The grown up guide to teenage skin: how to tackle adult acne

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Joanna McGarry
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With more women seeking acne treatment than ever before, Stylist enlists dermatologist-turned-acne-vlogger Dr Pimple Popper to share her blemish-banishing tips

What’s your guilty pleasure? Eighties power ballads? Ryan Gosling films? For millions, it’s watching spots being popped by a dermatologist online. For fun. In one of the most peculiar psychosocial trends to be born of the digital age, pimple-popping has now exploded into the mainstream. 

There is one woman at the heart of all: Dr Sandra Lee. As a board-certified dermatologist, skin-cancer surgeon and cosmetic surgeon, she heals diseased skin. But it’s her work in excavating giant spots that’s established Lee as Dr Pimple Popper.

Two years ago, the LA-based skin doctor uploaded a video of a blackhead extraction as an experiment. It went stratospheric. She filmed more. Now, her videos can glean 25 million YouTube views – ranging from the excision of a 10-year-old cyst to a particularly stubborn blackhead behind the ear. The uninitiated require an iron stomach. For die-hard ‘poppers’, they are a portal to heaven.

But behind the thrill of the pop lies a shift in our skin’s behaviour. Adult forms of acne – where pores on the face, chest or back regularly become blocked with oil – is on the rise, with a 200% increase in the number of adults seeking specialist treatment. Dermatologists put this down to an increase in stress and poor diet, though data connecting certain foods to acne is sketchy. 

Women are the most afflicted, with 44% of UK female adults now suffering – almost twice that of men. “Acne is very hormonally driven so tends to affect women at a higher rate,” says Lee, which explains why 75% of her audience are adult women. And yet, even up until 2015, 97% of the acne skincare market was aimed at teenagers.

But what’s scarcely acknowledged is the psychological impact of a flare-up. One study found almost half of all adult women with acne were suffering with depression or anxiety, while a further 40% believed it interfered with their ability to focus at work.

Mercifully, a batch of acne-targeting skincare products, with adults in mind, is set to hit the shelves. Still, as Dr Pimple Popper’s success proves, sometimes a squeeze is also necessary. Follow Dr Pimple Popper’s guide to tackling it head on…

The anatomy of acne

The key causes

If both parents had acne, you have a 75% chance of getting it too – dropping to 50% if it’s only one parent. Studies show a greater chance of inheriting acne if your mum passes it down, implying it’s carried through the X chromosome.

The menstrual cycle is a trigger and tends to impact skin the week before a period. A surge in progesterone increases sebum production, causing spots. Studies show if you had acne as a teen, there’s a greater chance of pre-menstrual acne.

High stress causes the adrenal gland to produce more testosterone, heightening the propensity for blocked pores and acne. Research shows the stress hormone cortisol raises the risk of inflammation in the body, a vital proponent of acne.

White grains with a high glycaemic load, such as bread, are seen as a cause. Acne is also less prevalent in non-Western countries where diets tend to be low-sugar and low-glycaemic.

The pimple preventers

  • Alumier MD Acne Balancing Serum

    This serum provides a deep clean for acne breakouts. It houses a potent blend of 2% encapsulated salicylic acid, a dose of anti-inflammatory hinokitiol, plus spot-fighting honey, aloe and rice bran to soothe.

  • Garnier Pure Active Sensitive Soap-Free Gel Wash

    Tackle spots without drying out skin with this hypoallergenic, salicylic acid-infused face wash. It’s non-abrasive yet gently sloughs off dead cells and leaves skin soothed.

  • May Lindstrom The Honey Mud Enzyme Cleanse and Masque

    If trying everything to combat cystic acne has made the problem worse, then opt for naturally effective formulas and focus on cleansing. This formula contains clays, salts and vitamin C to shift bacteria.

The overnight heroes

  • Malin + Goetz 10% Sulphur Paste

    This intensive spot treatment kills off the bacteria in whiteheads and pustules overnight, and improves skin clarity. After cleansing, dip a cotton bud into the gel fluid and dab directly onto blemishes before bed.

  • La Roche-Posay Effaclar AI Targeted Breakout Corrector

    You’ll find this unassuming white tube parked on the bedside table of many a beauty editor. Niacinamide halts pimples in their track, while a glycacil complex purifies the area.

  • Amanda Lacey Miracle Tonic

    This stuff really packs a punch. Use it directly on whiteheads with a cotton bud before bed. It may sting a little, but it’s been known to half the life-span of pimples, thanks to salicylic acid and soothing mint and rosemary.

To pop or not to pop?

Navigating a breakout can be problematic. Allow Dr Pimple Popper to guide the way in tackling blemishes quickly and effectively

How to treat blackheads

How to spot one: “Small, dark-coloured spots on the skin’s surface. They occur on cheeks, across the nose and between the brows.”

How it got there: “When a pore that’s clogged with debris and keratin remains open at the surface, the keratin reacts with oxygen and turns a dark colour.”

To pop or not to pop? “Pop. I recommend using a comedone extraction tool – I use one called the Shamberg [£24] which is medical grade so the edges are honed to avoid scratches. You can use clean fingers too, but put your face over a steam bowl first so heat softens the blackhead.”.

Then what? “If the area is red following an extraction, apply an over-the-counter topical steroid or an acne spot treatment containing salicylic acid to keep the area clean.”

How to treat whiteheads

How to spot one: “Bumps on the skin with small white heads, harder to remove than blackheads. They tend to be found in women in their early 20s, as they often have oilier skin.”

How it got there: “When skin is oily, it’s the perfect environment for bacteria to thrive and that’s when you get the pimple.”

To pop or not to pop? “You shouldn’t pop anything unless it has a head. Cleanse the area first and use a clean tool. It should come out easily if it is ready – if not, give up because forcing will only irritate your skin and increase the risk of scarring.”

Then what? “A spot treatment is the best way to target a breakout. You can’t guarantee a whitehead will be gone in the morning, but squeezing it repeatedly will make things worse.”

How to treat pustules

How to spot one: “Inflammatory yellowish bumps with a red base, often painful to touch. They house bacteria-formed purulent contents inside – also known as pus. They are connected to hormonal imbalances, resulting in breakouts around the chin and jawline.”

How it got there: “A build-up of dead leukocytes [white blood cells] binds with bacteria in response to a localised infection. The area then fills with fluid.”

To pop or not to pop? “If the pimple doesn’t have a head, don’t extract it. If you can pop it, stop once there is no more pus, or you see a little blood.”

Then what? “Disinfect with an antiseptic after popping and then a cold, wet compress to soothe the area. Avoid putting make-up on for two days to let it heal.”

How to treat cysts

How to spot one: “Deep-seated bumps in the deeper layers of the skin; very painful and red, and carry a high risk of scarring. Cysts can occur anywhere from the scalp to the neck, but they’re usually found in oily areas of the face, such as the chin.”

How it got there: “Dead skin cells combine with bacteria causing the area to become infected, red and swollen. Cysts occur when the infection goes deep in the skin and over a wider area.”

To pop or not to pop? “Never squeeze a cyst. This can cause further inflammation. For a persistent cyst, seek a dermatologist as prescription medication can be needed.”

Then what? “Use acne products containing salicylic acid to remove excess oil. Take a daily zinc supplement to reduce inflammation.”

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The quick fixers

  • SLMD x Dr Pimple Popper Acne Spot Treatment

    The first product to come from Dr Pimple Popper’s long-awaited full skincare line, this non-comedogenic, oil-free, paraben- free and cruelty-free formula contains 2% salicylic acid to quell all types of eruptions and slough off bacteria from clogged pores.

  • Nip + Fab Teen Skin Fix Spot Zap

    Yes, it contains the word ‘teen’ in the title, but this fast-acting zapper is ideal for spot-prone skin of any age. Gently roll the soothing tip directly onto pustules and cysts – wasabi extract acts as an antibacterial, while witch hazel and tea tree oil calm redness.

  • Drying out a recently purged pustule in a matter of hours is no mean feat, but this sulphur-infused ointment is powered with vitamin B3 to reduce inflammation in record time. Plus, it smells reassuringly medicinal.

The spot-fighting concealers

  • BareMinerals Blemish Rescue Spot Concealer

    Available in four shades, this soft, pencil-tipped concealer is built for blotting away the redness of a recently brewed cyst – thanks to dense pigments and pore-refining aspen bark extract – and contains kaolin clay to draw away excess oil from the skin.

  • Hourglass Hidden Corrective Concealer

    A super-lightweight formula that won’t add bulk to pustules, and instead sits gently on top. A shot of vitamin E provides a protective layer, helping to reduce further infection from polluted air. The impressive range of 10 shades, covers off a wide spectrum of skintones.

  • iT Cosmetics Bye Bye Breakout

    Witch hazel, tea tree and kaolin clay combine in this full coverage concealer to hide and reduce spots while you wear it. There are seven different shades, this is specially formulated for oily, acne prone skin so don’t worry about it sliding off over the day.

Images: iStock


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Joanna McGarry

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