Problem skin isn’t just a worry for teenagers — spots affect half of over-25s, many of whom get their first outbreak in their 40s.
Women are affected twice as much as men, because of hormonal fluctuations.
‘Changes in hormones around the menopause can trigger acne, and stopping the contraceptive pill after many years to start a family can also trigger a flare-up of spots,’ says Dr Justine Hextall, a consultant dermatologist from the Tarrant Street Clinic in Arundel, West Sussex.
Spots occur when the skin’s oil glands, which sit around each hair follicle, become overactive, producing excess oil that blocks the follicle, or pore.
A bacterium known as C. acnes, which normally lives harmlessly on the skin’s surface, can then enter and cause inflammation, which results in a spot.
CAROLINE JONES asked Dr Hextall to assess a selection of products for spots, which we then rated.
30g, £10.49, boots.com
Claim: This 5 per cent strength benzoyl peroxide gel promises to effectively treat your spots by killing the bacteria that cause them. Apply once or twice a day.
Expert verdict: There is lots of robust research to show the effectiveness of benzoyl peroxide at this strength; it is often prescribed as a first- line treatment for acne.
It kills the bacteria that cause acne and is also a ‘keratolytic’, meaning it encourages the dead skin cells to shed, which unblocks pores.
This means it is particularly effective for ‘comedonal acne’ — typified by very bumpy skin and blackheads — as well as deeper inflammatory spots.
But benzoyl peroxide can irritate skin, so introducing it slowly is crucial — perhaps every other night — and use it alongside a gentle cleanser and light moisturiser to protect the skin barrier.
Pack of four, £5.99, boots.com
Claim: These strips contain witch hazel and claim to ‘pull out’ blackheads [plugs of oil that block the hair follicle and are considered a type of acne] for ‘purified pores’.
Use only on the nose, applying to wet skin — then after ten minutes or when it has dried, peel off carefully.
Expert verdict: Strips like this usually just remove dead cells or dirt from on top of the skin. They won’t do much to remove blackheads on the nose.
In fact, I’d be concerned that they remove too much from the top layer of skin and disrupt the skin barrier, which would make the area dry, irritated and inflamed — and could cause more spots.
Witch hazel has been shown in studies to help reduce inflammation and to encourage healing — but I’d skip the strips and just apply some of the pure liquid (available from a pharmacy) directly to a pimple.
10ml, £3.69, chemistdirect.co.uk
Claim: This contains chloroxylenol, which promises to inhibit the growth of the C. acnes bacterium, and moisturisers including panthenol and allantoin. Apply directly to spots as often as required.
Expert verdict: I am pleased to see this treats the acne while also hydrating, which many spot products don’t do.
Panthenol, which the body converts to vitamin B5, acts as a humectant, which means it binds water to skin, keeping it soft and moisturised. Allantoin, from plants, is anti-inflammatory, hydrating and exfoliating.
My one concern is the chloroxylenol — an antibacterial found in products such as Dettol.
You may find this kills the acne-causing bacteria but also the ‘good’ bacteria on the skin that protect the skin barrier — and this may cause dryness and inflammation.
I’d prefer a product with salicylic acid, which has proven spot-fighting benefits with less risk of irritation.
100ml, £19, dermalogica.co.uk
Claim: This foam promises to both clear and prevent breakouts with the exfoliating ingredients salicylic acid and grape extract. Apply one squirt once daily to a cleansed face and allow the foam to absorb.
Expert verdict: Salicylic acid works by breaking the bonds between dead skin cells, which can otherwise combine with oil to block pores and trigger spots.
But it’s in a low percentage (0.5 per cent) here — I advocate around 2 per cent for acne.
That said, it is combined with grape extract (or alpha hydroxy acid), which is another good exfoliator, so this will boost the overall power.
What is striking is that it contains a lot of essential oils. I would be cautious about using this product on sensitive skin, as these oils can irritate — which is the last thing you want on already inflamed acne.
100g, £7.50, boots.com
Claim: This soap contains charcoal and tea tree oil and promises to prevent and clear breakouts from your shoulders and back.
Expert verdict: Around 60 per cent of those with facial acne also get acne on the back, an area with a high concentration of oil-producing glands. Exercise can exacerbate the problem, as sweat may encourage the overgrowth of bacteria.
Activated charcoal — which is very absorbent — will, in theory, help to draw out oil and dirt from follicles, although this has never been properly tested in trials.
There is much more evidence for tea tree oil — one review suggested that at concentrations of 5 to 10 per cent it is effective, although this bar doesn’t state how much it contains. It also contains shea butter, which is an ideal moisturiser.
20ml, £16.99, superdrug.com
Claim: This paste contains sulphur, a mineral that the maker says reduces blemishes ‘overnight’ and prevents breakouts.
It also contains niacinamide to reduce redness. Apply to the blemish before bed.
Expert verdict: The niacinamide, a form of vitamin B3, is a useful ingredient, as it reduces oil production in the skin and can calm any red spots.
Sulphur has long been used in skin treatments for its natural antibacterial and anti-inflammatory properties — although there don’t seem to have been any large studies on its use in acne to date.
In fact, sulphur can dry out the skin, which may cause irritation, so it should only be used sparingly on the spot itself.
24 patches, £7, beautybay.com
Claim: The maker says these ‘hydrocolloid’ patches promote spot healing. Apply to a pimple before bed and remove in the morning.
Expert verdict: The patches harness the healing benefits of hydrocolloid dressings, usually used to heal wounds. They contain hydrocolloids which moisten and seal a wound.
In many ways, a spot is a skin wound and these are useful, as they help draw out pus.
A 2006 study on hydrocolloid dressings as an acne treatment found they could reduce oiliness, redness and pigment changes as spots heal.
I like that patches stop you picking a spot, which increases the scarring risk. But other patches contain additional spot-fighting ingredients such as salicylic acid.
Claim: This battery-powered device claims to use the same LED light used in clinics to treat acne. After cleansing, hold the light on the blemish for 30 seconds, repeating up to four times.
Use daily until the spot clears. A study by the maker found four in five users reported a reduction in breakouts after four weeks.
Expert comment: Studies show that ‘blue’ LED light — with a wavelength of 415nm — can kill the acne-causing C. acnes bacterium. It is thought the light activates the release of the chemical porphyrins that kill it.
Despite the claims for this product, blue-light treatment in skin clinics is applied to the whole face — this only targets the spot — and in clinics is usually followed by a ‘red’ light, which helps to reduce inflammation.
A dermatologist would combine this treatment with a topical lotion such as retinol (from vitamin A). I’d like to see more research on the effectiveness of targeted blue light. But it may be worth a try, if you can afford it.
15ml, £6, johnbellcroyden.co.uk
Claim: A rollerball which contains salicylic acid and tea tree oil to help clear spots.
It also contains hyaluronic acid to moisturise the affected area and ‘brightening’ vitamin C. Roll onto the blemish as needed.
Expert verdict: Salicylic acid is good at unblocking pores and well-tolerated on skin without causing irritation.
There are studies that support the spot-fighting benefits of tea tree oil, a natural antiseptic, and I am always keen on hyaluronic acid in acne treatment for hydration.
I also like the inclusion of vitamin C to prevent pigmentation that can occur after a spot clears.
It looks very effective but it is unclear whether the ingredients are in high enough concentrations to really work.