The grown-up guide to building a skincare routine with adult acne
Adult acne doesn't discriminate. It can affect any of us and there are various causes behind it – from genetics and hormones to stress. While spotty skin is often viewed as a 'teenage' problem, it is very common for the issue to continue into, or even start in, adulthood. My own experience began at 17 and did not clear until I sought professional help at 30 – and I'm not alone.
"According to studies, nearly 50 per cent of women between the ages of 20-40 experience adult acne," says Alice Henshaw, advanced nurse practitioner and founder of Skincycles and Harley Street Injectables. "What’s alarming is the emotional toll adult acne can take, often impacting confidence and self-esteem."
Do you have adult acne?
"Blemish-prone skin and adult acne may appear similar, but they differ in severity and persistence" says the aesthetic expert Dr Tatiana Mandavia. "Blemish-prone skin tends to feature occasional pimples, blackheads and whiteheads, often triggered by diet, stress or hormonal fluctuations. It’s less chronic and localised."
Adult acne, which is defined as acne affecting those over 25, is much more persistent. "It often manifests as cystic breakouts, painful nodules or pustules, especially around the jawline, chin and lower face. It can appear on the neck, chest and back as well," shares Dr Mandavia.
If your breakouts are severe, painful and consistent, there's a high chance you're experiencing adult acne.
It's a myth that adult acne only affects those with very oily skin. "In reality, people with all skin types – dry, combination, or sensitive – can experience acne," says the consultant dermatologist Dr Derrick Phillips.
"Another misconception is that washing your face more frequently will cure acne," he adds. "Over-washing, especially with harsh ingredients, can strip the skin of its natural oils, leading to increased oil production, which can trigger breakouts rather than preventing them."
For persistent adult acne, it's worth booking in with a consultant dermatologist to identify the root causes. There are plenty of in-clinic solutions to help clear things up (although it must be said that acne cannot be completely 'cured', only managed).
At-home, a solid skincare routine can support your skin health. Here's how to approach it.
Do you really need a specific skincare routine for acne?
In short, yes, as some ingredients and formulas can worsen the condition. The right routine will address inflammation, control sebum production, restore good bacteria and clarify clogged pores. "A tailored approach, with the use of targeted products means that we can treat existing blemishes, prevent new ones, and minimise skin irritation or damage," says Holly Mason, the founder and CEO of The Skin Investment Clinic, which has branches in Hampshire, Wiltshire, Surrey and Harley Street, London.
The morning routine will generally focus on protection, says Mason. This includes taking down inflammation and redness while shielding it from the sun and environmental aggressors.
"Evening routines typically target treatment; cleansing, exfoliating and using actives like retinol or salicylic acid to treat acne," shares Mason, although she caveats that no two complexions are the same and it's worth considering your specific skin type, any sensitivity, and whether you might be pregnant.
A good rule of thumb is to always start with gentler formulas that contain both active ingredients and barrier-builders such as ceramides to treat your complexion with velvet gloves.
The essential morning routine for acne
Here's how to approach your day and night regime according to Dr Phillips:
Start with a gentle, non-comedogenic cleanser to remove impurities without irritating the skin.
Follow with a serum containing salicylic acid or niacinamide to reduce inflammation and unclog the pores.
Apply a lightweight, oil-free moisturiser to hydrate the skin.
Finish with a broad-spectrum sunscreen to protect against UV exposure, which can exacerbate post-acne pigmentation.
Murad Heartleaf Soothing Cleanser
Skinceuticals Silymarin CF
Alpha-H High Tide Water Cream
Mecca To Save Face SPF50+ Superscreen
The essential evening routine for acne
Double cleanse if you’ve been wearing make-up or sunscreen to ensure your skin is thoroughly clean. If you have oily or combination skin, use micellar water instead of an oil cleanser. Follow with a gel cleanser. I have found Clinisoothe+ helpful for calming redness, too. It's made of skin-safe hypochlorous acid and has anti-microbial properties.
Apply your retinol or a prescription retinoid to promote cell turnover, unblock the pores and tackle post-acne marks. Those who are pregnant can opt for azelaic acid instead.
Finish with a non-comedogenic moisturiser or night cream to maintain hydration and repair the skin barrier overnight.
iS Clinical Cleansing Complex
Clinisoothe Skin Purifier
The Klira Special
Dr Sam's Flawless Moisturiser Light
The added extras
Gadgets
LED masks with blue light can help tackle acne-causing bacteria to a certain degree, but it's imperative that you use it every day to start seeing results.
Face masks
Forget harsh, drying masks and instead opt for something with plenty of barrier-caring and calming ingredients to minimise inflammation. Added niacinamide and salicylic acid can help clarify pimples that have come to a head, but it's not likely to tackle those brewing under the skin.
Pimple patches
They might be all the rage for Gen Z but don't sleep on these, especially the clear ones that look like skin. If you have painful spots that have come to a head, a pimple sticker is made with hydrocolloid to draw out fluid from the zit once it's popped and take down the swelling. It also helps to minimise soreness and keeps you from skin-picking.
Toners and exfoliation
Once or twice a week, try incorporating a salicylic acid toner in your evening routine. After cleansing, apply it with a cotton pad before using your moisturiser. For stubborn spots, gently press a toner-soaked cotton pad directly on the spot for a few seconds to help minimise the swelling and encourage it to come to the surface.
Professional facials and treatments
Depending on the severity of your acne, having hands-on facials can be an irritating experience so make sure you have a thorough consultation with your practitioner beforehand.
AviClear is a clinically-proven laser technology that promises to clarify acne and provide lasting relief, the facialists at Sarah Chapman are experts when it comes to extracting blemishes with little to no pain (or scarring), while the Bespoke Acne Facial at Young LDN uses cooling devices to help calm aggravated skin.
That said, facials should complement your routine, not replace it.
Paula's Choice Skin Perfecting 2% BHA Liquid Exfoliant
Hero Mighty Patches Invisible 24
Dr Dennis Gross DRx Spectralite FaceWare Pro
The gadget
La Mer Deep Purifying Mask 50ml
Spot treatments
From personal experience, I've found that targeted pimple treatments and drying lotions deliver little to no difference – especially if you have persistent acne. However, if you only have the occasional breakout and the blemish comes to a head, a salicylic acid-rich formula can help reduce inflammation and encourage speedier healing.
The best ingredients for acne
Dr Sindhu Siddiqi, an aesthetic practitioner, GP and founder of No Filter Clinic recommends:
Salicylic acid to exfoliate the pores.
Niacinamide to reduces redness and inflammation.
Retinol and azelaic acid for improving skin texture and preventing future breakouts.
The ingredients to avoid
It's strongly advised to skip heavy oils, which can clog pores; any alcohol-based products that can dry and irritate the skin; and physical exfoliants, which can cause micro-tears and worsen inflammation,
Can lifestyle tweaks improve adult acne?
As someone who's lived through 13 years of adult acne (and finally reached the other side), I found that the only thing that truly made a difference was seeing a professional and having a consistent skincare regime. When it comes to nutrition, it can be tempting to experiment with your diet to try and figure out triggers, but I found it more damaging to cancel out food groups without truly understanding whether or not it affected my skin. As my own dermatologist says, anything that's good for your body, will be good for your skin.
I would also advise washing your pillowcases often, while managing your stress levels through wellbeing exercises can help, too.
Acne and mental health
Some who experience adult acne also find that it can impact their mental health.
"The skin on our faces is the most visible to the outside world and, for women especially, years of conditioning about the importance of the male gaze has imprinted how we’ve internalised what it is to be desirable," says the psychotherapist Lorraine Collins.
Having a skincare routine is all well and good, but do be kind to yourself. "Having compassion towards ourselves for the occasional flare-up and accepting that this is just part of the human condition is how we cultivate. Our skin is an organ and performs in ways that gives us clues about what’s happening beneath the surface," says Collins.
If your skin condition is causing low moods and anxiety, do check-in with a mental health practitioner.
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