I love Well + Good, but I loved Well + Good even more after I read contributor Rachel Lapidos’ recent essay on acne and mental health. Breakouts both big and small impact the way we view ourselves and the world around us – which is why I passionately insist that taking care of your skin is an important form of self-care.
My boyfriend and I swap stories about acne and confidence frequently. We have had opposite experiences with acne: while he struggled with his skin growing up, I only recently developed adult-onset hormonal acne when I got the Liletta IUD.
For him, acne was a source of stigma and insecurity that affected the way he saw himself, and the way his peers treated him. For me, having adult-onset hormonal acne is a frustrating insight into the life of the modern American woman: I am presented with a choice between preventing pregnancy and having clear skin. Acne seems like a small price to pay for seven years of pregnancy protection, but as someone who has faced social anxiety and disordered eating, it’s a daily challenge to look in the mirror and not always like what I see.
Some of you might say, “Well, why not change your thinking instead of your skin?” Redirecting and rewiring negative thought patterns is certainly an element of building body confidence – but looking and feeling good in the skin you’re in helps, too. After all, it’s hard to feel good about the skin I’m in when the skin I’m in is greasy and inflamed.
That’s why skincare is an essential component of my self-care routine: when I neglect my skin, I neglect my mental health, too. The opposite is often true, too: skin problems can be an outward reflection of an internal health problem (such as gut dysbiosis, which can be caused by stress, medication use or depression/anxiety).
Thus, skin is an important component of our mental health, both as a symptom and a treatment for stress, anxiety and depression. Specifically, this guide hones in on acne: what its causes are, how it relates to mental health and, most excitingly, some of my favorite tips, tricks and products for treating your skin well. Let’s get to it!
Acne and Mental Health
First thing’s first: acne is more common than you think. In fact, 80% of people between the ages of 11 and 30 struggle with a breakout at some point in their lives. And as for those of us with chronic acne, we have a 63% increased risk for developing depression – which is why it’s so important we address the relationship between skin and mental health.
Below, you’ll find some facts I selected to show you just how interconnected skin and mental health truly are:
- Studies show that acne directly impacts teen girls’ self-esteem. Many say they feel unattractive, even if their acne is mild, during a breakout.
- One study showed that 38% of acne patients suffered from depression, and 34% suffered from social anxiety. These results were more prevalent among females than males.
- 88% of acne cases reported embarrassment as a result of their skin condition. As a result, 69% of patients avoided daily activities like shopping, 57% reported negative effects on work or study and 68% said it negatively impacted their social lives.
- Adult female acne is also prevalent, with the average age of onset ranging from 19-31 years old. Female patients reported perceiving their adult acne as burdensome and impacting their self-confidence, and frequently used makeup to conceal their blemishes.
What Causes Acne?
We’ve perpetuated many myths about what causes acne over the course of the years – ever hear the rumor that chocolate causes acne? (Yeah, not true.) Unfortunately, the causes of acne aren’t as clear-cut as magazines and health gurus may lead you to believe.
Many acne triggers are individualized, and must be identified through self-awareness of symptoms and the conditions causing them – think food diaries and period tracking, for one thing. The causes of acne range from allergy responses to things like gluten or dairy, to hormonal imbalance and gut dysbiosis, to a bodily stress response to the over-production of cortisol.
There are more rumors and myths surrounding the causes of acne than concrete facts; however, here is what we do know about the potential triggers of acne in adolescents and adults alike:
- Hormonal changes. In women, hormonal changes are a top cause of breakouts. Many women break out due to the changes in sex hormones during puberty, the menstrual cycle and when using certain types of birth control. (For me, it was the hormonal IUD that did it.)
- Medication. As mentioned previously, the side effects of certain medications may include acne. These medications include, but are not limited to, corticosteroids, anti-seizure medications, antidepressants and birth control pills.
- Oily skin. The bacteria that causes inflammatory acne – p. acnes – thrives in sebaceous (oily) environments. Thus, if you have oily skin, or use too many oil-containing beauty products, you may have a greater tendency to break out.
- Environment. Both nature and nurture contribute to the onset of acne. While you can definitely inherit a tendency toward acne from your parents, you can also compound the problem by hanging out in humid, polluted or oily environments – think kitchens with fryers, the Everglades or LA smog.
My Skincare Tips
Since the onset of my adult hormonal acne at 19, I have tried just about everything to eliminate it. I’ve had many trials and errors – but in the process, I’m thankful to have discovered at least a few things that help in both my lifestyle and my beauty routine.
Below, I’ll share just a few of my favorite products and tips for treating acne. If you have mental health issues, and you have acne, I highly recommend trying these out – because skin care is self-care, and you are not selfish or vain for taking care of your skin!
- Keep a food and symptom diary. I don’t believe in dieting as a general rule, nor do I think there’s anything wrong with eating a cupcake (or five) every once in awhile! However, there is evidence to show that eating certain foods – like gluten, sugar or dairy – can be linked in breakouts to people prone to acne. I recommend keeping track of your diet in a food diary (note: by “diet” I simply mean “the foods you eat every day,” not a diet in the traditional sense of the word!) and taking note of your breakouts alongside it. Soon, you may notice an emerging pattern of what foods affect your skin in a negative, or positive, way! (Side note, but if your acne is linked to gut dysbiosis or another digestive condition, you may also want to consider an elimination diet to identify potential food intolerances.)
- Identify inflammatory ingredients using CosDNA. I learned about CosDNA from a dermatologist on Curology after reviewing their custom acne-treatment service for my previous blog. Basically, this website lists all your favorite skincare products with their ingredients, and rates their ingredients from 1 to 5 from the least to most harmful for acne. Remember to take the results with a grain of salt – for example, retinol is given a 5 for inflammation but is one of the best over-the-counter treatments for acne – but this site is amazing for giving you a general idea of what skincare products might be contributing to your breakouts.
- Read The Skincare Bible by Dr. Anjali Mahto. THIS BOOK CHANGED MY LIFE. It taught me everything I didn’t know (but wish I had) about acne and skincare back in high school when I first started dealing with oily skin and breakouts. Dr. Anjali Mahto is a consulting dermatologist in the U.K. who not only treats women with everything from cystic acne to menopausal rosacea, but also suffered from acne herself. Her book goes through everything from how to read the ingredients on your skincare labels to what ingredients to look for and avoid for different skin care conditions to how acne affected her own health and self-confidence as a teen. Basically, it’s equal parts big sisterly advice and dermatology appointment for a fraction of the cost – and I highly recommend it!
- Know when to visit your doctor. If everything you try over the counter fails to treat your cystic acne, if you’re suffering from deep, painful, blistering blemishes or if you suspect there’s a co-occurring medical condition with your acne, it’s probably time to make an appointment with your GP or a board-licensed dermatologist. To find a qualified, board-certified derm in the United States, visit the American Academy of Dermatology’s Find-a-Derm site to search for a local professional who accepts your insurance.
Source: Aim for Glam
For acne-prone skin: Kate Somerville Eradikate Daily Foaming Cleanser ($38)
Source: Ulta Beauty Coupon 2017
For stubborn blackheads: Biore Deep Cleansing Pore Strips ($7)
Source: Garden Collage Magazine
For removing every drop of makeup: Simple Micellar Cleansing Water ($5)
Source: Dress with Yas
For an extra-deep clean: Peter Thomas Roth Therapeutic Sulfur Masque ($47)