Don”t be so glum, Posh… you CAN beat acne
| UPDATED:21:07 GMT, 31 March 2012
Victoria Beckham has suffered with acne
It is often dismissed as a phase linked with ‘hormones’ or something in the diet. But skin experts believe that no one should have to suffer the indignity and pain of acne.
The condition, commonly associated with teenagers, is on the rise among adults, with 12 per cent of women and three per cent of men over 25 suffering from the skin disease.
Famous grown-up sufferers include Victoria Beckham, 37, Cameron Diaz, 39, and Katy Perry, 27, and stressful lifestyles are partly to blame.
‘Acne can cause serious psychological problems, including anxiety and depression,’ says dermatologist Dr Tapan Patel, of the Acne Clinic UK.
In 2010, Gloucestershire student Melissa Martin-Hughes, 18, hanged herself after suffering severe acne on her face and upper body from the age of 14. Many clinical studies show links between acne and clinical depression.
‘Similar to any medical condition, the sooner acne is treated, the easier it is to cure,’ says Dr Patel. ‘There are many effective treatments, some over-the-counter, others from a GP or dermatologist.’
Here, some of the country’s leading skin experts give their step-by-step guide to beating acne, whatever your age.
THE DIET MYTH
Acne typically occurs on the face, neck, chest and back. As well as blackheads, whiteheads and pustules, in severe cases painful nodules and cysts can occur, and it may cause scarring.
‘The idea that chocolate, sugar or greasy food can cause spots is nonsense,’ says consultant dermatologist Dr Tim Clayton at Salford Royal Hospital in Manchester. ‘Acne is caused when male sex hormones such as testosterone, present in men and women, trigger the production of excess oil in the sebaceous glands of the skin.’
The bacteria Propionibacterium acnes (P. acnes) lives on most people’s skin and is generally harmless. But when hair follicles become blocked with sebum and an overgrowth of skin cells, the P. acnes grows in the pore and causes spots, swellings and inflammation.
Stress can spark the hormonal imbalances that cause acne. Clinical studies have proved it can induce flare-ups.
‘When you’re stressed, the adrenal glands secrete more of the male hormones that stimulate oil production,’ says Dr Clayton. ‘Stress can play havoc with the immune system, which means there’s a reduced natural defence to the effects of the P. acnes bacteria, resulting in more inflammation.’
Mrs Beckham, who is thought to have polycystic ovarian syndrome, during one of her outbreaks
Acne caused by stress can be more difficult to get rid of. Stress has been shown to lower the body’s wound-healing capacity by up to 40 per cent.
CONSIDER THE PILL
Dr Tamara Griffiths, of the British Skin Foundation, says: ‘Combined oral contraceptive pills such as Dianette, or mild anti-androgen drugs such as Spironolactone may be beneficial for some women. They prevent testosterone from stimulating the sebaceous glands.’
Studies have shown that Dianette can be as effective as a long course of antibiotics, even when used on its own.
Some cases of acne in women can be caused by polycystic ovarian syndrome (Victoria Beckham is a sufferer) and in these cases the above medicines can also be effective.
Dr Clayton adds: ‘Use oil-free or “non-comedogenic” skincare products and make-up which won’t block pores. Oil-based products will worsen acne and stopping them is often enough to cure mild cases.’
WHAT ABOUT THE NATURAL OPTIONS
New research published last week suggests that the herb thyme may be effective in treating acne but experts are cautious. ‘It’s promising news, but clinical trials need to be done before people start using it,’ says Dr Patel. There are other natural options, though. A clinical study comparing tea tree oil to benzoyl peroxide on mild to moderate acne concluded that it was effective in reducing lesions.
Although it worked more slowly than the chemical, there were fewer side effects. Even so, Dr Patel recommends taking medical advice if you suffer more than the occasional spot.
‘Otherwise, I’m unaware of clinical evidence for any natural remedies such as witch hazel or vinegar, although they may have positive effects on some people. The treatments doctors are recommending are safe and effective and are manufactured to pharmaceutical grade, unlike natural solutions.’
ANSWERS ON A CHEMIST’S SHELF
If you suffer occasionally, try a face wash or cleanser containing salicylic acid – from willow bark. ‘It removes the top layer of cells and helps dislodge blockages in the pores,’ says Dr Patel. ‘But it has no effect on oil production, cannot kill P. acnes and must be used continuously to keep the pores from clogging.’
Consultant dermatologist Dr Edward Seaton, at London’s Royal Free Hospital, suggests products containing benzoyl peroxide can be highly effective for mild to moderate acne. ‘It introduces oxygen into the pore which kills P. acnes. When the bacteria population is reduced, the number of breakouts is, too. It needs to be used only at low strengths such as 2.5 per cent to work. Higher strengths can be more irritating to the skin.’
Melissa Martin-Hughes hanged herself in a park after suffering with depression because of severe acne
RUB ON VITAMIN A
‘Retinoid medicines, available on prescription only, are derivatives of Vitamin A and highly effective in treating acne,’ says Dr Patel.
‘They speed up cell turnover rates, rapidly exfoliating the skin and decreasing the build-up of dead cells within the follicle, reducing the formation of blockages.’
Dr Seaton says: ‘Retinoids work by stopping spots from forming in the first place. These creams can produce an improvement after four weeks.’
SHINE A BLUE LIGHT
Therapies such as hyfrecation (treating the spots with a small electric pulse), laser and light therapy can also help.
‘P. acnes bacteria produce chemicals called porphyrins which, when blue light is applied at a certain wavelength, become active and destroy the bacteria,’ says Dr Patel.
‘Blue light therapies, offered through dermatologists, can be expensive. But in recent trials of a new at-home device called Lustre Pure Light, there was an improvement in those with mild to moderate acne.’
Dr Seaton says: ‘Light therapy may be helpful but only alongside more mainstream, proven treatments.’
OLD DRUGS STILL WORK
A rapid increase of antibiotic resistance in the P. acnes bacteria has caused some experts to call for a greater focus on alternative treatments. But Dr Seaton says: ‘Antibiotics, such as tetracycline, erythromycin, lymecycline and trimethoprim, in tablet form, still have a role to play. They need to be prescribed for three months to give them the chance to work. Antibiotics such as clindamycin are available as a solution, lotion or gel.’
DON’T FEAR THE STRONG STUFF
These tablets contain the retinoid isotretinoin and is very effective in treating severe, persistent cases.
‘Patients are often nervous about taking it as there can be side effects,’ says Dr Seaton.
‘It speeds up skin cell renewal but can lead to very dry lips. One in ten get headaches, or achy joints. We believe it may also affect chemicals in the brain, and depression is a rare complication. But 90 per cent of patients feel much better about themselves as their skin improves.’
If dryness is a problem, Dr Patel recommends a non-greasy moisturiser such as Cetaphil.