If you think you’re alone in your struggle against adult acne, you may be surprised to learn that some 10 percent of Americans between ages 25 and 44 have the same problem. Most are women, though some men get acne, too.
While acne can be embarrassing, it’s seldom serious. The majority of cases respond well to self-care. Combining over-thecounter acne treatments with proven alternative remedies may be your ticket to clear, problem-free skin.
Acne begins in hair follicles that are connected to the sebaceous glands. These glands produce oil, or sebum, which helps keep the skin from drying out. Normally, the oil flows out of the hair follicles and travels through the pores to the surface of the skin. Along the way, it picks up dead skin cells that are constantly sloughing off inside the hair follicles.
This process is disrupted during puberty, when the body’s level of male sex hormones called androgens surges higher. Androgens enlarge the sebaceous glands, boosts oil production, makes the walls of hair follicles less flexible, and causes shedding skin cells to clump together. Combine these changes with the bacteria that live inside hair follicles, and conditions are ripe for plugs to form. These plugs, called comedones, block pores and lead to acne.
Once a plug forms, it may get pushed to the surface of the skin, where it protrudes slightly. This is what’s known as a blackhead. The dark color of a blackhead comes not from dirt but rather from skin pigment that gets mixed into the plug as it travels to the surface. Usually, a blackhead does not become a full-fledged pimple.
If a plug doesn’t move to the surface of the skin but instead continues to grow inside a hair follicle, it can rupture the follicle wall. Then the oil, dead skin cells, and bacteria that made up the plug spill into the tissue around the follicle, causing a minor infection. In response, infection-fighting white blood cells rush to the scene. Their battle against the invading bacteria produces a pimple.
Pimples take three basic forms: Pustules are the classic whiteheads. Papules are red bumps that remain bumps-they don’t turn into whiteheads. Nodules are cysts that form on the surface of the skin. These can cause scarring.
Pimples and blackheads seem to prefer facial skin, which has the most sebaceous glands. But they can also appear on the chest and back, where the skin has quite a few of those oil-producing glands, says Nicholas J. Lowe, M.D., clinical professor of dermatology at the University of California, Los Angeles, School of Medicine.
Some 85 percent of young people between ages 12 and 25 experience acne. Most outgrow the condition over time, as their bodies adjust to the higher levels of androgens. But if your acne has lingered well into adulthood, it doesn’t mean that you have even more androgens than everyone else. Rather, you may be extrasensitive to these hormones.
There’s also the possibility that some other factor is putting you at risk. In women, the hormonal fluctuations that occur during the menstrual cycle and pregnancy can trigger breakouts. So can taking oral contraceptives or postmenopausal hormone-replacement therapy. Other contributing factors include stress, sunlight, cosmetics, and some medications. Facial irritation can also be a problem-for instance, from holding the phone next to your face all day.
No matter what the cause of acne, the treatment remains pretty much the same. Mainstream medicine offers an array of overthe-counter and prescription medicines that do a good job of clearing skin quickly. But if you want to enhance the effectiveness of whatever medication you’re using, or if you’ve tried a number of medications without success, consider adding a blend of natural and alternative remedies to your skin-care regimen.
Best Choices
Nutrition
Partake of more fiber. Several population studies suggest that eating more fiber and less meat and processed foods can help keep your complexion clear.
There’s no guarantee that eating more fiber will improve your complexion. But you have plenty of other health reasons to increase your fiber intake. So start replacing animal-derived and processed foods with plenty of whole grains, legumes, fruits, and vegetables. If this dietary change also helps control acne, so much the better.
Keep an eye on iodine. Large doses of iodine can aggravate acne, according to Joseph PizzornoJr., N.D. We Americans get most of our iodine from iodized salt. Cutting back on salt-laden foods-especially snack foods like potato chips, crackers, and pretzels-may help control breakouts. Other high-iodine foods include beef liver, turkey, asparagus, broccoli, and white onions.
Supplements
Zap breakouts with zinc. About a dozen studies have analyzed zinc supplementation as an acne treatment. Most suggest that zinc has significant benefit. In one study, people who took 135 milligrams of zinc every day for 12 weeks saw 85 percent of their blemishes disappear.
Zinc works by reducing blood levels of the male sex hormone dihydrotestosterone (DH1). DHT is believed to trigger even more breakouts than other androgens. Dr. Pizzorno suggests taking 50 milligrams of zinc a day until your blemishes clear up. But check with your doctor first since zinc dosages over 30 milligrams should only be taken under medical supervision.
Herbal Medicine
Become acne-free with tea tree. When the British explorer James Cook first arrived in Australia in 1777, he found the native aborigines treating skin infections with the crushed leaves of the tea tree. As modern science has discovered, the oil released by crushing tea tree leaves is a powerful antiseptic that can help battle acne.
Tea tree oil is available in most health food stores and some drugstores. Read labels and choose a product that contains 100 percent pure oil, advises Andrew T. Weil, M.D., director of the program in integrative medicine at the University of Arizona College of Medicine in Tucson.
Tea tree oil is intended for topical use only. It should never be ingested. And if it irritates your skin, stop using it.