Q. My ten-year-old has started to get pimples. What can I do to help avoid an acne problem?
A. For some reason kids nowadays seem to grow up earlier than we or previous generations did. It might have something to do with all the food additives they eat and the psychological effects of the “grown up” television shows and movies they watch.
Whatever it may be, the fact is they start their adolescent years (and associated problems) quite early. The hormonal changes in the body affect the skin, and pimples are one of the tell-tale signs of puberty; body hair is another.
Teach you daughter or son to use only cold water to wash the face. Warm or hot water would promote more loss of the skin’s own oil or moisture and would increase oil production, which is out of balance already. No soap should be used for the face. Soaps are more alkaline-based and the skin should be in an acid medium. It may help to put a little lemon juice or apple cider vinegar in the wash water. It is also important to always towel-dry the skin. The evaporation also causes dehydration, and this has to be avoided.
In order to avoid dehydration, a very light moisturizer should be used after every washing. A monthly deep cleansing mask would also help keep the skin soft so that the oil can get out and not plug it up.
Make up will only aid in plugging up the pores. During physical activity the skin should be able to breathe, especially during perspiration, and make up will not allow this to happen. A lot of acne sufferers use make up to cover up their blemishes, but this accentuates the acne, so it should be avoided. Do not squeeze pimples. To break one without the proper asepsis could mean an invasion of bacteria.
Some sunshine is good, but excessive sun exposure will harden the surface cells of the skin and the oil will not be able to get out. Suntan lotion may be advisable. Personally, I do not recommend the very high SPF numbers since they may have a toxic side effect and also give the person a false sense of security with too much time spent in the sun.
The food for an adolescent with acneic tendencies should be light and natural. Avoid deep fried foods and go easy on sugary snacks.
Q. What causes acne?
A. There are several factors including excessive oil build-up; hardening (keratinisation) of the skin, for example, by too much sun or detergent-type cleansing products; and invasion of bacteria.
In some people, the skin would produce too much oil at the base of the hair follicles. This is mostly genetic. It starts during maturation and is caused by the hormone testosterone, which is produced by both boys and girls.
Depending on some inner chemical activity in the individual, testosterone changes the balance within the sebacious glands/cells. When more oil is produced it could result in dehydration. You can have dry skin when you become too oily. Dehydration causes the oil glands to work overtime and produce even more oil. This is why you cannot dry out oily skin–it is already dried out.
Within the sebacious cells are keratinised cells which normally move to the top layer of skin gradually, die and fall off. In the case of acne, they kind of glue together in clumps to form a plug and the oil (sebum) cannot get out. They either cause the pores to enlarge and form blackheads, or if they block the evacuation of sebum totally, a hard comedo or even a small cyst under the skin could appear. By manipulation, or if you force it open, you may invite bacteria in, which could cause an inflammation: You will develop papules (hard, red bumps under the skin) and pustules, which sometimes come to a yellow head with puss inside.
Q. How can acne be treated?
A. 1. By a dermatologist, using topical medications.
2. By an esthetician/cosmetologist, who will deep cleanse the skin, removing the blackheads before they develop into comedogenic cysts.
3. By a common sense home care system, as outline in Question #1.
Q. What kind of treatments can I expect from a dermatologist?
A. Depending on the type of acne and the age of the patient, expect one of the following:
a) hormonal treatment with estrogen and anti-androgenes,
b) antibiotics and cyclins, topically or orally, and azelaic acid to fight bacteria. Some of these drugs have serious side-effects on the reproductive system and should not be used during pregnancy, and
c) for very young patients, incisions on mycrocysts, deep-cleaning and removal of blackheads. They should not have the treatments outlined in b.
Q. Can acne be caused by the sun?
A. Yes. It is known as “Mallorca acne” in Europe and can happen through a fungi infection, for instance, lying in the sand without a towel or blanket underneath. It can be a reaction to a suntan product or appear simply by exposing a pale body too quickly and too long in the sun.
In the case of an active or even a chronic acne the sun may seem to have a healing effect. However, the sun exposure will promote keratinisation and the acne will come back or might even be more severe than before.
Q. Can cosmetic ingredients cause acne?
A. Definitely. Some are more comedogenous than others. Vegetal oils like peanut oil, sunflower oil, coconut oil and sweet almond oil cause more problems than, for instance, petroleum jelly as an ingredient (not in pure form).
Basic lanolin or lanolin oil are supposed to have relatively low comedogenous factors, contrary to hydrogenated or acetylated lanolin. It is hard to know which type is used in a product if the list of ingredients only shows lanolin. You may have to experiment or avoid products listing it.
Should you find the following names in the list of ingredients, the product is not suitable for young acne sufferes: isopropyl myristate, isopropyl palmitate, isopropyl isostearate. In connection with other ingredients such as solvents, emulsifiers or pigments, the comedogenous effect could be lower. Read the manufacturers’ recommendations. Try to get advice from your retailer or write to the manufacturer.
Q. Can I get rid of freckles I picked up over the summer?
A. Most likely not. If you tend to get freckles you have to start wearing sun protection lotions very early in spring and stay out of the sun. An appropriate cover-up is difficult to choose since you cannot achieve an even tone between the darker and lighter spots.
Q. Facial exercises have toned up my skin, but it seems that my eye area got worse. Is it better to use a cream only? I’m in my 30s and these lines make me look tired and older.
A. You cannot tone up the eye areas because the skin is very thin there and the lines and wrinkles are practically ironed in from laughing, squinting and crying. It is almost impossible to avoid these lines.
Keep the skin around the eyes soft. Wrinkles don’t get as deep in soft skin. My recommendations: Don’t use warm or hot water in the eye area. When in the sun, wear sunglasses or a wide brimmed hat to avoid squinting. Do not stay in the sun too long because this hardens your skin. Apply eye cream softly around the eyes by following the eyebrows.
Q. I break out when I use creams and lotions. Do you recommend the new HABA Squalane line?
A. The HABA line gives the skin a good rest from all other cosmetics. Since it is fragrance-free and allergy-tested, you might have no problems with it. I especially like the toner. Don’t use more than three drops of the liquid moisturizer, it goes a long way. When you use too much, you will perspire.
I tried it in my eye area with no side effects. I use the “soap” only once a week, since the skin does not really get dirty when you don’t use make up. If you do wear make up, use it every evening. By the way, the HABA Company has a book- with lots of useful information. Look for their advertisement in this magazine.