Adult acne is the easiest thing we ever work on, as well as the most frustrating.
Easiest, because we can fix it so simply if people take our advice.
Most frustrating, because 98% of those who come to us for treatment, are also taking the advice of a non-scientific source of natural medicine, getting no results, but persisting in the belief that it's the right thing to do. Despite having little to no results and ending up in our clinic for further help.
As a fully paid up graduate of the natural wellness school of upbringing, I am all for what I call a natural approach to life - aka. common sense: eat fruits, veggies, legumes, drink water, get sunshine in moderation, take gentle daily exercise, be on good terms with all those in your life as far as it doesn't hurt you.
Those who know my passion for science are often surprised to learn that I ran one of NZ's first ever organic skincare clinics, alongside one of the Southern Hemispheres first Bikram Yoga franchises. We literally sold Lululemon in the waiting lounge, before they had their own stores in the Pacific.
I'm a hippie to the core. My mum used to drive me 30 minutes out of town to wash my hair in the mountain-fed Motueka River, using shampoo she made from our neighbours rosemary bush. I didn't drink milk till I was five. I sit in the full moon and my periods are synced to it. I'm paid up y'all.
Which is why I get so angry at the current state of the natural health industry and their attempts to treat acne with modalities which should, based on current science, be long dead.
For example one traditional therapy which teaches that you should never put cold food into your body (say what?? aha... no fruits off the tree ladies...) is currently a very popular go-to for women seeking adult acne treatment in Melbourne.
People pay around $100 per consultation here in Melbourne. They're vulnerable people, because they have sores bursting out of their chins which hurt, and nobody seems able to help them. So I don't blame them for seeking help this way, but I dearly wish they would stop, and listen to science.
I have yet to meet a single person who has had a decent result commensurate with what they have spent, from their alternative treatment for long-term stubborn acne, because it is literally impossible.
Before everyone gets keyboard warrior on me, I'll explain why this cannot happen.
In it's early stages, acne is about the oil gland being stimulated to produce extra oil, and the keratinocytes (you probably know them as 'dead' skin cells) being stimulated to grow and produce at a high rate. The mixture of extra keratinocytes & thicker oil creates a plug, blocking up a pore, trapping bacteria inside. The bacteria are always with us, but they thrive in oxygen free environments, such as the one just created by said plug.
These bacteria now have a big old orgy, replicating away, causing the walls of the pore to rip through. Your body sends fluids to lock it all down, stopping the bacteria from moving. You experience this as swelling.
Your body sends in white blood cells to eat the bacterial infection, leaving behind pus.
If your acne never progresses beyond this stage, wonderful, because you caught it early and you may be lucky enough to have no scarring.
However for adult acne sufferers, this is rarely the case.
In adult acne it is the androgen hormones who are responsible for stimulating the oil gland in the first place. This means your standard prescription antibiotics don't work, because they only address the infection, which is not the cause but the symptom. We have to go one step further back to get to the hormones, and many people try to do this, going on the contraceptive pill or even having an injection of 3 months worth of contraceptive at once.
If this works for you, you are very lucky and are in a very small number of women who get relief this way.
For the rest, it can make it worse. Much, much worse. In this, the alternative therapies crew and I are in agreement. ( I also agree with much of their talent in leading people towards generally healthy eating and lifestyle.) But that's about where our agreement ends.
You see the next phase of acne is the one that nothing can address except manual or chemical breakdown of the skin: the scarring.
When bacterial infection rips through the wall of your pores, your body responds a very clever, highly evolved way: it forms scar tissue around that infection to prevent it travelling any further.
This is a wonderful control mechanism of the body and a vital part of our healing abilities.
However in acne, it is happening in an area of tissue that is already basically a series of tunnels INTO the body. Tiny, convoluted tunnels, full of places for bacteria to hide. If you consider you were in a tunnel and blew the wall out with dynamite, then tiled that blown-out area creating a little side-room.. this is what acne blow-outs and scar tissue are like. They create a more complex tissue beneath the surface, with a greater surface area.
This matters because surface area exfoliates itself into the space. Surface area has dead cells falling off it at all times. So you can have the healthiest internal body, the best topical bacterial levels. Everything can be fine. But you also have a hormone receptor on the skin cells that is now highly sensitised to any little hormone floating by. It will react differently. This, you can ameliorate with retinol therapy (topical vitamin A).
But what about those tunnels?
What about the very shape of the tissue?
Successful acne treatment nearly always requires that we go a step beyond diet, beyond skincare, beyond herbs, beyond vitamins. It requires that we do something to physically break down those tunnelled, convoluted, scarred areas beneath the skin, and regrow them in a better, healthier shape.
If we don't, we will have endless recurrence of the breakouts, as the surface area naturally exfoliates into the space created. Those who don't have this are lucky. The majority will.
By physical breakdown, I mean we use chemical solutions applied topically, or we use lasers that take out columns of damaged tissue at at time. Or we use needling such as Dermapen or DermaCiT to take out columns of damaged tissue at a time. We physically break down the scar.
The result is less visible scarring, but also less invisible scarring beneath the surface.
Less breakouts, and true resolution of the acne as the tissue returns to a normal shape.
There is no diet, no detox, no ritual, no tonic and no herbs in the world that can make that happen.
This scarring process is totally natural, so I guess you might say we are going against nature to fix it. It's a time we have to set aside our feelings and look at the cold hard science: the shape of this tissue ain't changing on it's own. We need intervention and real science, the kind that understands the body and it's priorities.
It's liberating to find solutions that work, and they have been found. Right at this moment people are sitting 6 year long degrees in this subject, simply to correct skin issues. It's a profession.
If you're still seeking answers for your stubborn adult acne, and you live in Melbourne, we invite you to visit us at Natashas Skin Spa for a consultation. Principal therapists here are $150 for a 1 hour consult which will change the way you see your skin forever. Senior therapists are $55 redeemable on skin treatment. All can change your skin forever.
Disclaimer: And I do hate disclaimers. This post in no way implies that eating well or addressing other health issues is a waste of time. It is absolutely a good idea to take professional advice regarding other health issues, and it is possible that they affect the skin or cause acne. This post speaks to adult acne which is ongoing, resistant and not responsive to basic skincare routines such as cleanser and retinol therapy. The kind which involves scar tissue, generally all adult acne of the lower third of the face beyond the 2 month mark will fall into this category. Love and cleanser, Tash. x