Adult Acne 101 & Herbal Treatments!

The very real adult acne, how it manifests and some herbal allies to help alleviate this pesky condition and give clear skin.

Sigh, it's real - unfortunately!

There is nothing worse than waiting till your mid-20s to finally have beautiful, smooth skin to then find out that you are still suffering from breakouts - or that it has manifested for the first time in adulthood! 😭

Rest assured, you are not alone! Adult acne affects women more so than men and understanding the root cause is the best way in dealing with those pesky breakouts - and finally having the smooth, clear skin you have coveted 🙂

Acne - what is it?

Simply put, it is when a pore becomes clogged by excess oil, dirt, dead skin cells and possibly bacteria, leading to the formation of a pimple. This can either present as a whitehead, blackhead or an inflammatory lesion (these usually are the ones to leave scars).

OKAY, so what are the causes?

Something has to trigger the over-production of sebum (oil) by the sebaceous glands found in our skin. For some very lucky people, having some sort of skin cleansing routine can be enough to rid the face of acne. However, for the majority, this is not enough and the root cause becomes even more important!

1. Hormones!

It always seems to come back to hormones right? They play such an essential role in keeping our bodies running, that it is almost expected that if there is an imbalance in this area, then it will manifest in visible symptoms such as acne.

A surge in male hormones, known as androgens, are one of the main causes of breakouts in all genders. They lead to the growth and increase of sebum-production of sebaceous glands. Oestrogen, on the other hand, does the opposite. It actually suppresses androgens and helps to modulate sebaceous glands.

For women, this surge in androgenic activity may be seen during:

• Premenstrual phase - when oestrogen levels usually take a dip and testosterone increases just before menses.

• Ovulation - testosterone usually surges during this period.

• Pregnancy - an increase in androgen levels is usually responsible for that 'glow', for some this results in acne, particularly the third trimester as androgens help to get the cervix ready for labour.

• Perimenopause (menopause transition) - hormone levels fluctuate as ovaries gradually begin to produce less oestrogen.

• Menopause - oestrogen levels significantly drop as the ovaries no longer produce this hormone.

• Endocrine diseases such as PCOS - this favours the elevation of free androgens.

Note: hormonal contraception is sometimes given as a treatment for acne, as a means to 'stabilise hormones' but be aware that this only masks symptoms, and doesn't deal with the imbalance in hormones (the actual underlying cause) and in some cases, is the actual cause of acne (particularly with progestin-only contraceptives).

If you suffer from period cramps, check out this blog post: Period Cramps: What's the Deal? And How to Relieve them Naturally!

Another not so obvious hormone, or lack thereof, may also cause acne: VITAMIN D. Yes, this is a hormone! This wonderful sunshine produced hormone has been shown to have anti-inflammatory effects, it's believed that this helps contribute to clearer skin. Vitamin D deficiency has been shown to increase frequency of acne (hello inflammation!). I know this is the case for me, my skin thrives in the sun - when I can top up my vitamin D levels. If this isn't your reminder to go out safely into the sun (SPF-free) then I don't know what else would motivate you!

Wondering where your hormonal disruption is stemming from and how to reduce it?! Check out this article on: 6 Holistic Approaches to Reduce Hormone Disruption.

2. Gut Health & Sluggish Detox Pathways!

What we consume and our lifestyles all influence the state of our gut microbiome which in turn, has an influence on our skin. Your gut and skin actually communicate with each other through the gut-skin axis! If there is an imbalance in your gut it can lead to leaky gut or inflammatory responses which can manifest as acne on your skin.

Constipation or sluggish drainage pathways, can lead to a build up of toxins in the body. Since your skin is an organ that helps to rid your body of said toxins, it can be overburdened when other detoxification organs are not doing their part. Regular bowel movements and an optimally functioning detox pathway, like the liver, allows for your body to rid itself of excess hormones, bacteria and toxins, allowing for: glowy (not oily) skin!

You can't talk about gut and detox pathways without mentioning nutrition. What we eat can also play a role in acne formation. Not only do food sensitivities or an inflammatory diet contribute to inflammatory bowel disorders, disrupting gut health! But consuming certain dairy products and foods with a high glycemic index can lead to a surge in blood sugar and ultimately, insulin and a hormone known as IGF-1 (insulin-like growth factor). Both of these activate sebaceous gland receptors to produce androgens, and prevent the conversion of testosterone to oestrogen, ultimately causing breakouts.

3. Stress!

The pressures of modern adult life can really wreak havoc on our skin, leading to adult acne. Whether it is physical or emotional, acute but particularly chronic stress, that elevation in cortisol (the stress hormone) can cause an increase in blood sugar levels (and we just learned what that can do). High cortisol levels can also lead to a surge in inflammatory processes and sebum production.This creates a favourable environment for acne-causing bacteria (mentioned below) to thrive and produce inflammatory acne.

Funny how stress can lead to acne, meaning that worrying about them as well can cause them too! So for goodness sake *in mom's voice*: 'don't pay them any mind!' - easier said than done though right?!

If lack of sleep is something that contributes to your stress levels, be sure to give this blog post a read: Why Can't I Sleep? And Ways to Drift Off Naturally. We all know getting enough restful sleep is key to being more stress-free.

4. Bacterial Colonisation!

Propionibacterium acnes (P. acnes) - the bacteria involved in the pathogenesis of acne, makes up the natural microbiome of our skin pores and hair follicles, and loves to eat our sebaceous matter (YUM!🤢). The reason it is on our skin, is that it helps to protect the skin by stopping other harmful bacteria from entering our pores.

Since P. acnes is involved in several mechanisms on the skin like: inflammatory responses, maintenance of sebum and producing different enzymes - an overgrowth or a trigger of this bacteria can lead to acne formation.

Excessively cleaning your face is not the answer to ridding or reducing the activity of P. acnes - it may actually make it worse especially if using harsh acne-targeted cosmeceuticals. These tend to strip the skin, damaging the barrier and leading to an overdrive in the different mechanisms that maintain skin health.

5. Other Factors

• Certain medications: some drugs such as those containing corticosteroids, testosterone, lithium or progestin-contraceptives can contribute to acne formation in adults.

• Smoking tobacco: nicotine stimulates acetylcholine, which sebaceous glands are sensitive to. Acetylcholine induces several cellular level responses, including sebum production and composition.

Herbal care for adult acne

Natural herbal treatments are a great way to address acne concerns because generally herbs are well tolerated with little to no side effects, they have a long history of use, are gentler on your body so they won't overwhelm/overload your skin and not to mention it is more cost effective.

When it comes to using herbs, it is important to adapt an holistic approach. What you nourish your body with, your lifestyle choices, your mental and spiritual health should all be attended to as well. Herbs work better when we are in alignment with ourselves.

Topical treatments:

For treatments that are applied onto your skin you want to keep it simple, don't overload your skin with too many chemicals that you struggle to pronounce. More is not more when it comes to skincare - keep it natural and keep it simple.

I certainly am a skincare fiend and research everything and anything I put in and on my body (I guess it is the scientist in me #biochemistrygeek). I used to get lured into elaborate routines and 'fancy', scientific type products with ingredients like glycolic acid and salicylic acid, thinking that this would be the answer to my constant breakouts - what it actually did was just make my skin more vulnerable and photosensitive *sigh*! Stripping back my routine and understanding how and where things are made has truly been transformative for my skin and adult acne.

Have fun with researching and incorporating herbs, depending on your skins needs and what is accessible to you. Topical application includes: washes/cleansers, oils, compresses, masks, moisturisers, toners etc.

- Antibacterial herbs (to support a healthy skin microbiome): tea tree (Melaleuca alternifolia), yarrow (Achillea millefolium), lavender (Lavandula spp.), neem (Azadiracta indica), thyme (Thymus vulgaris), mugwort (Artemisia vulgaris; A. princeps), honey (not a herb but worth a mention)

- Anti-inflammatory herbs (for inflammation modulation/calm the skin): calendula (Calendula officinalis), chamomile (Anathemis nobilis; Matricaria chamomilla), aloe (Aloe vera), lavender (Lavandula spp.), willow (Salix spp.), mugwort (Artemisia vulgaris; A. princeps), turmeric (Curcuma longa), castor-oil (Ricinus communis)

- Astringent herbs (to support healthy function of sebaceous glands): rose (Rosa spp.), green tea (Camellia sinensis), witch hazel (Hamamelis virginia), white oak (Quercus alba), yarrow (Achillea millefolium), willow (Salix spp.), gotu kola (Centella asiatica)

Systemic treatments:

When adapting an holistic approach to skincare, what we ingest is a major part of the routine. With acne, it is no different. We can apply herbs topically, but this is likely not going to address the root cause of our adult acne. Best bet is to identify the trigger (as per some of the suggestions above) and then systemically treat said cause, while also adapting a natural, simple topical acne-friendly routine (say that 3 times as fast).

For me, my adult acne is hormonal, I tend to breakout during the premenstrual and ovulatory phase and also it is linked to vitamin D deficiency. So, sun is a must for my skin to thrive (what a great excuse for a holiday at the beach). I also ensure that I incorporate some of the following herbs, I switch up what I take regularly and intuitively listen to what my body needs. When taking herbal supplements systemically this includes: teas/infusions, tinctures, capsules, applying generous amounts to food etc.

- Hormone balancing herbs (to help regulate hormones): green tea (Camellia sinensis), soy (Glycine max), liquorice (Glycyrrhiza glabra), red clover (Trifolium pratense), evening primrose (Oenothera biennis), Chasteberry (Vitex agnus-castus), flax (Linum usitatissimum)

- Alterative / Hepatic herbs (to support detoxification & healthy liver function): turmeric (Curcuma longa), dandelion (Taraxacum officinale), barberry (Berberis vulgaris), burdock (Articium lappa; Lappa minor), red clover (Trifolium pratense), yarrow (Achillea millefolium), nettle (Urtica dioica), milk thistle (Silybum marianum), garlic (Allium sativum)

- Blood sugar balancing herbs (for blood sugar regulation & supporting digestion): fenugreek (Trigonella foenum-graecum), milk thistle (Silybum marianum), cinnamon (Cinnamonum zeylanium), fennel (Foeniculum vulgare), dandelion (Taraxacum officinale), holy basil/tulsi (Ocimum tenuiflorum)

- Nervine herbs (mood-stabilising for moments of stress): holy basil/tulsi (Ocimum tenuiflorum), chamomile (Anathemis nobilis; Matricaria chamomilla), oat (Avena sativa), st. john's wort (Hypericum perforatum), saffron (Crocus sativus), rhodiola (Rhodiola rosea)

Learn more about relieving stress at this blog post about 5 Herbs to Uplift Your Mood & Relieve Stress.

Adult acne be gone!! Okay, WOW! So the cause of adult acne is not that straight forward, a lot can contribute to our skin's health. Lifestyle choices and understanding our bodies should not be overlooked. Thank goodness for herbs though, amirite? So many to chose from and this list is, of course, not exhaustive! Happy exploring!

Enjoyed this post? Then please share and leave a comment below with what herbs you like to incorporate into your anti-acne routine?

References:

Dréno, B., Thiboutot, D., Layton, A.M., Berson, D., Perez, M., & Kang, S. (2015). Global Alliance to Improve Outcomes in Acne. Large-scale international study enhances understanding of an emerging acne population: adult females. J Eur Acad Dermatol Venereol, 29(6):1096-106.

Bagatin, E., Freitas, T., Rivitti-Machado, M. C., Machado, M., Ribeiro, B. M., Nunes, S., & Rocha, M. (2019). Adult female acne: a guide to clinical practice. Anais brasileiros de dermatologia, 94(1): 62–75.

Lim, S. K., Ha, J. M., Lee, Y. H., Lee, Y., Seo, Y. J., Kim, C. D., Lee, J. H., & Im, M. (2016). Comparison of Vitamin D Levels in Patients with and without Acne: A Case-Control Study Combined with a Randomized Controlled Trial. PloS one, 11(8), e0161162.

Nasri, H., Bahmani, M., Shahinfard, N., Moradi Nafchi, A., Saberianpour, S., & Rafieian Kopaei, M. (2015). Medicinal Plants for the Treatment of Acne Vulgaris: A Review of Recent Evidences. Jundishapur journal of microbiology, 8(11), e25580.