Spots were once the scourge of hormonal teenage years, a skin problem that was thank-fully kissed goodbye come adulthood. But for a growing number of British women, pimples no longer disappear when the school uniform is hung up.
According to the British Association of Dermatology, around 14 percent of women aged 26 to 44 seek help for adult acne every year, with many more suffering in silence. What is compounding this eruption in skin problems, say experts, is raised levels of stress, poor diets and even too much exercise.
At any age, the underlying cause of acne is an over-sensitivity to the male hormone testosterone.
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In response, skin glands produce excessive amounts of oil that, along with dead skin cells, clog up in hair follicles, trapping bacteria and triggering superficial pimples and blackheads, as well as bumps beneath the skin's surface, says Susan Mayou, a consultant dermatologist at the Cadogan Clinic and Cromwell Hospital.
Mayou says it has always been known that some women are more prone to spots at times when hormones fluctuate, such as adolescence, pregnancy and during the menopause. Many more also experience monthly breakouts triggered by the menstrual cycle.
But our lifestyles are being added to the list of factors that can spark the hormonal imbalances that cause acne in people who are in their 30s and 40s.
For years, the medical field was divided on whether stress affected the complexion, but several clinical studies in recent years have proven that it can induce flare-ups. In one small trial at Stanford University involving 22 students with acne, exam pressures were proven to make their skin condition worse.
When someone is stressed, the adrenal glands secrete more androgens (male hormones) that stimulate the production of oil, which can result in pimples.
But psychological stress has also been shown to lower the body's wound-healing capacity by up to 40 percent, meaning that stress-induced acne is also likely to be more stubborn.
Researchers have shown that unhealthy Western diets can also make spots worse.
Two years ago, Australian nutritionists asked a group of young adults with acne to follow either their regular diet, which included plenty of processed and sugary foods, or to switch to a low glycaemic index (GI) diet of wholegrains, fruit and vegetables, lean meat and fish.
After 12 weeks, their results, published in the American Journal of Clinical Nutrition, showed that the healthier eating group had a measurable drop in the severity of their acne, with 51 percent fewer pimples than when they started. That is a better result than you would see from topical acne products, said Professor Neil Mann, who led the study.
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