Acne is supposed to be an adolescent's affliction. But "Why the hell am I still getting zits in my late 30s?" is a question I've been asked more than once.
Most of us get the odd pimple here and there. Some of us have it worse. Acne, even into adulthood, can be painful and unsightly. Let's be honest it's hard not to get grossed out by lumps full of pus. Other folks' oozings are always harder to take than our own.
This is why acne can be so devastating. Serious cases can be treated with prescription drugs like Accutane, but these have a terrifying list of potential side effects that include psychosis and suicidal ideation.
When we were kids, they warned us to wash regularly and for god's sake stay away from greasy foods. Then we were told that there is absolutely no relationship between diet and acne. Some say the pendulum is swinging the other way, but others disagree.
They also told us not to pop zits. Leave them alone, they said. Squeezing only makes them worse, causes scarring, blah blah.
Like we ever listened.
Pimple popping is fun. And irresistible.
What the experts say
"I tried the gamut of conventional treatments, and nothing worked for me. It turns out that benzoyl peroxide is a phenomenal treatment in 2.5 per cent strength. Accutane is [good] for people with severe acne, but because of severe side effects it's a last resort. It shrinks oil glands by 80 per cent, permanently. The dermatological community has agreed for decades that diet and acne are not related, but that's based on two studies from 1969 and 1971, not enough to draw conclusions from. If you can keep your body from becoming inflamed through a low glycemic diet , you're not going to have severe acne. If you pop something that is not ready, it can lead to much bigger problems."
DAN KERN, director, www.acne.org, San Francisco
"We examined almost 1,500 people living on the tiny island of Kitava, off the coast of Papua New Guinea. There were over 300 adolescents. We did not find a single zit. We also spent about two and a half years in the jungles of Paraguay looking at a group of hunter-gatherers called the Ache. Over this period, not a single zit developed in the entire population. In the Western world, between 85 and 95 per cent of the adolescent population has acne. This suggested an environmental factor. We just completed a trial in 2005: we put a bunch of Western teenagers on a diet and their acne went into remission. It's was a low glycemic, low carbohydrate diet, eliminating processed foods, sugars and refined grains . Increasingly, we believe dairy products are also involved."
LOREN CORDAIN, department of health and exercise science, Colorado State University, author, The Dietary Cure For Acne
"Acne can differ depending on what dosha is involved. Mostly it's the pitta dosha. If the general levels of toxins in the body, called ama, are high, then the skin becomes a way to excrete these toxins. We look into the general physiology and the digestive system. Neem is the best remedy for any skin condition as an application. Licorice and rose teas are good, as is turmeric . Triphala can be taken internally if the digestive system is off. Drinking milk is a really good remedy."
ISMAT NATHANI, ayurvedic practitioner, Toronto
"People want a quick fix, but there isn't one. If you're having a problem with acne, it's a secondary problem. It could be because your liver is not detoxing properly, your intestines aren't functioning [well] or because you have a hormonal imbalance. Those all have different treatments. Often, food sensitivities are involved, which is why the liver and intestines aren't working well. A good cleanse can rule out basic stuff. You need to decrease inflammation. So essential fats and vitamins E and C can be important. A high dose of vitamin A (50,000 IU a day for a month) is one treatment, but it's toxic in pregnancy and hard on the liver. Tea tree oil topically helps. Over-washing the face can be irritating. Some people are sensitive to products, so it's worth switching to a hypoallergenic face care line like Aubrey Organics. If the problem is hormonal, there's a whole other treatment protocol."
MASINA WRIGHT, naturopath, Toronto
"There's no evidence-based medicine that certain foods affect acne. There might be some anecdotal evidence. Some people swear certain foods make them break out, and if that's the case I tell them to avoid them. There are different grades of acne. Treatments start with topical medications and go on to laser treatment and oral medications. A lot of patients try the oral meds, and if they don't work go to laser, which is the strongest, safest and most effective treatment.'
LISA KELLETT, dermatologist, Toronto