This time of year can present a challenge for teenage skins. This is when I get a lot of requests for skincare advice, as the exam season, combined with prolonged periods of revision, worry over choices about future education and fluctuating hormone levels combine to result in some young people suffering from spots, psoriasis or eczema as the resultant stress takes its toll. Today I am going to look at breakouts and acne.
Spots and acne may have a number of contributing factors, but like eczema and psoriasis, they are the result of inflammation. The causes of inflammation can be numerous. Hormones, stress, diet, sleep deprivation, oxidative stress, an unhealthy gut and/or poor skincare regimes may all play their part.
Before going any further, it is always wise to remember that the oil (sebum) on our skin serves a purpose. It is there to lubricate the skin, and to mix with the dead skin cells on the surface of the skin to form a protective layer called the acid mantle. This barrier protects the sensitive lower layers of the skin from pollution, UV damage and external irritants, so whilst we may wish to reduce the amount of sebum on the surface of the skin, in order to prevent blemishes, we do not wish to remove it entirely.
Not all spots are acne, but according to The British Skin Foundation acne affects around 80% of adolescents between 13 and 18 years at some point. This may be because during puberty, the hormones that promote a teenagers natural development will also increase the production of the sebum producing hormone called testosterone, in both boys and girls. At the same time, puberty in itself can often be stressful – as can exams and social pressures. This stress results in the increased production of Cortisol – which also increases sebum production, and this combination of puberty and stress may result in the skin becoming inflamed and the onset of spots and or acne may follow.
There are a lot of myths about acne. It is not caused by a lack of cleanliness or hygiene or by chocolate! The most common contributor is fluctuating hormones. Hormonal imbalances cause the sebum in the skin to become thicker which in turn makes it more likely that the sebaceous glands will become blocked, causing pimples and spots to appear. These only become acne when a perfectly normal bacteria called p.acnes, which lives on our skin, finds its way down into the sebum in the blocked follicle below the skins surface, becoming trapped and causing inflammation, and then acne may result. In an age where appearances are so important to the young, the adverse effects constant outbreaks of spots, papules and pustules on a young persons sense of wellbeing and their self esteem, should not be underestimated. Telling them to stop worrying about them and that they will eventually go away may well be true, but will not help them feel any better about themselves, and is rarely helpful. Try initially to resolve the breakouts using over the counter products, but always get advice from your GP if the skin has enlarged inflamed painful pustules or papules.
Eating chips and chocolate will not in itself cause acne! However a poor diet, high in sugars ,is increasingly being linked to this condition. One study suggests that those who frequently eat added sugars have a 30% higher chance of developing acne, because a rapid intake of sugar causes an increase in the insulin levels in the body. Insulin also makes our androgen hormones more active, which stimulates the increased production of skin cells and further boosts sebum production, further aggravating the condition. So cutting back on sugary treats, fizzy drinks, ice creams, saturated fats and refined carbohydrates, can only be considered sensible for those suffering with a problem skin. Try adding plenty of anti oxidant brightly coloured fruit and veg into your diet to reduce oxidative stress! Your skin will thank you!
Talking of food intake…. Increasingly our skin health has been linked to our gut health or “Gut Biome”. Some studies suggest that people who suffer from acne are more likely to have a poor gut biome. Taking a skin specific pre biotic skin supplement containing carefully selected strains of good bacteria may help both the the skin in particular, and the gut in general. Increasing your intake of pro biotic foods (bananas, vegetables, legumes and flax seeds) has also been recommended by some studies.
Sleep deprivation weakens our immune system. Getting a good nights sleep isn’t always possible, but aim to get into a good sleep routine, and keep away from blue light emitting devices (sadly that includes the beloved mobile phones and Xboxes!) for at least an hour before bedtime.
Skincare advice for spots and acne is always a tricky one. Most people instinctively head for oil dissolving water based cleansers and scrubs to eradicate the oil on their skins. Consider however what happens when you pour oil on water… they just don’t mix! The best way to remove sticky residues is with an oil based product. Furthermore, totally stripping our skin of its oil will just encourage it to make more to replace it, so when looking for a cleanser, look for a cream or oil based one which will break down the excess surface oils on the skin, without stripping it completely. These products can usually be emulsified with water after massaging into the skin to remove dirt and makeup, and always cleanse twice if wearing makeup. Cleansers containing Salicylic acid which has an exfoliating effect, can be helpful as long as the skin is not sensitive.
An old fashioned but very effective effective skin toner can be made of half and half cooled boiled water and Organic Cider Vinegar (check that the bottle says it includes “the mother”- that is very important!) – use it at night after cleansing- effective but sadly not the most attractive smell!
Facial Scrubs- especially gritty ones, are not usually helpful in my experience as they further disrupt the protective acid mantle which is there to protect our skin from external aggressors. I would suggest looking for an oil based moisturiser containing vitamin A which helps to normalise the skins oil and moisture levels, and is essential to skin health. Clay masks can be helpful too as they absorb excess oils.
I am often told by people that their skin looks better after a holiday in the sun, and that UV exposure appears to get rid of their spots…but sadly this will only be temporary. Afterwards your skin sebum levels will surge again in response to the inevitable rapid increase in cellular turnover as a result of UV exposure, as your skin tries to protect itself! When you go on holiday you need a sunscreen. Try a powder based mineral sunscreen, many contain zinc oxide which has anti inflammatory as well having healing properties and will not leave the skin feeling greasy.
Finally, Don’t squeeze! You may be tempted to squish that yellow headed spot out, but in doing so you will spread the infected sebum around under the skin into new follicles, causing a whole stack of new ones to appear!
As ever, please do feel free to contact me if you have questions.