You’ve heard stories about the ugly duckling’s transformation into the beautiful swan and childhood friends who’ve blossomed into their own skin 10 years down the road. I, too, thought that as I entered my 20s, I could finally bid farewell to my awkward teenage years. But, life had other plans for me.
When I turned 22, I found myself battling adult acne. All of a sudden, I was waking up to new clusters of pimples every morning. Angry, painful mounds of cystic acne plagued my temples and chin, whiteheads that didn’t seem to go away popped up on my cheeks and huge, red pimples covered my forehead. Everyday was like playing whack-a-mole with my acne – every time I dealt with one pimple, another would appear immediately.
As someone who was blessed with pretty clear skin, I felt lost and scared. These were deep, unknown waters for me and it took a toll on my self-esteem and confidence. I found myself refusing to leave the house and limiting social interactions. I didn’t understand why I was still getting acne as a young adult.
Though many months have passed and my skin is starting to stabilise again after hundreds of dollars spent in dermatologist treatments, I still have so many unanswered questions. So, I started my personal journey to find out more about adult acne. I approached Dr Kevin Chua, a MOH accredited Family Physician with special interest in aesthetics and tattoo removals for professional insight.
What causes acne?
Dr Chua: Basically, acne is caused by overactive oil glands. Anything that increases blood flow to the face and stimulates the oil glands can increase the chances of someone developing acne.
And the number one contributing factor to acne? The answer may surprise you.
“Caffeine acts as a stimulant that increases metabolism. So, it serves as an engine to already stimulated oil glands.”
Dr Chua also recommends avoiding beverages such as alcohol, energy drinks and whey protein as they all increase blood flow to the face. Bubble tea fans may also be disappointed to know that the sugary, tapioca-filled drink contributes to potential acne outbreaks as well.
Beware of Skincare
In my case, my acne began after getting too excited over the myriad of skincare available to me while holidaying in Seoul. I asked Dr Chua if my beloved skincare products could be causing my skin more harm than good.
“If you’d given yourself a chemical peel, that would have been enough to increase the blood flow and trigger your acne.”
“Always check the ingredients list and stop using the product if any rash, tingling, pain or blister forms,” he advises.
Contrary to popular belief, facials are not a quick fix for acne breakouts. The key lies in timing. “If you go for a facial while dealing with an active acne flare up, it triggers an inflammatory process and causes the oil glands to overproduce again so it ends up getting worse”. Generally, facials should only be done when the skin is calm.
As it is with any other medical problem, the treatment of acne varies depending on how severe it is. Dr Chua splits it into three categories: mild, moderate and severe.
Mild. Vitamin A derivatives such as Retinol reduce the production of oil by the oil glands. “Vitamin B3 serums is enough to control the oil secretion,” Dr Chua recommends. Vitamin B3, also known as Niacinamide, is most commonly found in serum form to deliver the best results. Differin, a third-generation topic retinoid gel is often used to treat mild-moderate acne.
Moderate. At the moderate stage, oral medication has to be introduced alongside topical creams. Dr Chua usually prescribes a course of antibiotics to his patients, lasting around three to four months which is the minimum amount of time it takes for bacteria to be killed.
Severe. For more severe cases of acne, oral retinoids are prescribed. The most common oral retinoid is Roaccutane (also known as Isoretinoin). “They basically reprogram your oil glands,” Dr Chua explains. Treatment lasts any time between four to six months. However, these oral retinoids come with their own set of side effects to be wary of as well. Side effects include: dry and cracked lips, dry, irritated eyes, and possible psychological effects at high dosages.
While looking at ‘before’ and ‘after’ acne pictures online for motivation, I realised what acne survivors consistently fail to mention is the scarring. After the pimples are gone, what’s left is a scattering of scars in their place. Whether it’s in the most common form of hyper pigmentation, or pitted scars such as icepick and boxcar scars, they act as a shadow of the acne that used to plague the skin. Thankfully, Dr Chua reveals that scar treatment has made stunning advancements over the years. Treatment may come in the form of creams, supplements or lasers.
Prevention Is Better Than Cure
Dr Chua gives some practical advice on how to prevent acne breakouts.
1. Have a balanced diet
Ensuring that you eat a balanced and colourful diet with fruits and vegetables is vital as they contain a lot of antioxidants. Fruits such as oranges, kiwis and guavas are high in Vitamin C which aid in skin repair. Remember to keep yourself hydrated.
2. Don’t smoke and drink excessively
Do everything in moderation.
3. Stay out of the sun
All the usual anti-ageing rules still apply.
4. Exercise regularly
It releases endorphins and regulates metabolism levels.
5. Manage stress adequately
Stress is unavoidable in the course of life but you can adopt a healthy way of coping with it.
Too long; didn’t read?
“Basically a sensible approach to life in general will ensure your skin behaves. Your skin is a direct reflection of how you treat your body — it cannot lie,” Dr Chua sums it up.
A Gratifying Process
I shared with Dr Chua about how dealing with acne was an emotionally draining experience for me. To my relief, he echoed my sentiments. “It can be quite debilitating in terms of affecting a person’s self-confidence and causing low moods. I actually enjoy treating acne as it is gratifying to see them regain their confidence again,” he muses.
A New Perspective
Ultimately, the meeting with Dr Chua made me see acne in a different light. Adult acne is pretty common in Singapore and you shouldn’t feel like you’re going through this journey alone. Just like any other illness, there are remedies and treatments available. This too, shall pass with time and a lot of patience.
In the meantime, I learnt how to focus more on my inner being than what’s on the surface. While acne can be eradicated with topical creams and antibiotics, there’s no quick fix for the emotional scars it leaves behind.
It’s been a long two-and-a-half year journey of losing my confidence, and slowly finding it again. But I didn’t find it in smooth, blemish-free skin. I found it in the moments I let myself be vulnerable in front of others. I found it in the mornings when I dared to face my mirror again. I found it as I removed my makeup at the end of a long day and thought to myself:
“I’m still beautiful this way.”