Adult acne is the most common skincare complaint in post teens and can affect women right past the menopause. GTG Editor Susannah Taylor speaks to dermatologist Dr Sam Bunting about how to manage, prevent and cure the condition
ST More and more women are coming to you to be treated for adult acne. Why do you think this is?
SB I think perhaps it's because we are more demanding then ever of the way we look but also women are also coming off the Pill and hormone fluctuations can mean dramatic changes in the skin. We also have increasingly busy lives which means that we are pushed to our breakout limits. I see an increasing number of high-powered women for this reason.
ST What do you see as major causes for adult acne at the moment?
SB A lot of people's skin doesn’t agree with oily hot cloth cleansers, but I also think that long-wear foundations haven’t done anything for our skin. Some foundations can cause bumpiness under the skin. This gets worse when clients decide that they need to clean their skin really aggressively and can result in a horrible spiral of covering up in the day and scrubbing the skin at night which aggravates the problem.
ST So do you think a gentler skincare approach is needed?
SB Most definitely, I’m not into bells and whistles. The importance of a basic support wardrobe of products cannot be underestimated. Harsh foaming cleansers can take away the skin's natural oils and damage the moisture barrier, which can cause skin to flare up. Studies show that on acne, those who use a gentle cleanser had a much better result.
ST Which cleansing products would you recommend to anyone prone to breakouts?
SB To buy over the counter I recommend Cetaphil ( www.cetaphil.co.uk ), La Roche Posay ( www.laroche-posay.co.uk ) and Avène ( www.avene.co.uk ). I see a lot of people whose skin breaks out and they panic and go for harsh, abrasive products which can be counterproductive.
ST Which moisturisers would you recommend?
SB Even acne-prone skin requires a moisturiser, but it is absolutely essential to find the right one and the simpler the better. You need one that you can use comfortably without making matters worse. The key is to find products that are non-comedogenic, which means that they have been tested to ensure they do not clog pores. My favourites are La Roche Posay Effaclar H Compensating Moisturiser ( http://tinyurl.com/cuuldq9 ) and Cetaphil Moisturising Lotion ( http://tinyurl.com/7jd9eny ).
ST There are now so many layers to skincare regimes: cleansers, toners, serums and moisturisers. Are we using too much?
SB Overloading skin can be a huge problem. I see women who use a bit of this and a bit of that and there is no cohesion behind product selection. It’s important to remember that each element to your skincare regime should do something useful. Toner is fairly redundant unless it deposits something effective, and your moisturiser should replenish what the cleanser has taken away.
ST Are there changes that we can make to our diet to prevent breakouts?
SB Dairy products have been proven to inflame skin, as have high GI foods. Slow release carbs keep your insulin levels more stable, which is helpful in inflammatory skin conditions.
ST If over-the-counter products don’t work, what will you use on clients' skin?
SB Retinoids are really the mainstay of reducing and preventing acne, as they treat the cause which is the tendency for dead skin cells to clump and clog the pores. Adult acne needs an individualised approach as it can be very stubborn. For some people, the only thing that works may be something like acne drug Roaccutane , though this is by no means for everyone, due to its side effects. It tackles every aspect of the acne pathway: stops the comedones forming (the blocked pores), reduces the consistency of the oil in the pores (thick, sticky oil can lead to spots), and it reduces the colonisation of bacteria and reduces inflammation.
ST How do you feel about using "natural" products?
SB I’m not in favour of natural trends. People assume that "natural" equals safe and that is not necessarily correct. I prefer ingredients which have been thoroughly tested to ensure that they are both efficacious and safe. Many natural oils can be clogging or irritating and often they just don’t do anything to help the skin. Coconut oil is a disaster, as is putting cocoa butter on your face. Bio Oil is not natural but is something that people often turn to when they have skin problems, but there’s nothing specific in it which helps with acne.
ST I understand that skin turnover slows in our late twenties and thirties and can cause skin to clog, is that correct?
SB Yes that is true, and you need to keep your fibroblasts, the skin "youth factory" going. Retinoids are important, as is Vitamin C, AHAs and possibly peptides. It's what you do on a daily basis that counts, not having an in-office treatment such as microdermabrasion or blue light treatment once a month.
ST Which brands do you use in your practice?
SB Skinceuticals ( www.skinceuticals.co.uk ) and Medik8 ( www.medik8.co.uk ) do great retinol products. Vitamin C can be expensive, but Skinceuticals is good for that as is Obagi ( www.obagi.com ) and Neostrata ( www.neostrata.com ) for AHAs. (Please note all of these products should be administered by a professional)
ST Which foundations would you recommend that don't clog the pores?
SB I’m a huge fan of Dermablend by Vichy, the foundation stick is amazing. I also tell clients to avoid powder as much as possible – if you think how tiny those finely milled particles are, how do they not fill up your pores?
Dr Sam Bunting is available for appointments at 10 Harley Street, London W1 Tel: 020 74678493, email: firstname.lastname@example.org