You thought once you’d emerged from your teens, kicked acne in the butt and started wearing sunscreen on the regs (kudos) that your skin would just fall into line. But then you hit your late 20s or 30s and – along with a sudden urge to have a Dyson in your life – you’re suddenly blessed with cystic pimples, tiny white unsqueezable bumps or weird blotchy patches around your nose. What fresh hell is this?
Several factors contribute to skin conditions in adults, according to aesthetic practitioner Sarah Hudson of Skin by Sarah Hudson. “Emotional or work stress, environmental influences and caffeine, alcohol and rich foods can play havoc with our immune system, which [in turn] manifests through our skin,” she explains. “Additionally, women’s skin is affected by hormonal imbalances [during] menstruation, pregnancy and menopause.”
The challenges these changes bring are emotional as well as physical. One study published in BMC Public Health revealed that skin conditions are associated with anxiety and depression. The good news? Effective treatments do exist, and experts are constantly discovering new ways to diagnose and address issues such as adult acne.
Get clued up and take control with our guide.
#1 / Milia
What it is: We’re talking about those tiny white bumps underneath your skin that seem immune to your squeezing skills. “Milia are caused by a build-up of [the protein] keratin that gets trapped in the skin, causing a tiny cyst to form,” explains Dr Giulia D’Anna from Dermal Distinction. “They’re found on the cheeks, around the eyes, forehead, nose and chin. They can feel rough, but are harmless.”
How to treat it: First off, nix the squeezing – milia can’t and shouldn’t be popped. They sit deep under the skin and, unlike whiteheads, they don’t have an opening or connection to the surface. Squeezing milia not only creates trauma and inflammation (hello, red marks) but can also lead to scarring. As the cysts are so deep, it’s best to have them professionally removed via a process called lancing. Deep exfoliation treatments in your routine can also help. Products with Alpha Hydroxy Acids (AHAs), Beta Hydroxy Acids (BHAs) and vitamin A assist with cell turnover, while chemical peels and laser treatments are also great if milia are proving more stubborn than that wine stain on your white jeans.
#2 / Rosacea
What it is: If you get next-level flushed when you drink alcohol, eat spicy food, overheat or just because, you might have rosacea. “This skin condition causes redness on your cheeks, nose, chin and forehead. It may make you feel like you are constantly blushing,” explains Hudson. In some cases, pimple-like bumps and dryness can show up to the party, too. “The exact cause of rosacea is unknown, but it tends to be more prevalent in people with fair skin or who blush easily. Hormonal imbalances and changes may contribute, too.” Scientists are also investigating the role of our body’s microbiomes and gut health. A study of almost 50,000 people in the British Journal of Dermatology found those with rosacea were likelier than a control group to struggle with gastrointestinal issues such as irritable bowel syndrome and ulcerative colitis. Meanwhile, 2012 research by the National University of Ireland concluded that the condition might be triggered by bacteria living within tiny mites in the skin itself.
How to treat it: There are different types of rosacea so, to find the right treatment, get a diagnosis from a specialist dermatologist. According to Hudson, in-clinic light-based treatments such as BBL (BroadBand Light) can be very effective at treating rosacea with visible pustules, whereas laser treatments can work well for less severe cases. Also skip products with fragrances and irritants in favour of ones geared towards sensitive skin. “Often people with rosacea have an impaired skin barrier, so use a gentle milk-based cleanser to avoid stripping,” says D’Anna. “There are some beautiful face serums designed to reduce inflammation, seal and protect. A super-rich moisturiser is important, too.”
#3 / Keratosis Pilaris
What it is: If you feel like you have goose bumps 24/7, the culprit might be keratosis pilaris (KP). Also known as ‘chicken skin’, KP presents as raised bumps that can appear scaly and red. “Keratosis pilaris develops when the skin produces too much keratin. This blocks the hair follicles and causes the bumps to develop,” explains Hudson. “It usually appears on the upper arms, thighs, buttocks and can occur on the cheeks. It’s more common in winter, when the skin tends to be drier.”
How to treat it: “Using a cleanser and body moisturiser with lactic acid can help to loosen dead skin, keep the skin functioning well and reduce keratin plugs,” says D’Anna. Get into a committed relationship with your body brush, she adds. “Most people forget to exfoliate the back of their thighs, buttocks and arms. Trust me – implement this [into your routine] once or twice a week, and your skin will feel super soft. It’ll turn around any KP.”
#4 / Adult acne
What it is: “Acne is caused by sluggish sebum – oil – production as well as an increase in both testosterone and bacteria in the hair follicles [on the skin],” explains D’Anna. Hudson adds, “While teenage acne is characterised by pimples and pustules, adult acne tends to [be] red, painful, inflamed and persistent, occurring around the chin, jawline and neck.” A 2017 review in the International Journal of Women’s Dermatology found that acne (especially severe) can negatively impact self-esteem. Yep, no fun whatsoever.
How to treat it: Before looking at the treatment options, it’s important to understand what’s driving adult acne. “Due to its complex nature, this may vary from person to person,” says Hudson. Let’s break it down:
These happen just before your menstrual cycle begins and are one of the main players behind adult acne. For hormonal-related conditions, such as polycystic ovary syndrome (PCOS), Hudson recommends seeing an endocrinologist, who specialises in select hormonal testing.
Not a cause in itself, but the big S can make acne a hell of a lot worse. “Chronic stress causes the adrenal glands to release cortisol, which can create a favourable environment for inflammatory acne,” says Hudson. Focus on getting your stress levels under control and avoid stimulants such as caffeine, sugar and energy drinks.
What’s on your plate can exacerbate what’s on your face. “Keep a food diary, then talk to a doctor or dietitian,” advises Hudson. Dietary triggers can include refined grains and sugar, dairy, fast food, items rich in omega-6 (soy and corn oils) and chocolate. While research is still ongoing, a 2019 study by Kabul University of Medical Sciences revealed a link between acne and the consumption of whole and low-fat milk, chocolate, potato chips and egg.
Ingredients found in cosmetics can contribute to and worsen breakouts, so play detective. Hudson advises looking for products that are oil-free, ‘non-comedogenic’ or ‘non-acnegenic’ (meaning they exclude certain pore-clogging and acne-driving ingredients). Also go for mineral-based make-up that’s free from things including fragrances, silicones and parabens.
“Air pollution leaves a layer of toxins on the skin, so it’s important to double cleanse at night, even when you’re not wearing make-up,” tips Hudson. “The first cleanse removes pollution from the skin, while the second gets rid of excess oils and bacteria.” D’Anna notes, “Make sure your cleanser contains a BHA, as this will target the oil sitting in your skin.”
#5 / Psoriasis
What it is: This is usually characterised by “patches of red, inflamed skin and loose silver-coloured scales, which may flake off every few days,” says Hudson. Severe types include plaque psoriasis, where the skin can be itchy, painful and crack. “A combination of genetic and environmental factors tends to be the most common causes,” she adds. “Exacerbating factors include stress, certain medications, alcohol and smoking.”
How to treat it: Coping with psoriasis is no easy feat (just ask Kim KW). While the condition is fairly common – about 2.6 per cent of Aussies are impacted, according to the Australian Journal of Pharmacy – it can be confusing when it comes to treatment. “As there are several types of psoriasis, it’s important to seek the advice of a specialist dermatologist,” says Hudson. “That way, you can receive an accurate diagnosis so the management can be personalised.” D’Anna explains, “Skincare like retinols, which are designed to remove dead skin cells, are perfect for psoriasis. Generally, stick with a mild non-foaming cleanser and other products for super-dry skin. Around that, some oil-based serums can be applied to the lesions to [soothe their appearance] and help you avoid the itch.” Sounds like sweet relief.
Looking for more skin care tips? Check out 5 rules to follow for amazing skin, according to one of Sydney's top facialists.
Main image credit: @alexachung
This article was originally published on womenshealth.com.au
Erin Docherty is a Beauty Writer for BEAUTYcrew, Beauty Editor for Women's Health magazine and a Grooming Writer for Men's Health magazine. She has a keen interest in cosmeceutical skin care and is currently working on minimising her 9-step skin care routine – because ain’t nobody got time for that. When she’s not writing about the latest beauty news, or applying copious amounts of serum, you can find her spending all her money in Sephora.