Saving Face: Strategies To Keep Mature Skin Blemish-free
By Jennifer Barrett

Battling acne ranks among the most embarrassing trials of the teenage years. Many of us have stories about the pimple that ruined prom night or marred our yearbook photo. Most adults look back on acne as a thing of the past—but not always. For the nearly 17 million people grappling with acne, this painful and pernicious skin condition is a source of embarrassment and concern, especially given the potential for lifelong scarring.

"Adult acne is about hormones," says Ann Louise Gittleman, MS, CNS, author of The Fat Flush Plan (McGraw Hill, 2002). "Just as hormonal imbalances can plague an adolescent, they can also affect an adult." The problem can prove particularly vexing for women, whose hormones fluctuate with each monthly cycle, not to mention the effects of major hormonal changes during events like pregnancy and menopause. That doesn't mean that if you have adult acne you're powerless to heal it—or that high-octane drugstore cures are your only recourse. On the contrary, there are more natural means of acne control than you might think.

Anatomy Of A Bump
Acne comes in several varieties, each associated with the bacterium Propionibacterium acnes that promotes skin inflammation. Acne vulgaris, the most common and least severe form, produces pimples and blackheads; acne conglobata, the most severe, can result in cysts and scarring. A third form, acne rosacea, manifests in older adults as a persistent and painful reddish rash covering the cheeks and nose. While categorized as acne, rosacea arises from different causes and requires specialized treatments.

Blemish problems begin with a single hair follicle and its corresponding sebaceous, or oil, gland. The gland's job is to keep the skin lubricated with sebum. When this lubricant is kept from the surface due to a clogged follicle opening or when the gland simply produces too much oil, the sebum sits underneath, mixing with bacteria and eventually erupting onto the skin surface.

That's when we usually take notice, but the root of the problem begins much earlier. "Acne can reflect estrogen dominance, progesterone deficiency, or excess amounts of androgens, the male sex hormones," explains Gittleman, "any of which can create overactive sebaceous glands and unhealthy skin." Testosterone, for example, can prompt an overproduction of sebum, which is why young males as a group have the dubious honor of experiencing more acne than most. But women's hormone cycles can bring on breakouts as well; particularly at the onset of a woman's period, fluctuating levels of estrogen and progesterone create the ideal climate for pimples.

Aging and the stress of toxins also figure into the mix. "As we age, skin slows down in its exfoliation process, causing old, dead cells to just sit there and clog things up," explains Debbie Townes, co-owner of The HomeSpa, a holistic day spa in Brooklyn, N.Y. Karta Purkh Singh Khalsa, CN, AHG, a professional clinical herbalist and state-certified nutritionist in Seattle, adds that acne is "fundamentally a problem of accumulated waste material in the body—material that irritates the skin and causes persistent inflammation."

Well-nourished Skin
Smart dietary choices are essential to healthy skin, says Gittleman. Lean protein, vegetables, fruits and purified water, in addition to oils such as flaxseed, are beneficial. Overindulging in carbohydrates, on the other hand, can prove problematic. "Excessive amounts of carbohydrates without enough dietary protein and fat can elevate blood sugar, producing high levels of insulin that will trigger, through the adrenals, high levels of androgens. That will affect excessive release of sebum in your pores," Gittleman explains.

She also flags refined sugar as a major acne culprit. "Your body needs to use its own mineral reserves just to digest it," she says. Indeed, she believes minerals and vitamins play a big role in skin health: "Too much copper, for instance, from foods like chocolate, tea and soy, can compromise production of collagen and elastin and contribute to rosacea" (see "Supplement Your Skin"). Gittleman suggests working with a naturopathic doctor who can assess imbalances and advise dietary changes accordingly.

Liver health also affects skin health. When this blood-cleansing organ is overburdened with wastes and toxins or is depleted through age, the resulting system imbalance can compromise skin. Detoxifying the liver, therefore, helps support the skin and mitigate acne. Khalsa emphasizes a diet rich in green vegetables for overall detoxification. Although not yet proven, the high magnesium content in the green pigment of these plants may also cool inflammation. "Wheat grass is especially beneficial," he says, "but broccoli, cucumber, and dark leafy greens all do the trick." He recommends drinking a quart of juiced greens daily.

Lasting Effects
Conventional treatments offered by dermatologists are one option, but Townes advises these as a last resort. "Doctors have ways to dry up the skin and otherwise force it into submission, but the expense to the skin is often traumatic. Unless things have reached an absolute critical point, a much better approach is to work with your body's natural systems to establish an inner balance that will then be reflected in healthy skin."

Improvements won't appear in the mirror overnight, but in one month, you'll probably see a change for the better—and progress will prove long-lasting. "As with anything else," Townes explains, "we need to give the body time to go through what it takes to heal itself."

Jennifer Barrett is a health, gardening and travel writer based in West Hartford, Conn.