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We thought acne was something that only teenagers had to deal with, but more and more adults are finding themselves facing the return of the pizza face in their late 20s and early 30s. The reason? Hormones! According to an interview with New York City-based dermatologist Joshua Zeichner in Women’s Health, “when your hormones are out of whack, your skin’s oil production may go into overdrive, causing an acne flare-up.” Unfortunately, when most of us see a zit, our automatic reaction is to stress out about it, which will only make the situation way worse.

Here are a few ways to deal:

The Situation

Whitehead/Blackhead – a raised white or black bump you are dying to pop (but shouldn’t!)

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The Cause

A blocked pore.

The Natural Solution

Tea tree oil. Also known as melaleuca oil, this essential oil has long been praised as one of the best natural ways to deal with a breakout. New Jersey-based dermatologist and aesthetician Aurora DeJuliis tells the Huffington Post, “tea tree oil works on pimples because it has disinfecting and soothing properties.” Use it by applying a small amount directly on the spot or add a few drops to a pot of boiling water and let the steam wash over your face. Steam will open up your pores allowing the oil to penetrate and disinfect any bacteria.

If that Doesn’t Work

Try a spot treatment. Your drug store will have quite a selection, but pick one containing benzoyl peroxide or salicylic acid to dry up the zit. Olay Fresh Effects Clear Skin Spot Zinger is one that has worked for us. $13 at Well.ca

Prevent a Relapse

An exfoliating cleanser used once a week will help keep pores clean and free of excess oil. The Body Shop Tea Tree Squeaky Clean Scrub contains small beads and tea tree oil to unclog pores and clear out any excess oil. $15 at The Body Shop

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The Situation

Cystic – The under-the-skin monster ruining your life

The Cause

A blocked pore that gets irritated and causes the bacteria to go deeper into your skin, like a volcano that’s about to erupt but just won’t.

The Natural Solution

A hot cloth can help bring down the inflammation and help the bacteria move closer to the surface of the skin. Once the whitehead pops out, you can treat it as described above.

If that Doesn’t Work

Again, salicylic acid might be your best friend. Though you don’t want to go overboard with the stuff—because that will only dry out your skin and encourage more oil production—a wash with 2 per cent or more used once a day when necessary will calm inflammation and reduce excess sebum. To get the job done quick, try Dermalogica Overnight Clearing Gel, which pretty much does exactly what the label says when you apply it before bed. $64 at Dermalogica.

Prevent a Relapse

Stress is often the culprit behind these volcanic facial erruptions. That’s why they tend to crop up right before an interview or a big presentation. Keep these at bay by lowering your stress levels. A lot of people find yoga or meditation helpful, but getting at least eight hours of sleep or simple time management can help make you feel ready for the challenges of each day. Things like exercise and sex can also help, claims Ava Shamban, a dermatologist and author of Heal Your Skin, who tells Women’s Health, “these [activities] reduce excess cortisol and produce endorphins, which have a calming effect.”

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The Situation

Pustules – A next-level whitehead

The Cause

Harder to the touch and bigger than a whitehead, this dreaded form of acne often comes in a spread that covers patches of the body like sandpaper. This can be caused by a number of things, but the main culprit is diet and hormones. “Eating chocolate or a lot of junk food doesn’t by itself seem to cause acne, but not having a balanced diet and eating too many refined carbs can cause problems,” Albert Lefkovits, a New York City-based dermatologist tells Prevention.com. Similarly, an increase in hormones caused by stress or going on/off the birth control pill can turn your skin into an oil factory.

The Natural Solution

The over-the-counter acne stuff likely won’t be strong enough to battle a major breakout like this. Our best advice is to visit your family doctor or dermatologist to get something heavy duty to clear this up.

If that Doesn’t Work

You’re likely looking at a prescription to treat this kind of acne. Most derms will reach for a retinoid like Retin-A to promote healing, an anti-inflammatory to bring down the swelling or an antibiotic to kill any bacteria and tame the inflammation. Some might also suggest going on the birth control pill if you aren’t already. Shamban explains, “birth control pills like Beyaz, Yaz, and Yasmin contain analog hormones that may help clear the skin.”

Prevent a Relapse

Washing your face regularly: We know, this is pretty obvious, but keeping your face fresh and clean will help control how much oil is sitting in your pores.

Change your diet: Refined carbs, salt and dairy have all been linked to an increase of acne-causing hormones. Before you cancel your late night snack of milk and cookies, speak to a nutritionist or homeopathic doctor to see if this is the culprit behind your breakout.

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Other treatment options

Proactiv

With promoters like Adam Levine and Julianne Hough, it’s no wonder people reach for Proactiv as a miracle acne treatment. Developed by Stanford-trained dermatologists Katie Rodan and Kathy Fields, the three-step system’s main ingredient is benzoyl peroxide with some salicylic acid in the moisturizer. The percentage is a little higher than what you might find in the drugstore, but there are plenty of other products on the market that will likely work just as well.

Chemical Peels

Cosmetic procedures like microdermabrasion or chemical peels remove the top layer of skin and can therefore help you get closer to acne that has burrowed deep beneath the surface. Multiple treatments are usually required to clear up a breakout, which can get expensive and should be done in consultation with an experienced cosmetologist so you don’t damage your skin further.

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For a less abrasive procedure, try an at-home peel like this Mild Papaya Peeling mask, which uses natural papaya enzymes with hyaluronic acid to remove dead skin cells and moisturize. $15 at THEFACESHOP

Photodynamic therapy (PDT)

A newer method of dealing with mild to moderate acne, PDT uses intense wavelengths of light to penetrate skin and kill acne-causing bacteria. It usually takes a few sessions to see results and because most health plans don’t cover it, it can get pretty expensive. That said, the Toronto Centre for Advanced Skin Repair claims 70 per cent of patients experience 50-70 per cent clearing.

Accutane

Typically used for extreme cases of adolescent acne, it’s rare that a dermatologist will prescribe Accutane (isotretinoin) these days because of the many psychological side effects—anyone who’s tried it knows what we mean. A retinoid like Retin-A, isotretinoin is taken orally and is considered a last resort medication for severe cases of acne. “I don’t think the acne is severe enough in adults to warrant using that aggressive a medication,” David H. Weingold, an Arkansas-based dermatologist tells Dermatology Times.

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