Feel and see the difference


One of my passions in skin care is acne treatments whether its teenage acne or adult acne. For teenagers it’s such an annoying experience, and because you are not well informed about what’s happening internally that’s causing the acne, it can be very frustrating. The good news for some is it will soon disappear with age and unfortunately for others it’s a lifelong battle. It’s also a common thing for adults who never had problematic skin in their young years to start experiencing such challenges.

Acne often leads to scarring, which is extremely difficult to treat. It can produce significant psychological and social problems, including lower self-esteem, anxiety, depression and low mood.

While teens get acne because of hormones during puberty which trigger excess sebum (oily secretion) production in the skin, adults can get acne due to a variety of reasons ranging from innate factors and external factors.



Research has shown us that there is no specific acne gene however some people tend to produce excess sebum or skin cells which increase the likelihood of clogged follicles leading to breakouts.

Hormonal Changes

We know from science that there is a relationship between testosterone and sebaceous glands. Testosterone is produced by the gonads (Leydig cells in testes in man and by the ovaries in women) and also small quantities are produced by the adrenal glands in both sexes. When testosterone enters into the sebaceous gland where enzymes convert it into di-hydrotestestorone which stimulates increased sebum production and sticker sebum leading to acne.

Not only can sebaceous glands become over stimulated, adrenal glands can produce less progesterone which is a natural anti-anxiety or anti-depressant substance. This hormonal shift can lead to an imbalance in oestrogen and progesterone leading to breakouts.

Women have tendencies to experience hormonal fluctuations and acne breakouts during menstruation, pregnancy and menopause. In women too, Polycystic Ovary syndrome is a main cause of acne.


We may not realise the toll on our skin due to our busy daily schedules, increased pressures to do more and faster in a short space of time. This causes chronic internal and external stress leading to adult skin acne and pre-mature ageing.

Research shows that ,not only does internal stress trigger breakouts ,it can also make existing breakouts worse as one gets stressed about them more.

Continual stress increases levels of stress related hormones such as the corticotrophin -releasing hormone ,cortisol and adrenalin which send sebaceous glands into overdrive. This leads to excess sebum production which mixes with dead skin cells to clog follicles in the skin and causes the breakouts. Cortisol also lowers natural production of Hyaluronic Acid, and this lowering dehydrates the skin. Now combining dehydration and excess sebum creates an imbalanced microbiome, a perfect breeding ground for breakouts.

Stress also causes skin’s barrier to be compromised causing it to lose some of its ability to protect itself .



Smoking, drugs, certain medications, under-cleansing , what and how much you eat and drink affects the skin.
Hair, make-up or skincare products that contain comedogenic ingredients can lead to clogged follicles.

Some people find squeezing their spots a stress-release mechanism that is hard to stop no matter how much they are advised not to. The truth is, after squeezing a spot, the skin is inflamed and appears more red , often you feel guilty about it which then adds more stress and the vicious cycle continues.

Excessive acne treatments or harsh exfoliation can worsen inflammation ,dryness and sensitivity around breakouts, making them appear more red , flakier and leading to post acne hyper pigmentation.

Studies suggest that certain foods may influence sebum production and inflammation. Low -glycemic diets that includes fruits ,vegetables, lean protein and healthy fats are recommended.


Those with persistent acne experience continuation or relapse of acne from adolescence to adulthood.

Late onset acne ( 25 years and above) can happen to everyone irrespective of prior acne during teenage years.
Both acne types are associated with inflammation , changes in pigmentation and scarring which cause the skin to have the appearance of premature skin ageing.

Breakouts tend to occur along the mandibular region(chin, mouth and jaw line) and sides of the neck .

Adults also often have dry, sensitised skin conditions in addition to acne, which makes it a bit more complex to treat than teens.

Post-Inflammatory Hyperpigmentation (PIH) is discolouration that follows an inflammatory wound and is a common concern among adults with acne breakouts. The discolouration ranges from pink to black depending on your skin tone. It creates dark marks that remain for several weeks after a breakout has cleared. This prolongs the stressful experience of having acne and causes uneven skin tone that accelerates the appearance of premature skin ageing , more common in darker skin tones.

How is Post-inflammatory Hyperpigmentation (PIH) formed?

PIH is caused by the exaggerated response to injury of the skin melanocytes and this results in an abnormal distribution of the pigment melanin in the tissues. Melanocyte activity is stimulated by the same inflammatory mediators that are activated when the skin’s immune response is activated. When inflammation subsides, the inflammation mediators revert to normal levels, and so does the production of melanin.

In due season the cells causing hyperpigmentation rise to the stratum corneum and slough off, causing the hyperpigmentation to disappear. However if the inflammation is severe, the hyperpigmentation will be evident in both the epidermis (top layer of skin) and the dermis (middle layer of the skin).The pigments will not go into the slough-off process but can be stuck for many years.

If you have any skin concerns and do not know what to do, please send us an email or call us , will be happy to help.

Pamela Sithole x


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