The War on Zits: Adult Acne Survival

I am pretty fed up with my skin right now. I am a full-grown woman in my early 30s and I am sitting here typing this post while my face is slathered in a layer of glycolic acid serum and manuka honey. This isn’t for the sake of tiny little wrinkles or vanity or any of that. Nope, this is because for the past two weeks my skin has been FREAKING OUT and breaking out like crazy. The worst I have seen in years, to be honest. And this is really fabulous timing because I have a black tie wedding reception to go to in 24 hours so my face is covered in sticky crap for the sake of damage control.

I know I am not alone in waging skin battle against my very own traitorous face. I have been fighting this long war on my acne for more than half of my life now. It is a bit better than when I was in my teens/twenties, but I never would have dreamt back then that even over the age of 30 I would STILL be obsessing over the state of my pores and scars. Throughout the past 20 years, I have tried everything from every antibiotic under the sun (nope), birth control (nope, makes me ill), Retin-A and other topicals (some improvement, not a cure), and the mother of them all: I have been on Accutane (or Roaccutane). Twice. It was like a miracle drug for me, but it didn’t last!

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So what do I do to cope?

For the past few years, I have been relying on skincare products to manage my skin, and normally (although not this month) they do a great job. In the pic above, you’ll see that I have divided my favourite products into “Bling” and “Budget” categories, because some of these things are quite pricey, and some of them are ridiculously cheap, and this way you can pick and choose what works for your budget.

My skincare falls into two modes: maintenance and damage control. Maintenance is the every day routine that I follow to try and keep my skin clear and lovely. Damage control is what I do to quell breakouts and try and clear up my spots and scars as quickly as possible. I find that the longer you let a breakout boss you around, the longer it will go on and keep breaking out, so when I start seeing spots, I come down on them hard with everything in my arsenal. No mercy!

My maintenance routine involves a LOT of exfoliation. I am not sure if my skin is weird and turns over super quickly because I was on accutane ten years ago, or maybe it’s the topical exfoliants I use, but I have crazy skin that flakes and sheds like crazy. Literally I never go a day without exfoliating my face. If I skip it, I can actually feel the clogged pores gumming up on my nose and chin, and random flaky bits will pop up elsewhere. To keep things clear, what I have traditionally done is use a very gentle creamy cleanser and a washcloth to gently wipe it off using little circles. Cleansers I have known and loved are Neal’s Yard Chamomile Cleanser (which is quite thick and good in winter) and good old Cetaphil.

Recently, my mom got me a Clarisonic Mia (in Jaguar, mrow!). I was skeptical about these being any better than a washcloth, but in short: YES. It really gets the crap off my face. Perhaps too well. I am somewhat concerned that it worsened this breakout, but I am still testing it to see what happens once my skin clears up. I will report back!

Anyway, the most important thing about the cleanser you choose is that it should be as gentle and kind and lubricating as possible to help the washcloth/Clarisonic glide over your skin without rubbing it raw. Be kind! I really advise against any sort of foaming gel-like acne-related cleanser, because they will dry your skin right out and just make your spots angrier. Right now I just started using Alpha H‘s Balancing Cleanser since A Model Recommends really rated it for skin like mine. It seems really lovely and gentle but also gets my face nice and clean.

Once my skin is clean and glowing from a gentle scrub, I get some moisture on it as soon as possible. What I normally do is mix a light but creamy moisturiser (Clarins Multi Active Jour, for example) with a little squirt of Eau Thermale Avene’s Triacneal cream. Triacneal was my holy grail product until two weeks ago: it is a very clever blend of retinol and glycolic acid (AHA).

Retinol and glycolic acid are the only ONLY things that have ever worked for me to keep my skin clear. They basically cause my skin to turn over quickly in the hopes of preventing things from getting stuck in my pores and causing zits. They also help to fade scars quickly. The main difference between my maintenance mode and my damage control mode is How Much retinol + glycolic acid I am using daily. In maintenance mode, it is not very much at all. Just a little dab of Triacneal.

If the Triacneal is a bit pricey for you, a good light moisturiser that is fairly effective at preventing breakouts is Olay’s 7-in-1 blemish care. This has some salicylic acid (a BHA) in it to keep skin turning over. BHAs do not work as well as AHAs for me, so I find it is okay for maintenance, but it is not enough moisture for me in winter, and it doesn’t do much for me once an actual breakout has started. If you aren’t worried about anti-aging, Cleanance K, also from Thermale Avene, has both salicylic and glycolic acids in it, so that might be another really nice inexpensive pick.

Now, I am not sure what happened last month to break me out so badly, but I am chalking it up to a perfect storm of exam stress, hormones, sunblock, travelling (flying makes me break out, I don’t understand why but it does), the new Clarisonic Mia, more hormones, and more stress. The Triacneal couldn’t stave off the barbarians at the gate forever, I guess.

So now I am in damage control mode: Every day I am alternately chemically peeling my skin and/or soothing it trying to break the inflammation cycle and get it to heal. Acne isn’t just about clogged pores, but also about inflammation. If it were just clogged pores, we could just squeeze our blackheads to clear things out and have a nice day. Instead I get horrible red angry pustules, sometimes cystic, and they usually don’t come to a head until the inflammation beneath the surface stops. And when it stops, they all deflate at once and heal but leave lovely red marks. It is a strange thing, but it is a graphic display of how forces beneath your skin control what manifests on the surface. In my case: a seething boiling pot of cortisol and androgen = angry red blemishes.

For me, only one topical thing breaks the inflammation cycle: carpet bombing with Benzoyl Peroxide. Salicylic Acid does not work for me. The usual glycolic acid and retinol will bring things to a head more quickly and fade marks, but nothing deflates them from the bottom up like good plain old benzoyl peroxide. Every night right now I mix a little dab of Quinoderm 10% BP in with a good rich moisturiser and put it over my WHOLE face, before adding dabs of BP straight to the angriest spots. Then I go to sleep (on my white pillowcases and in a white tshirt because this will bleach everything it touches). Usually in the morning, my skin is a bit less red and angry. Two or three nights of this in a row usually breaks the cycle. NB: don’t put BP cream all over your face at full strength! Blend it with some good soothing moisturiser first!

After the acute inflammation stage is starting to pass, I ramp up the glycolic acid treatment to bring out the last of the spots and start fading the post-zit marks as quickly as possible. Nothing fades marks as effectively as glycolic acid. Also, BP is really drying to your skin, so a good moisturiser that also exfoliates will help keep your skin from drying out and getting angrier. I use a 10% glycolic acid moisturiser from Alpha H, or Gamma Hydroxy by Skin Doctors, but these are both quite strong.

It might be best to start with a serum with glycolic acid in it first (like Liquid Gold from Alpha H) to see how your skin reacts. Unfortunately, glycolic acid products are quite expensive. The most cost effective one that I have seen is Olay’s Regenerist Night Resurfacing Serum. This would be great at night in maintenance mode, but I would use it during the day during acute mode.

And, finally, the reason I am sitting here with manuka honey all over my face is because raw honey, especially manuka, is anti-microbial and really good at cutting inflammation and also fading scars. It is also extremely soothing and moisturising, and given all that my skin has been through this week, I am just trying to give it a little TLC. Seriously, if you are struggling to get your skin to heal, try a honey mask.

If this successfully stops the breakout cycle this time, I’ll go back to my usual triacneal + glycolic moisturiser routine with gentle daily exfoliation. I’ll also do a weekly preventative mask, like Queen Helene’s Mint Julep Masque, which uses clay to suck up oil and sulphur to kill nasty bacteria.

Very important: If you use glycolic acid and/or retinols, you have to keep your skin out of the sun because it will burn very easily! Unfortunately, sunblocks break me out like crazy (I just found this new Neutrogena Clear Skin in the US and it does seem better), so I just keep my face out of harm’s way as much as possible. The sun also causes post-zit scars to get darker with hyperpigmentation, making them more difficult to fade, so really, be careful with the sun until everything is healed up and back in maintenance mode.

So. Here I have related to you my 20 years of experience on how I best manage my troubled skin. There is an upside to all of this, though. A huge benefit of using some of the products I do means that my skin literally looks ten years younger than it would otherwise. Retinol and glycolic acid are the ONLY truly proven anti-aging ingredients, because both of them not only make skin turn over faster, but also cause it to produce more collagen. And guess what have been sitting on my face since I was 20? A ha! The only wrinkles I have are my forehead frown lines that I got way back in childhood from being grumpy all the time, and past that I am just now starting to get laugh lines. I have no wrinkles around my eyes at all. So, not only do these things work to keep your skin clear, they will also keep you looking young.

I hope that if you also struggle with ongoing persistent adult acne, these tips will also help you. Everyone’s skin is different and reacts to products differently, but years of trial and error have indicated that glycolic acid and retinols are really good friends of mine. Of course, ultimately I wish that I would just have clear skin one day, but it’s something I constantly have to work at.