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Adult acne: causes, treatments and advice

What is acne?

Up to 85 per cent of us suffer from acne between the ages of 12 and 25. Acne Vulgaris is the most common form, appearing in a variety of undesirable guises including blackheads, whiteheads, papules, pustules, nodules and cysts.

According to Cosmetic Dermatologist Dr Sam Bunting, acne can be classified in the following ways and in addition to the face, can also be found on the chest and back too:

  • Inflamed spots. These can be in the form of red bumps (papules), red bumps with white heads (pustules) or nodules (larger, more deep-seated bumps);
  • Non-inflamed lesions called comedones. These signify clogged pores and can be open (blackheads) or closed, in which case they are skin-coloured. Cysts would fall within this category;
  • Secondary lesions. These occur as a consequence of the acne process, whether due to human interference (excoriations or picking!), post-inflammatory hyperpigmentation (which causes flat red marks in fair skin and brown marks in darker skin) or scarring.

“In real life, these scenarios may often be present in one patient – hence the need for a rational treatment regime but also a thorough skincare and make-up MOT," explains Dr Bunting.

What causes acne?

The exact cause is still unknown. It has been suggested that acne may be caused if your body experiences an increase in testosterone, which, in turn, causes the sebaceous glands to become inflamed, leading to greater skin cell and sebum production. These two processes allow the bacteria to thrive potentially leading to acne.

Dr Bunting has found the following to be common causes for the condition in her clients:

  • Clogging skincare and cosmetics (called acne cosmetica). These can include the use of oily hot cleansers and long-wear foundations;
  • Excessive washing and use of facial irritants such as certain botanicals, which may irritate and clog the hair follicle (called acne detergicans);
  • Increasingly busy lifestyles which mean we are pushed to our breakout limits;
  • Women coming off the Pill and subsequent hormone fluctuations causing dramatic changes to the skin;
  • Diet.

How to get rid of it

In severe cases your GP can prescribe antibiotics or the Pill to clear things up. But with various side-effects neither are desirable long-term if you're taking them purely for acne, so Shabir Daya, co-founder of, believes in treating it with natural supplements. “Acne arises from within the body so it makes sense to treat the problems within the body. Although science tells us that diet has no correlation to acne, I believe that because gluten intolerance is widespread it can make a difference, so it makes sense to try to avoid gluten for a couple of months and see if your acne improves. Changing your lifestyle and diet will have a major impact on your skin."

Though lifestyle is key, Dr Bunting takes a medical approach to the skin. “The medical approach rests on tackling the different parts of the acne process with prescription ingredients in combination – this is key.

“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. Acutely inflamed spots need anti-inflammatory agents like benzoyl peroxide, salicylic acid or antibiotics. Depending on disease severity and site, oral therapy may also be commenced.

“Many women will benefit from therapies that work on the hormonal drive to breakout, but for some people, the only thing that works may be something like 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.

“Finally for those who are unable to tolerate the medicated approach, light-based therapies like red and blue light may offer an alternative approach.”

Find out more about Roaccutane drugs and side effects here.

Products to try

Antiac Acne Cleansing Spray (£9.99 for 50ml, was voted the best acne product by a panel of testers on Channel 4's Embarrassing Bodies. Packed with natural anti-blemish properties such as tea-tree, sandalwood, manuka and nerolina oils to kill bacteria and aloe and sea buckthorn to reduce inflammation, it provides a natural and effective solution for problem skin.

Bliss No Zit Sherlock Complete Clarifying System, £25, is a fast-acting daily regimen for pimple-prone skin that helps to treat and repair acne blemishes. Including a cleanser/toner, correcting serum and oil control moisturiser, it uses salicylic acid to break up dead skin cells and oil and natural probiotics to boost the skin's antibacterial defences.

iS Clinical Active Serum, £59 for 15ml,, is designed to improve overall skin quality. You'll feel an "active" tingling sensation as the formula absorbs deep within the dermal layers.

Pro-Heal Serum Advanced+, £108 for 30ml,, is particularly good for cystic acne, offering antioxidant protection and healing properties. The science part is something to do with L ascorbic acid (scientifically advanced Vitamin C), olive leaf extract, and pure vitamin E and A. Whatever. It definitely reduces inflammation.

Read more about adult acne

The top 10 products for acne-prone skin

5 things you need to know about hormonal acne

The adult acne diary: 6 months to clearer skin

All you need to know about back acne

Everything you need to know about Roaccutane and acne

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