I’m Too Old to Get Acne, Right?

( [email protected] ) Oct 28, 2004 12:27 PM EDT

That’s it, aging stinks and I’ve got the wrinkles and pimples to prove it. I woke this morning to find another freakin’ breakout. At 33, I thought I was too old for acne, or at least this was one measly benefit of aging that I’d been clinging to. But, there’s no doubt; they’re there, staring back at me, those evil little spots.

What exactly are acne spots?

Acne is a disorder resulting from the action of hormones on the skin's sebaceous glands (oil glands), which leads to plugged pores and outbreaks of lesions commonly called pimples or zits. Acne lesions usually occur on the face, neck, back, chest and shoulders. Although acne is not a serious health threat, the blemishes and scarring are no doubt harmful to self esteem and social life. Adults are also affected by acne as well as acne rosacea.

A specific cause for acne has yet to be determined however there are various postulated exacerbating factors like fluctuation in sex hormones, certain skin products or cosmetics, vitamin deficiencies, thyroid hormone deficiency, stress, diet and genetics. Topical treatment can be sufficient for most persons with acne. However, systemic treatment is often required for deep acne with nodules and cysts, or acne associated with symptoms of hormonal imbalance like stress, hypothyroidism, anxiety, PMS, polycystic ovarian disease, male pattern baldness or hirsutism.

What can contribute to adult acne?

Sex hormone imbalance

Women often experience a flare-up of acne symptoms from a few days to as much as a week before the onset of their menstrual periods. This occurs as progesterone, which tends to worsen acne, is naturally highest during this time of the cycle. Estrogen, highest in the first half of the menstrual cycle is typically beneficial for preventing acne. Due to this, birth control pills higher in estrogen can be useful in the treatment and prevention of acne, while some women experience acne for the first time only once they stop taking the pill. The use of the birth control pill for acne is not without side effects including increased risk of blood clots, depression, weight gain, and some sources may suggest a slight increase in the risk of certain types of cancer with long-term use.

If any of these patterns apply to your acne prone skin you may want to consider the following options:

• Methods to balance estrogen and progesterone. Having one serving of soy product per day as well as 2 -3 tablespoons of ground flaxseed can have phytoestrogenic effects in the body and help to prevent breakouts.

• If you are coming off the birth control pill, indol 3 carbinol is a must for you. This compound, an extract from broccoli and other cruciferous vegetables helps to correct estrogen balance in the body and is very protective against certain forms of cancer such as cervical, breast and in men, prostate cancer. Typical dose is 200mg twice per day and it is best to take this product for 3 months.

• The herb vitex may be useful for the treatment of hormonally related acne, especially blemishes associated with PCOS and possibly higher testosterone in women.

• The B vitamin which helps with healthy hormone balance, vitamin B6 may also be of benefit. Taking 250 – 500mg per day is useful in both men and women.

Acne is often considered to be an androgen-dependent condition. Androgens are male sex hormones including free testosterone, dihydrotestosterone, dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEA-S). Low sex hormone binding globulin (SHBG) levels (SHBG binds to testosterone rendering it less bio-available, reducing its effect in the body), as well as high androgens, have all been implicated in acne. This is because androgens control sebaceous gland secretion, thus exacerbating blemishes when elevated. Higher levels of androgens may be treated with the herb saw palmetto in both men and women. If higher levels of androgens are a result of too much being produced by the adrenal glands, then herbs or products to reduce further stimulation of the adrenals may be of assistance. These include ashwaganda or hydrolyzed milk protein (a product called Seriane). Note that I would not recommend Relora, an herb commonly used for stress support in this situation, since it may actually increase levels of DHEAs and worsen the problem.

Stress hormone imbalance

Although the relationship between emotional stress and acne is debatable, cortisol, the body's primary stress hormone, does have several negative side effects like suppression of the immune system, destruction of muscle fibers, increased calcium loss from the bones, elevation of blood sugars and destruction of the area of the brain associated with memory. Cortisol has been implicated in female adult acne and it is suggested that it is also responsible for most age-related damage to the skin. To reduce cortisol, vitamin B5, vitamin B6, vitamin C and the herb holy basil can be useful. In this instance, Relora may be beneficial as it has been found to reduce cortisol levels. Lifestyle is essential here and you should be sure to adopt healthy stress management techniques. Be sure to get adequate rest, exercise, downtime and sunshine.

A note about the thyroid

In my practice, I have seen men and women experience acne when their thyroid is underactive. Be sure to rule this out with blood tests (TSH, Free T3, Free T4, Thyroid antibodies and reverse T3) through your doctor. Another simple test that you can do at home is to take your temperature under your arm every morning before getting out of bed with a basal body thermometer. If your temperature is consistently below 36.4 degrees Celsius you may have a sluggish thyroid and could benefit from the Truestar Supplement Plan for Thyroid Health.


Products containing retinoic acid may be useful topically, but you should see your dermatologist. Tea tree oil is a natural astringent and antibacterial, so you may want to consider products containing this. Some cosmetics, night creams and heavy moisturizers may actually block oil glands, worsening existing lesions and causing new ones. Try to find products that are oil-free, water-based, non-comedogenic, or speak to your doctor for specific recommendations. Try to limit the use of products with antibiotics, as they are not without side effects too!

The basic treatment plan for acne and healthy skin

Selecting one or more of the treatment options above will help you get to the cause of your acne. Along with this, there are fundamental dietary guidelines and supplements that should be included in any treatment plan for optimal results.

There is controversy over whether or not dietary habits have any influence on the frequency or severity of breakouts. So many references say there is no correlation between the two, however in my practice I have found that the removal of dairy products, caffeine, reducing the intake of chocolate and avoiding sugar as much as possible are all effective.

Eating a healthy ratio of protein and carbohydrates with each meal and snack can also balance blood sugar and subsequently stress hormones, both of which may reduce acne. Finally, be sure to include natural anti-inflammatory, healthy fats in your diet such as olive oil and fish oils. Avoid unhealthy oils like peanut, soy, vegetable or hydrogenated oils which will increase inflammation in the skin and worsen the problem.

As far as supplements are concerned, regardless of the cause of your acne one should include zinc 25-50mg per day, vitamin A 10,000-50,000IU per day (not to be taken by women who may be pregnant or attempting to conceive), vitamin C 1000-3000mg per day, and MSM 2000-4000mg per day for healing, collagen formation and tissue repair. I have formulated the Truestar Supplement Plan for Healthy Skin just for this purpose.