There are few things as dispiriting as dealing with spots when you are also on high alert for crow’s feet and dehydrated skin. Yes, just when you thought you’d left acne behind when you exited your hormonal teenage years, it makes an unwelcome reappearance. While much work has been done in the important space of “acne positivity” – that is those who, especially on social media, normalise and even celebrate the skin imperfections most of us will deal with (some 85 per cent of adults will experience acne) – clear skin is still seen by many as the ultimate prize. What’s more, with more of us wearing face masks and coverings thanks to a global pandemic, there’s a whole new category of acne to deal with: maskne . But what is adult acne? View this post on Instagram Simple everyday makeup #acne #acnepositivity #acnefightersquad #acnecommunity #acnejourney #acneprone #acnemakeup #skin #skintexturetuesday #skinpositive #skinpositivitysquad #iamnotmyskin #skinspiration #yourskinstory #skinjourney #makeup #makeuplover A post shared by Vanessa | Skin Positivity (@tomatofacebeauty) on Aug 17, 2020 at 12:29pm PDT Post-adolescent acne is something some women will experience into their fifties, says Dr Shyamalar Gunatheesan, a dermatologist based in Melbourne, Australia. There are a lot of myths about acne – that people “grow out of it”, that it’s caused by dirt, and that there is just one approach to fixing it. What retinoids do, and why the anti-ageing star has a dark side Genetics, hormones, diet, stress, pregnancy and the environment are all factors in the development of adult acne. It starts as a blockage of the hair follicle opening – or pore – because of the body’s overproduction of sebum, or oil. This causes abnormal cell turnover in the hair follicle and overgrowth of skin bacteria, which results in an inflammatory cascade of pimples and cysts. Gunatheesan says adult acne in women can also be a sign of underlying hormone-related conditions such as polycystic ovary syndrome (other important signs of these include hair loss, weight gain and irregular periods). Let’s start with what not to do. “One of the worst things you can do when experiencing adult acne is to over wash your face and use harsh physical exfoliants, as these will further impair your skin barrier and can induce oversecretion of sebum, compounding the problem,” Gunatheesan says. She advises seeking early intervention from a dermatologist to minimise scarring. There are plenty of ways to deal with acne. Lucy Shaw, skincare education manager at beauty company Mecca Brands, says it’s important to look for products and ingredients that don’t strip the skin and dry it out, which will increase skin stress and inflammation. She’s a fan of bakuchiol , a plant exact that behaves similarly to retinol , a vitamin A derivative that renews skin cells, causes scarring to fade, and speeds up the healing of a blemish. For those who can tolerate it, she says retinol “is a fantastic go-to ingredient and will also firm, tighten lift skin at the same time”, making it ideal for people who are battling signs of ageing at the same time. “I would suggest finding a serum or oil with these ingredients, such as Verso Super Facial Serum, which has Retinol8 complex, or Omorovicza Miracle Facial Oil, which features hero ingredient bakuchiol. By using a serum or oil, you can easily add them into an existing routine,” says Shaw. “I would also suggest using something anti-inflammatory to calm and ease stress. Niacinamide [vitamin B3] is my go-to ingredient because it also brightens and hydrates. You can find it in Drunk Elephant F-Balm and Apot.Care B3 Pure Serum.” Other ingredients good for targeting acne include mandelic acid and salicylic acid (a beta hydroxy acid, BHA, that works to dissolve dead skin cells and decongest the skin’s surface). Lactic acid serums and peels can also help decongest pores and recalibrate the skin’s pH level. Shaw is also a fan of using a weekly or daily peel to brighten and smooth your complexion, such as the Dr Dennis Gross Resurfacing Liquid Peel. Other new technologies Shaw recommends incorporating include LED light treatments (in salon and at home): blue light kills acne-causing bacteria, and red light reduces inflammation and promotes healing. She also advises treating acne holistically. “Take an anti-inflammatory, anti-stress approach, including your diet and lifestyle, and be careful not to overstimulate or irritate the skin; think careful cleansing strokes, light pressure and avoid picking at the area,” she says. The increased use of face masks has contributed to the rising incidence of acne, particularly among health care staff and other front-line workers. Elizabeth Fardon, global education director at skincare brand Ultraceuticals, says this is down to moist air staying trapped on the skin and causing friction with the face mask, leading to irritation. This can mean the skin may become more heated and sweaty, leading to oil and normal skin debris lingering on the skin and creating congestion. Fardon recommends using a cotton mask over a synthetic one, as it may allow skin to breathe more, and to change them frequently so oil, sweat and skin debris don’t collect. Fardon says it’s important to stick to an effective skincare regimen. “Make sure you are washing your face twice a day with a gentle cleansing product – look for coconut-derived surfactants like cocamidopropyl betaine and sodium lauroyl sarcosinate, and apply a light hydrating serum followed by a light moisturiser that contains ingredients that mimic the skin’s barrier – like ceramides, cholesterol, sodium hyaluronate and essential fatty acids. “Use a spot treatment [try Ultraceuticals Ultra Clear Spot Treatment] with salicylic acid and anti-inflammatories with a cotton tip on any breakouts two, three times a day,” she says. Two new products to try Dennis Gross DRx Blemish Solutions Breakout Clearing Gel. The star ingredient is monk pepper, a new ingredient in acne treatment that regulates oil chemistry. Gross says: “It works by blocking testosterone and androgen – the hormones that throw off your oil production, causing breakouts – from binding to oil glands. This ingredient is key to treating adult acne caused by hormonal changes.” Avène Cleanance Comedomed is specifically designed for oily, acne-prone skin. A moisturising anti-blemish concentrate, it works on the visible and invisible stages of acne by moisturising and regulating excess sebum. Its hero plant-based active ingredient is made from milk thistle oil, which works to reduce blemishes and blackheads and restore the balance of the skin.