees and scalp. This presentation tends to be more common in areas of trauma, abrasions or repeated rubbing and use, although any area may be affected. Unlike eczema, psoriasis comes in five different forms: plaque, guttate, pustular, inverse and erythrodermic.

Plaque psoriasis affects about 80% of those who suffer from psoriasis, making it the most common type. …

It may initially appear as small red bumps that can then enlarge and form scales. The hallmarks of this type are raised, thickened patches of red skin covered in silvery scales. The other types are less common and present inflamed skin with red bumps; pustules; cracked, dry skin; and even burned-looking skin. Clients will most likely be under a physician’s care, who will diagnose the type of psoriasis present.

As of today, psoriasis has no cure. A single cause of the disease has yet to be uncovered, but it is known that developing the disease involves the immune system, genetics and environmental factors. In psoriasis, aberrant immune activity causes inflammatory signals to go haywire in the epidermis, causing a buildup of cells on the surface of the skin. While normal skin takes 28–30 days to mature, psoriatic skin takes only 3–4 days to mature and, instead of shedding off, the cells pile up on the surface of the skin, forming plaques and lesions. The underlying reason may be due to the hyperactivity of T-cells, which end up on the skin and trigger inflammation and keratinocyte overproduction. Although it is not known why this happens, it is known that the end result is a cycle of skin cells growing too fast, dead cell-debris accumulation and resulting inflammation.

Many psoriasis sufferers receive medication from their doctors but there is encouraging research that the use of OTC AHA (alpha hydroxy acids) can help improve psoriasis symptoms.  In the post How Alpha Hydroxy Acids Could Help Treat Psoriasis Rebecca Harmon writing on Future Derm explains:

In common plaque psoriasis, the overgrowth of skin cells that collect at elbows, knees, hands, scalp, face and other areas can cause embarrassment and in some cases can be painful as clothing catches and pulls on the dry skin patches.

During a particularly hard-to-manage outbreak in my late 20’s, I was desperate to avoid the greasy and expensive steroid cream ($50 for a small tube) and smelling like the back end of a large coal truck wasn’t working for me either.  My particular case was cosmetically disturbing but not medically-complicated so I decided to stop buying the $50 prescription cream and turned to the beauty industry which was just beginning to offer face cream with AHA’s.

I quickly became a fan as I discovered that the flaky psoriasis patches on my face disappeared with a skin care regimen that included a daily application of the AHA face cream. Those were my stay-at-home-with-babies days, and I was as far removed from research or academic writing as one could be, but I didn’t need the denial of a null hypothesis to tell me that this was working.  I used it twice daily on my face and then started rubbing it in to my elbows and knees.  I still laugh remembering the cosmetic rep who finally asked how much face cream I was using (I ordered a lot of this stuff!).

And, yet, the research is in my favor. One study of 12 patients found that a creams with 15% glycolic acid, as well as .05% betamethasone, respectively, were helpful in reducing erythema, transepidermal water loss (TEWL), and lowering Laser Doppler values (Dry Skin and Moisturizer). And alpha hydroxy acids mixed with betamethasone were found to be even more effective in treating psoriasis in a double-blind, split-face, single site clinical study (JEAVD).

I have experienced mild outbreaks of psoriasis since that period but have continued to treat them with AHA-based lotions with consistent results.

And Rebecca isn’t the only extolling AHAs as a psoriasis cure from personal experience.  In the post We Answer Cara Delevingne’s Skin SOS: Psoriasis Alexandra Owens writes in Allure that:

A few years ago, I accidently discovered that Bliss Ingrown Eliminating Pads relieved my symptoms even better than prescription creams I’d tried. I asked New York dermatologist Doris Day why they work so well. “The alpha and beta hydroxy acids [in the pads] would help thin out the plaques of psoriasis, and the oat extracts, witch hazel, and lavender oil would soothe and hydrate the skin—but I would still apply a moisturizer after using them,” she says. “The nice thing about the ingredients being in a pad is that it’s easy to apply to the affected areas.” Another nice thing: You don’t need to see a doctor to get your hands on them.

When it comes to treating clients with psoriasis at the spa keep things simple and gentle and place an emphasis on encouraging relaxation.  Once again I’ll turn to the Skin Inc. article mentioned above:

Both eczema and psoriasis clients have impaired barrier function and increased inflammation, so your goal will be to protect and repair. Remember to always check first with your client’s physician for contraindications to medications and therapies, because some ingredients may counteract each other. For example, salicylic acid may seem a likely choice for exfoliating psoriatic skin, but could, in fact, inactivate a common topical treatment for psoriasis.

Once a full consultation with the client and possibly her physician is completed, proceed with a treatment using minimal products and procedures. A good way to compensate for minimal skin treatment time is to add on stress-relieving techniques, because there is a psychological component to eczema and psoriasis. Complementary therapies, such as aromatherapy, acupressure, reflexology, massage and inhalation techniques can be coupled with skin treatments to lower stress hormones and control inflammation.

Gentle cleansing and exfoliation is crucial to allow the penetration of rich, emollient moisturizers used on dry, sensitive skin. Avoid harsh exfoliants and detergents, and look for ingredients, such as lactic acid. Use anti-inflammatory ingredients, such as red hogweed, ginger, oats and chamomile, coupled with barrier-repairing oils, including evening primrose, borage, argan and sea buckthorn. Finishing a treatment with a physical sunscreen, such as zinc oxide or titanium dioxide will ensure that harmful UV rays do not cause further damage.

Bottom Line:  Though there is currently no cure for psoriasis there are ways to keep symptoms under control.  Since stress makes psoriasis worse finding ways to reduce stress is an integral part of psoriasis treatment and estheticians can certainly be a positive part of that process.

Further Reading:

Image from worldinfo.info

 

Moisturizer Musings November 19, 2012

I came across a few things lately related to moisturizers that I thought would be good to share with my readers especially now that the weather is getting colder most places.

Future Derm recently addressed a number of common moisturizer misconceptions.  The issue I found most interesting was that of moisturizers with spf versus sunscreens:

Moisturizers with SPF versus Sunscreens

Incorrect Definitions:

I don’t actually know how people (in their minds) differentiate moisturizers with SPF from sunscreens. But I always see people give this distinction, without giving an explanation. For example, a reader recently commented that:

“… HOWEVER, the LRP is actually a MOISTURIZER with SPF rather than a straight sunscreen.So I was wondering if the PCA Sunscreen you recommend is moisturizing as well or would it require an additional moisturizer?…”

Analysis:

Now that we’ve defined what a “moisturizer” is, a moisturizer with SPF is therefore just a leave-on product that contains occlusive agents AND UV filters, and may also contain humectants, emollients, and other beneficial ingredients. What about sunscreens? I honestly don’t know what to say, except that sunscreens are the exact same thing. They can certainly be “moisturizing.” In fact, a common complaint is that “sunscreens,” especially those that contain inorganic UV filters like titanium dioxide and/or zinc oxide, are TOO moisturizing, greasy, emollient, and/or heavy. So I don’t understand how this distinction was imagined in the first place. I mean, anything with an SPF rating is measured the same way; a “moisturizer” with an SPF of 20 and a “sunscreen” with an SPF of 20, will both provide the same initial level of UVB protection.

Correct Definitions:

Moisturizers with SPF and sunscreens are the exact same thing: leave- on products that contain occlusive agents AND UV filters, and may also contain humectants, emollients, and other beneficial ingredients.

After reading the above analysis of moisturizers with spf versus sunscreens I thought – why did this never occur to me before!?!?  Truthfully I can’t say why I needed to read what someone else had written about this in order to realize that it was true.  The real key here is finding the right product for you and using it – make sure that you use it every day without fail and that you use enough of it.  A tiny drop of sunscreen (or moisturizer with spf) will not give you enough protection, and make sure you reapply throughout the day.  Sunscreen only lasts two to three hours.

The Importance of Moisturizer

Recently I reviewed the book Stop Aging, Stop Living by Dr. Jeannette Graf.  My review focused on Dr. Graf’s dietary and lifestyle advice and how an alkaline diet helps your skin look and function at its best.  When it comes to hands on skincare advice Dr. Graf’s is very straightforward and easy to follow.  I was struck by her insistence of the daily use of moisturizer for all skin types.  Here is her advice about using moisturizer during the day (pages 112-114)

It doesn’t matter whether your skin is dry, oily, combination, or normal.  You need moisturizer to replace moisture lost during cleansing and seal in that moisture so it does not escape.  Your skin type may affect what type of moisturizer you use, but not whether or not you use it.

Moisturizers replace lost water and hold it there with humectants (water-binding agents).  In other words, they add moisture to your skin and prevent existing moisture from escaping.  Although your skin naturally retains moisture through small molecular weight compounds called natural moisturizing factor (NMF), it needs a layer of fatty acids (lipids) above the NMF layer to seal in this moisture and prevent it from evaporating.  Showering, cleansing, sun exposure, wind, dry heating and air-conditioning, swimming, and other factors remove these fatty acids on a nearly constant basis.  If you don’t use a moisturizer to replace this lipid layer and seal in NMF, your skin’s natural moisture evaporates, resulting in dry, thin, tight, older-looking skin.  …

Look for a moisturizer that advertises an SPF of at least 30.  During the winter months, when UVB rays are weakest, you can get away with an SPF of 15.  This SPF will protect your skin from sun damage during short outdoor activities, such as going to and from the car.  Apply it first thing in the morning rather than waiting until you are ready to head outdoors.  Although glass blocks sunburn-inducing UVB rays, it does not block much of UVA.  Your SPF protection will last about an hour*, so reapply (or touch up your mineral makeup, which also provides some sun protection) before going outdoors later in the day.

Make sure the sunscreen and/or sunblock in your moisturizer is broad-spectrum, with wording on the packaging that says it protects against both UVB and UVA rays.  …  As an added bonus, any antioxidants in your moisturizer (vitamins C, E, grape seed extract, or green tea) will enhance the protection from your sunblock as well as provide protection from environmental pollutants.

Finding the perfect moisturizer may take some trial and error.  Try free samples whenever possible, and trust your instincts.  If your skin feels shiny or greasy, the moisturizer is too rich for your skin type.  If your skin feels tight and dry, it’s not rich enough.  If you have combination skin, you may need two different moisturizers – a gel or a sheer sunscreen for the oily areas and a thicker moisturizer for the drier areas.  If you have very dry skin, you may need to double your efforts, both using a rich moisturizer that contains no SPF or anti-wrinkle ingredients and applying a separate SPF product on top.  This first layer moisturizer should contain humectants and emollient lipids such as ceramides and evening primrose oil.  Evening primrose oil is the richest source of gamma-linolenic acid, a type of essential fatty acid that is soothing and particularly moisturizing for the skin.

As for the evening Dr. Graf has the following to say (pages 119-120):

Moisturize and Renew

Use a different moisturizer at night than you use in the morning.  At night, your skin is renewing itself, so you need a moisturizer that helps the skin to perform this important function.  That comes down to one important ingredient: retinol.  This highly studied skin care ingredient has been proven to even skin tone, promote elasticity, build collagen, and renew skin cells, promoting the birth of new skin cells as well as protecting the ones that already exist.  It’s the most important skin care ingredient, apart from sunblock, no matter your age, complexion, or skin type.

Retinol is a natural form of the vitamin A that is found in yellow and green vegetables, egg yolks, and fish oils.  It’s the most abundant form of Vitamin A found in the skin.  We learned about the benefits of retinol in the 1970s, when researchers began using it to treat acne.  They noticed a side benefit to people who used Retin-A (a very strong prescription form of retinol).  Their skin began to look younger.  Retin-A seemed to reverse sun-induced aging in the following ways:

  • Decreasing fine lines and wrinkles
  • Improving collagen production
  • Enhancing elasticity
  • Improving skin tone and texture
  • Enhancing skin lightening and minimizing age spots

It was most effective on the people who needed the most help – on skin that already had suffered lots of premature aging due to sun exposure.  Retin-A is not available over the counter.  You need a prescription for it.  Over-the-counter retinol moisturizers, however, have also been shown to reduce wrinkles and other signs of aging – and without all the irritating side effects of prescription Retin-A.

To choose a moisturizer, follow these tips:

  • To avoid redness or irritation, start with the lowest retinol cream you can find, slowly working your way up to increasingly stronger creams.
  • Look for a retinol cream that is formulated for sensitive skin.
  • Buy a cream from a respected company to ensure stability and safety.  Respected companies include Johnson and Johnson, Neutrogena, and Roc.
  • Don’t step using retinol once your appearance improves.  You need to keep using retinol to maintain the results.

 

So there you have it – two interesting opinions about moisturizers.  My take on the issue is that you should find a moisturizer that is right for you and use it.  How your skin looks and feels and the climate that you live in will definitely influence which moisturizer is right for you.  Just as Dr. Graf explains it might take some trial and error to find the right moisturizer for you but once you do your skin will thank you.

 

My Related Posts:

 

*Yes, I know that I wrote above that your sunscreen lasts two to three hours and Dr. Graf says one hour.  Who’s right?  I don’t know.  What I do know is that you should reapply your sunscreen throughout the day.

 

Image from health.howstuffworks.com

 

Ingredient Spotlight: Witch Hazel October 28, 2012

Filed under: Ingredients — askanesthetician @ 7:00 am
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Allure places it in its ingredient hall of fame, Paula Begoun says to avoid using products that contain it.  So what who should you believe?  What does witch hazel do for your skin?

Let’s begin with some facts about witch hazel:  it’s a very commonly used cosmetic ingredient that comes from the bark and leaves of the hamamelis virginiana plant.  I learned the following from the book The New Ideal in Skin Health (pages 318-319):

Topically used to treat cutaneous inflammation, swelling, itching, injury, hemorrhoids, insect bites and stings, minor burns and irritations.  Active elements include bitters, essential oils, gallic acid, and tannins.

Types of Products:  Skin fresheners, astringents, local anesthetic, vein cosmeceuticals

Functions:  Anti-inflammatory, antimicrobial, antioxidant, astringent, elastin synthesis stimulant

Adverse Effects:  The alcohol content contained in witch hazel can be a skin irritant

Clinical Studies:

a.  One clinical study shows Witch Hazel to be less effective in reducing UV-induced erythema than 1% hydrocortisone.

b.  It was shown to reduce inflammation and pruritis in 36 atopic dermatitis patients.

Why does Allure love witch hazel so much?  In the Daily Beauty blog post entitled Ingredient Hall of Fame: Witch Hazel they explain

For centuries, witch hazel has been known for its soothing and cleansing properties, but right now, one of our Web editors is going completely nuts over the stuff. While searching for an alternative to her over-drying cleanser, she tried a witch hazel-infused one, and it did the trick, degreasing her skin, without drying or stripping it.

“Witch hazel is a natural astringent,” says Kenneth Beer, a cosmetic dermatologist in West Palm Beach. “It removes surface debris and oil, and has a long history of safety and efficacy.” Hmm. No wonder why it’s in tons of popular face cleansers, treatments, and atomizers.  …

Bottom line: Witch hazel is the Madonna of skincare ingredients—it takes many forms and has been around forever.

But before you rush out to buy some witch hazel keep a few things in mind.  My Consumer’s Dictionary of Cosmetic Ingredients has the following to say about witch hazel (I have the 6th edition of the book, page 546):

One of the most widely used cosmetic ingredients, it is a skin freshener, local anesthetic, and astringent made from the leaves and/or twigs of Hammamelis virginiana.  Collected in the autumn.  Witch hazel has an ethanol content of 70 to 80 percent and a tannin content of 2 to 9 percent.  Witch hazel water, which is what you buy at the store, contains 15 percent ethanol.

[So then the question really becomes – what does ethanol do to your skin?  Well that readers is a whole other debate that I really can’t get into here in this post (or would want to).  Cutting to the chase – ethanol is an alcohol and there are varying opinions about how alcohols (we aren’t talking about alcohol that you drink, by the way) impact the skin.  I would suggest reading the following blog posts from Future Derm for more information about ethanol and about alcohol in skincare products:  Why Alcohol in Skin Care is Safe, Despite What Paula Begoun Says and Is Ethanol in Skin Care Products Safe?)]

Just how is witch hazel transformed into an ingredient that can be used in cosmetic products.  The Beauty Brains explain in their post How Does Witch Hazel Work?:

In its natural form witch hazel is a shrub that can grow to be 10 feet tall, or more. It has oval leaves and slender petals. In autumn,  the plant is harvested by cutting the branches to the ground and chipping the wood and leaves into little bite size pieces. This mulch is then transferred to large stainless-steel vats where it is steam distilled for thirty-six hours. After “stewing” the extracted mixture is condensed and filtered and ethanol is added as a preservative. (Depending on the exact processing, the witch hazel may contain more or less tannins. The mixture of plant parts also controls the tannin content – bark contains 31 times more tannin than the leaves.) The resulting liquid is bottled and sold to drug stores as “witch hazel.”

Paula Begoun’s objections to products containing witch hazel rests on the fact that you don’t know what you are getting in your product and because of possible skin irritation.  She explains:

Commonly used plant extract that can have potent antioxidant properties (Sources: Phytotherapy Research, June 2002, pages 364–367; and Journal of Dermatological Science, July 1995, pages 25–34) and some anti-irritant properties (Source: Skin Pharmacology and Applied Skin Physiology, March-April 2002, pages 125–132). However, witch hazel’s high tannin content (and tannin is a potent antioxidant), can also be irritating when used repeatedly on skin because it constricts blood flow. The bark of the witch hazel plant has higher tannin content than the leaves. Steam distillation for producing witch hazel water removes the tannins, but the plant’s astringent qualities are what most believe give it benefit. Alcohol is added during the distillation process, the amount typically being 14–15%. Witch hazel water is distilled from all parts of the plant, so in that sense you never know what you’re getting, though the alcohol content remains (Source: http://www.naturaldatabase.com; http://www.drugs.com). Depending on the form of witch hazel, you’re either exposing skin to an irritating amount of alcohol (which causes free radical damage and collagen breakdown), tannins, or both. Moreover, witch hazel contains the fragrance chemical eugenol, which is another source of irritation.

Personally I remember drying my face out with the use of a witch hazel astringent when I was a teenager with acne.  Now I know that the added ingredients in the product caused my skin to feel dry and tight not the witch hazel itself.  As a stand alone ingredient witch hazel has many skincare benefits.  When buying a product containing witch hazel look to see what the witch hazel is mixed with to make sure that you are getting the real benefits of this ingredient and not suffering side effects from the other ingredients in the product.

Further Reading:

Besides for the articles mentioned above I also suggest reading:  Spotlight On:  Witch HazelFuture Derm

 

 

Image from http://theabsoluteglamour.com

 

Beauty Briefs: BB Creams Are Over, Here Come CC Creams September 10, 2012

I toyed with the idea a while ago about writing about BB creams but decided against it when I realized that I had nothing new to add to the discussion.  In case you need a recap, BB creams were first developed in Germany but caught on in popularity in South Korea.  These creams only started recently appearing in the US market, but it is easy to find one in all price ranges since they’ve become popular very quickly.

In theory I like the idea of BB creams since they are really souped up tinted moisturizers.  Not only are they meant to hydrate and provide some coverage (like a light foundation), but they also include added ingredients that can act as a make-up primer and are anti-aging or anti-acne.  They also include sun protection though my great fear remains that people think they are getting enough sun protection from a product like this.  Always use a separate stand alone sunscreen.  Please!

Though it is not labeled a BB cream the one I’ve tried is called Miracle Skin Transformer.  I consider it a BB cream since it is a multi-tasker – it is tinted, hydrates, has spf, and contains antioxidants as well.  I first discovered it when I received a free sample with a Sephora purchase, and I thought that it made my skin look amazing.  A few months later I bought a travel size at Sephora.  Interestingly enough now that I have the product at home I don’t quite like it as much as I did when I had the sample.  I can’t figure out what would have changed about the product and how it looks on my face, but something did change.  Not that it looks bad, simply my skin doesn’t look as fresh or dewy as it did when I applied the product from the sample.  Nonetheless I still think it is a good product.

Just as US consumers were getting used to the idea of BB creams, it turns out that they are on their way out.  Here come the CC creams.  Allure explains:

Still trying to wrap your head around BB creams? (Pssst, we’ll help you out. They’re souped-up moisturizers that cover like a sheer foundation and treat various skin-care concerns such as acne or wrinkles.) Well now there’s a whole new category of multitasking formulas: CC creams. Short for “color and care” or “color and correct”, CC creams are essentially BB creams on steroids.

They’re designed to offer more coverage than BB creams but still go on sheer, they moisturize better, and they contain hard-core anti-aging ingredients. Look out for the first CC cream to hit the U.S. this October: Olay Total Effects CC Tone Correcting Moisturizer.

Future Derm isn’t so excited about either BB or CC creams.  The post How is a CC Cream Different From a BB Cream? explains and highlights a few important points:

A CC cream is a color correcting cream, meaning that it is a brightening primer, foundation, moisturizer, SPF and anti-aging cream.

On the other hand, a BB cream is a non-brightening primer, foundation, moisturizer, SPF and anti-aging cream.

BB creams are typically laden with hydrators to create a dewy finish, which are not so great for acne-prone or oily skin.

CC creams, on the other hand, are typically oil-free.  …

Delivery systems matter.  Ingredients like propylene glycol, butylene glycol, and other alcohols, as well as advanced delivery systems like liposomes, are commonly used to increase the skin’s absorption of ingredients.

Unfortunately, BB and CC creams typically are designed to be make-up products.  Yes, you will get benefits.  But I’d take 10% vitamin C in a serum over 10% vitamin C in a BB or CC cream any day!

I love the idea of multi-tasking skincare and make-up products that help cut down on the amount of time you spend prepping in the morning.  I just think you have to very careful before you buy something.  Remember my warning about not relying on a BB cream, a CC cream, or your make-up for your sun protection.  Additionally, keep in mind what the Future Derm post said about delivery systems in products.  Just because a product includes fabulous sounding ingredients doesn’t mean that they are actually getting into your skin and providing you with any benefit.  If you have a BB cream that you like I see no reason to stop using it and I see no reason not to try a CC cream, but don’t expect miracles.  Sometimes the newest thing on the market just makes a scene only to disappear.  Tried and true products are always around.

Further Reading:

Image from glamour.com

 

Adult Acne: Causes and Treatments May 31, 2012

Filed under: Acne — askanesthetician @ 5:00 am
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There are few things that are more frustrating than acne.  Once we reach our late 20s we figure that we shouldn’t have acne any more but that isn’t true for many, many people.  Case in point Selma Hayek.  Hayek revealed in the May, 2012 issue of Lucky magazine that she suffered from terrible acne as an adult:

“My skin?! When I was 25 and I left being a soap opera star in Mexico to go try to be a movie star in Hollywood and all of Mexico was laughing at me? And I could barely get work as an extra? You want to talk about bad skin? I had acne. And this acne was so bad, it sent me into a severe, severe depression. Like I couldn’t leave the house. I’d wake up in the morning and lie there and touch my face before I got up, just to prepare myself to look in the mirror! “The next stage with that sort of depression is food: too little, or too much. Guess what I did? I mean, I was fat and broken out, I couldn’t leave the house and I couldn’t pay the rent!” A friend, she says, saved her: “Alfonso Cuarón—amazing director—he came to the house. He did not play it down, he did not try to say, Oh you look fine. He said you can’t do this to yourself and taught me to meditate, relax. I got myself back together!” She also went on Accutane. “I didn’t want to, but it cured it. Since then my skin’s forever sensitive and dry.”

Hayek certainly is not alone when it comes to suffering from acne as an adult.  According to The New York Times article When ‘Younger’ Skin Is Not A Blessing:

More adult women are getting pimples than ever before, according to a study presented in March at the American Academy of Dermatology annual meeting. Today, clinical acne afflicts the complexions of 45 percent of women ages 21 to 30, 26 percent of women ages 31 to 40, and 12 percent of women ages 41 to 50, according to the study, conducted by researchers at Massachusetts General Hospital.

What Causes Adult Acne?

Just as with teenage acne hormones play a major role in the formation of adult acne.  As the WebMD article Is Your Skin Hormonal? explains:

Just as you may see a little thinning in your hairline or the slight shadow of a moustache, more blackheads and blemishes are a sign of aging. “About a third of women will get adult acne, usually in their early 30s, even if they didn’t have breakouts when they were younger,” says Beverly Hills dermatologist Dr. Stuart Kaplan. “Starting in your late 20s, estrogen levels decline faster than testosterone.” Because testosterone is an androgenic hormone, it increases masculine qualities (hence the new facial hair) and boosts oil production, plugging your pores and causing blemishes. The difference between adult acne and the teenage type? Small red bumps (not painful, cystic pimples) are more common when you’re older, according to Kaplan, and acne along the jawline or around the mouth are a telltale sign that you’re dealing with a hormonal breakout.

 Furthermore, according to another WebMD article, Adult Acne: Why You Get It, How To Fight It, adult acne is caused by:

Adult acne is caused by sebum, an oily substance produced by the skin’s sebaceous glands. Sebum clogs pores, which attract bacteria and become inflamed. For some adults, breakouts are a result of hypersensitivity or overproduction of androgens (male hormones). But an imbalance in both male and female hormones (estrogen) can also cause breakouts. For women, this can happen during pregnancy, perimenopause, and menopause. Some medications, such as corticosteroids, and cosmetics can also contribute to the development of acne.

 There can be even more causes for adult acne which include:

  • Changes in humidity or weather
  • Cosmetics, skin products or hair products
  • Family heritage or hypersensitivity
  • High-sugar food & drinks that increase oil production which blocks pores
  • Hormones from dairy products, pregnancy or menstrual cycle
  • Certain medications, such as corticosteroids
  • Smoking
  • Stress, which can trigger cortisol that may result in pore-clogging oil

(Source: How To Get Rid of Acne: 6 Treatments You Haven’t Tried!Future Derm)

If I see a client who has tried everything to get rid of their acne I always ask them about their diet and suggest trying a low-dairy, low-glycemic diet.  For some people changing their diet is really what helps their acne.  I also truly do believe in a strong link between what is going on with our skin and our stress levels.  Though I know it can be very, very difficult finding a way to relax can be very helpful for your skin.  But let me emphasize again, as I have done in the past in this blog, that everyone is very different and what could trigger your acne could be something completely different than what triggers your best friend’s acne.  I love Chapter 3: Targeting Your Acne Triggers from the book Healing Adult Acne by Richard G. Fried, MD, PhD because it helps you really track and figure out what is happening with your skin so that you are no longer playing a guessing game about what is causing your acne.

Treatment Options 

First and foremost, I would never recommend reaching for the same anti-acne products that are marketed to teenagers in order to treat your adult acne.  For many adults milder anti-acne products work best.  Having said that the one prescription topical skincare product that is both anti-aging and anti-acne is Retin-A (or tretinoin, its generic name).  There are many different forms of Retin-A available so I suggest seeing a doctor for a run down of your best options if this is the way you want to treat your skin.  Doctors also have available to them in-office light and laser therapies that can effectively treat acne with little or no downtime.  Going to an esthetician for an evaluation of your skin can help you as well since estheticians can also recommend a good home care routine for you.  If your acne is really severe you may have to take medication, but this is a decision that you and your doctor can make together.

According to Bethanee Jean Schlosser, MD, PhD as quoted in Skin Inc.‘s article Hormonal Factors Key to Understanding Acne in Women here are some steps you can take to prevent and treat acne:

  • Schlosser advises patients to use noncomedogenic and sensitive skin products in order to reduce the formation of new acne lesions and to minimize skin irritation.
  • Mild cleansers should be used twice a day.
  • Avoid cleansers or other skin care products with scrubbing particles or a gritty texture, because they can irritate the skin.
  • Use a noncomedogenic moisturizer daily.
  • Apply the appropriate amount of topical acne medications (enough for a very thin layer, generally a pea-sized amount for the face) to the skin. Using more medication than is recommended will not produce better results, but may cause more irritation or dryness.
  • When starting treatment with topical retinoids, Schlosser advises that the therapy should initially be applied three times a week in order for the skin to get accustomed to it. Over time, the frequency of the medication should be gradually increased with the goal of using a topical retinoid every night.
  • Avoid picking, squeezing, popping, or otherwise manipulating acne lesions to minimize trauma to the skin and help reduce the risk of scarring and secondary bacterial infections.

“With acne, it’s important for patients to understand that there are no quick fixes, and none of the therapies used to treat acne work overnight,” said Schlosser. “Clients need to be consistent when using their acne medications and realize that they may not see the full effects of their treatment regimen for eight to 10 weeks—and in many cases, some type of maintenance therapy is required for long-term clearance of acne. ”

Bottom Line: Do not give up hope if you suffer from adult acne!  There are numerous treatment options available and lifestyle changes that you can make in order to control your breakouts.

Further Reading

If you have the time I recommend reading the articles I quoted from above.  Here are some more interesting articles about adult acne:

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Image from clearogen.com

 

 
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