#AskID : Prof Ryan on breakouts in late twenties

According to Prof Ryan, up to 80% of the population experience acne at some stage in their life. Acne is a multifactorial condition, with a complex interplay between genetics (your family history), hormonal influences, and other environmental factors.  

Oil glands become oversensitive to hormones, which causes an increase in oil secretion. Follicular openings (pores) become blocked with a higher turnover of dead skin cells, which combined with this excessive oil production causes blackhead formation. The normal bacteria that colonise our skin then multiply and cause inflammatory acne lesions. It is relatively common for patients to have adult acne – up to 20% of men and 30% of women experience acne as an adult. This can occur in patients who never had acne as a teenager and is typically hormonally driven. In women, adult hormonal acne tends to flare premenstrually and more commonly affects the lower third of the face, chin, jawline and neck.
▫️Using a balancing acid-based mask such as Biologique Recherche Masque Vivant 2-3 times a week can help reduce breakouts while improving skin texture.
▫️Patients with mild acne can treat their acne with over the counter preparations containing salicylic acid or benzyl peroxide.
▫️Never pick, squeeze or ‘’pop’’ spots as this may cause deeper dermal scarring.
▫️Opt for gentle cleansers and chemical exfoliators as harsh or abrasive products can aggravate or inflame acne.
▫️Avoid using complex skin regimens which involve layering of serums, creams and moisturisres.
▫️At night it is important to double cleanse to remove oil, dirt, pollutants, makeup and SPF residue.
▫️Using a small amount of retinoid (retinol or tretinoin) at night reduces blackhead activity and inflammatory acne lesions.

When facing breakouts, it is important to know what is manageable with regular skincare, and when to seek medical advice. One of the most frustrating problems I encounter in clinic is patients struggling with adult hormonal acne or rosacea who have spent thousands of euros on complex skin care regimens and treatments at cosmetic clinics when they just needed simple medical treatment.
For those with grumbling adult acne they may be collecting further scars while they waste time and money. If you have cystic acne or persistent acne not responding to over the counter acne preparations, visit your GP or a Consultant Dermatologist for expert advice.