The Acne Diaries: Volume 6; The Causes That Might Surprise You

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Models looking surprised

What. The. F…..? (No, really. WTF?) This was my first reaction to being confronted (aged 38) with a face-full of angry red craters. Spots and wrinkles? Now that’s just not complexion cricket. But like that one dodgy Tinder date who never quite disappears, with acne there’s always that same vague fear they might turn up at your best friend’s engagement drinks. Just when you were thinking you were on a – permanent – break. And it seems I’m not alone as adult acne is officially on the rise (by 214% according to the most recent studies). Why? ”Diet, environmental factors and  the unrelenting stress of modern living means that acne is becoming more frequent in women in their 30s and beyond,” says skin guru Dr Murad. More disconcerting is a study by Neutrogena that found that ‘the spots you see today started 6 weeks ago’ as though they’re sinisterly lying in wait (much like that Tinder stalker). “What typically happens is people treat the spots when they see them without treating the root cause of the problem,” says Kesh Gunasinghe Associate Director of Beauty R&D at Neutrogena.  Those ‘root causes?’ (and how to treat them?). You may be surprised….

(For more causes click here)

Gigi Hadid on the phone

1. Your work phone

Well, any phone really but we’re betting this is the one stressing you out the most Because, although not a direct cause, research has found a relationship between acne flare ups and stress.  “This is why people often get random breakouts before exams or even the day of a first date,” says Dr Murad. “Stress releases hormones such as cortisol which increases oil production and inflammation,” explains Specialist Derm, Dr Stefanie Williams which is why author of ‘The Perfect Guide To Clear Skin’ Dr Nick Lowe often prescribes relaxation therapy for his patients.

And now for a gross-out stat – the average phone contains 18 times more harmful bacteria than a flush handle in a men’s loo. “Whilst bacteria are not the sole cause of acne, it’s important not to touch your skin with unclean hands or items like your phone which can also contain remnants of make-up that can block pores,” says Jasmina Vico, Aesthetic Skin Therapist at Hari’s Salon. “Carry anti-bacterial wipes to clean your gadgets and use headphones for calls to minimise bacteria spreading.” Wash the day’s grime away with Neutrogena’s Visibly Clear Spot Clearing Facial Wash Microclear Technology, £4.99, Neutrogena (

Model backstage with conditioner in her hair

2. Your conditioner

Spots around your hairline and shoulders? Your haircare products could be to blame. Gels and hairspray tend to be the most irritating, but it’s the oil-based products that trap the most acne-forming bacteria. Panthenol in particular (found in conditioners) is often a culprit so avoid in areas in contact with the skin such as fringes and tie your hair up before bed. And it’s not just hair products… “There’s a known connection between using the wrong skincare products (heavy moisturisers and creamy cleansers for example) and the aggravation of acne – I see it in my clinic every week,” says Dr Stefanie Williams who recommends opting for ‘non-comedogenic’ skincare specifically designed for acne-prone skin. “People also tend to forget that make-up is another leave-on skincare product, so it’s important to wear oil-free make-up, ideally with spot-fighting ingredients.” Try Bare Minerals’ Blemish Remedy Concealer, £22, BareMinerals ( and remove with Vichy’s Normaderm 3 in 1 Scrub + Cleanser + Mask, £11, not forgetting to clean those make-up brushes too.

Model backstage with laptop

3. Your NetFlix addiction

No, it’s not just from that unbearable tense feeling you get after watching Making Of A Murderer. It’s that your viewing gadget stops you from sleeping, and lack of sleep equals, yep you guessed it, spots, thanks to increased cortisol levels. “Electronic devices such as laptops and electronic readers used before bed can upset our circadian rhythm (our internal body clock),” warns Dr Williams. “They do this by emitting ‘short-wavelength-enriched light’ (ie blue light), which tells your brain that it’s not sleepy time.” The solution? “Stop looking at screens two hours before bed,” says Jasmina. “People with insomnia tend to have higher cortisol levels so take up mediation which has been proven to reduce stress and promote better sleep.” Try This Works Sleep plus+ Trouble Shooter 120ml, £35, This Works (

Big bag on model backstage

4. Your handbag choice

Your skin doesn’t care whether you have a Chanel Boy Bag or a Camden Market rip-off resting on your shoulder – it’s the resting bit that’s causing the issues. “Like phones, your handbag can be a breeding ground for bacteria so if you suffer from acne on your body/back, always make sure there’s a barrier between you bags straps and skin and invest in good anti-bacterial body wash,” says Jasmina. And it’s not just bags that can cause issues; “I also see lots of my clients who develop symmetrical patterns of acne from sports bras. Some bras are made of cheap elasticated rubber and combined with increased sweating and rubbing this can cause inflammation and breakouts.” Stick to breathable clothing and try ProActiv’s Cleansing Body Bar, £17, Proactiv+ ( post-gym.

Struggling with acne? Check out this link to the pros who are there to help

5 Your oil phobia

You’ve got spots so oil is bad, right? Not according to Neutrogena. “We did a year-long study into the importance of oil in acne-prone people,” says Kesh. “Say ‘oil’ and most acne sufferers freak out, but we’re learning about the idea of good and bad oils. Sebum is generally considered a ‘bad’ oil whilst ceramides and skin lipids (the ‘mortar’ that holds the cells in the skin’s barrier together) are good oils. What we found is that the ratio of good to bad oils in people suffering from acne has totally flipped and although we’re still struggling to find out why, it means we can start to tackle the problem by rebalancing rather than removing the oils.” Cleansing is your first step but beware – cleansing too often can over-stimulate the skin leading to an over-production of sebum. Kesh suggests making sure you’re using the right products from your cleanser all the way to your moisturiser; “Go for products with ingredients designed to micro-clear sebum such as salicylic acid.” Try Dr Nick Lowe’s Acclenz Deep Action Blemish Serum, £49 and Murad’s Advanced Acne & Wrinkle Reducer, £45.

Model drinking coffee backstage

6 Your skinny cappuccino.

And there you were thinking you were ordering the healthier option. According to Dr Lowe over 30% of all adult acne cases are down to diet with dairy (low-fat in particular) being the biggest culprit. “There’s now some good scientific evidence to show that exposure to the hormones found in milk can also trigger acne in humans.” He explains that skimmed milk is worse as it has a higher GI index than full-fat milk, sugar being the second most important skin offender. Intergrative Cosmetic and Skin Specialist Dr Terry Loong adds that food sensitivity and digestive problems can also be to blame; “Gut issues can certainly be a trigger either due to the overuse of antibiotics causing an overgrowth of microbes e.g. Candida, or because you’re lacking in digestive enzymes in the gut to break down the food appropriately.” Try Terranova’s Probiotic Complex with Prebiotics 100 Capsules, £26, ( to help support the gut and improve the digestive system.

Contraceptive pill

7. Your pill

According to derms such as Dr Lowe and Dr Loong some people are experiencing hormonal imbalances later in life thanks to a history of taking birth control pills which have essentially delayed their acne. “I’ve just seen a 31 year old patient who’s been on the pill for almost 12 years and now she’s come off it she’s experiencing acne for the first time,” says Dr Lowe. And yet one of the go-to treatments for hormonal acne (usually characterized by painful nodules on the lower face) is the combined pill.
Some people genetically have more hormone receptors on their oil glands which makes them more sensitive to fluctuations in androgens and oestrogen and certain birth control pills help to block these receptors but if you’re not keen on the idea of going on the pill a more holistic approach to balance out your hormones (ie looking at your diet and reducing stress levels) might be the way to go. And To fight those pre-period zits go for Neutrogena’s Visibly Clear Rapid Clear Treatment, £3.69.


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