Tips For Getting Rid Of Adult Acne - Causes and Care


Tips For Getting Rid Of Adult Acne - Causes and Care

Welcome to the Smazy Academy show with Tonia Ryan and...

Christopher Khorsandi MD, aka Doc Vegas.

Combined, the doctor and I have over 30 years of experience in medical and the skincare industry-

Small glitch in the matrix.

And we want to share our best practices as well as tips we've learned from seeing thousands of our client's skin transformed.

We got it all folks.

That's right.

Top to the bottom. We're going to teach, we're going to educate, we're going to make you laugh. It's going to be fun.

And in today's episode, we're going to talk about six ways to prevent adult acne.

Adult acne, nobody likes adult acne.

If you're an adult, we all have experienced adult acne, right?

Well yeah. I mean, it's part of life. I mean, for some people it's more a part of their life than they want it to be.


I think, acne is this thing that, it's kind of... it throws everything off, right? I mean, so you're having a good day, right? You wake up and all of a sudden, there's this kind of thing, it's in the middle of your face, or maybe it's a cluster somewhere. And it's like, why? Why today? Why of all days?

Why did that happen?

Why does this have to be now?

Right. A date, a job interview, something. And you get a pimple right on the tip of your nose or something.

Oh, the worst. Absolute worst.

It's terrible, where it's swollen and all, it's just no fun.

Well, I mean, there are some conditions that can lead to adult acne. So those we'll get into, as we talk about this, but there are some things that you guys are doing. It's stuff that you guys are doing that's creating this. So some of it's behavior-based.

Right. So we're going to go over six different tips to help you control adult acne. The first one, of course, is using the best skin care products, which is so important.

I mean, right. So we talked about before, maybe in another episode, we talked about you can't use your foot balm on your face. Not because it's gross to put foot stuff on your face-

Well it is.

But that stuff has tons of parabens in it.


Stuff that's supposed to lock in moisture. Stuff that's for kind of tougher parts of the body that can tolerate it. And so what do they do? I mean, you put the wrong skincare products on, you're basically locking all the oil and bacteria.

Clogging your pores.

Yeah, and the pores! And so acne, let's back it up for a second. What is acne? Well acne typically comes from-


Bacterial infection of the pores, right? And why does that happen? Well, the pores are like this cone, right? So it's, it's where the oil it comes from. And it's also, you have hair sometimes in your pores, you have what's called a pilosebaceous unit.


Yeah. That's a fancy word for the-

It's very fancy.

... hair waxy sort of gland unit, right? So it secretes wax and it secretes substances that protect the skin. And sometimes it doesn't have a hair in it, it just secretes oil and wax and things like that that protect our skin. I mean, it's there for a reason. I mean, we have oil glands because they protect our skin. They actually protect us from UV radiation. And so typically, you'll see people from areas where, evolutionarily there was more sunlight. They have more oilier skin, they have darker skin, they have thicker skin. It's more so that they can tolerate this environment. Or maybe their ancestors were more tolerant of that sunlight coming in. But acne occurs when that oil gland gets clogged and it traps bacteria in there. And now it's sometimes a synergistic infection, meaning that there's more than one bacteria in there.

In there, right.

And sometimes there's acne bacteria that's the main culprit. Like P acne vulgaris. Sounds like a bad guy, right?

I've heard of that many times.

Yeah. That's like the big gun. That's the big issue. That's the big... that's the culprit in a lot of this stuff. Because P acne vulgaris consecrates a little biofilm and it gets protected by itself from other things. And then it'll team up sometimes with a staff, right?

Oh. No one likes to hear that word.

Which, a staff bacteria... no. But staff lives on our body. I mean, there's trillions of cells on our body and staff makes up a lot of it. And so what happens is that that staff kind of gets into the pore, breaks down some of the cell walls and it feeds the P acne vulgaris. So you get this kind of tag team-


... going on and it's like Royal rumble in there. And what do they do? They cause damage, inflammation. And what happens is that, that opening where that oil is supposed to come out now closes. And so-

Well, what I've noticed for myself, with adult acne, maybe, women, our time of the month, our menstrual cycle, because it's hormonal sometimes.


And I feel retinol is really helped me with that because you kind of already know when your period's coming, you have a little bit of PMS, and then the retinol that's when I start using my retinol.

Right. I mean, you don't have to get PMS know when your periods coming, right? I mean.

No but for me-

You know when you're... right.

... that's what I get.

Okay. So I mean-

And that doesn't mean in a bad mood. That just means you're feeling it, because my body starts to feel that it's coming on.

Okay. You get premenstrual, and that's not necessarily a syndromic thing. Right?

Yes. Yeah.

It's not PMS, or a Premenstrual dysphoric disorder, PMDD is actually a classified entity where you really, your emotions change. And that's because again, that hormonal balancing milieu changes. So yes, you may know when your period's coming-

I can feel, I feel it in my body.

Yeah. For sure, absolutely.

It doesn't even have to be mood swings or mood changes.

So what do you do? What's your regimen?

Well, what I normally do is because some people use a retinol daily, or when you start out, you might want to only use it once or twice a week.

Take us through, all right, so the day you start feeling that.

Okay. So the day I start feeling that, I don't use a retinol every day like a lot of people do, because for me, it makes my skin a little bit irritated.


Some people, it doesn't, you have to kind of build up a tolerance for retinol.

Everybody's different, yes. And that's very important. You can build up a tolerance for it and we'll get into that one day about how to use retinols.

We'll get into that. We'll do a whole retinol-

For sure. So you feel this coming on?

I feel it's coming on.

You're not using retinol every day. Boom. You start feeling it.


How many days away is the period?

Normally seven. It's almost seven days-

Oh this is seven days before?

This is seven days before.


And my emotions don't change, I don't get moody or anything like that.

But you know it's coming.

It's almost like it's pre cramping. I get a cramping, so I'm like okay-

Okay. So you are having some... yeah.

Yeah. But it's not a full... the full cycle isn't here yet.

Got you.

So I know this is time to start using my retinol and where I normally break out is a little bit on my chin. A little bit of my forehead, not normally my nose, but sometimes, but you have to be careful with retinol because you don't want to put it in the nasal fold, and the sides of your mouth because you can really get irritated there.

And the corners of the eye.

Corners of the eyes. Right.

So those areas, I mean, I think a lot of people would mistakenly put it and these are really kind of high motion areas, not emotion. They are emotional areas as well.

Yes. But motion. The movement.

But there's a lot of motion. The corner of our nose, because every time we smile, it moves back, forth. Corner of our mouth, I mean, you don't have to explain that one.

Of course. Right.

And eyes, if you're smiling like I always do, right? So you're going to crinkle the corner of your eyes. Unless you have Botox, but even still, very sensitive area, sensitive area, sensitive area, you don't want to put a lot of retinol on those areas.

Right. So I do a little bit on my chin, a little teeny bit on my cheeks, a little on my nose and my forehead. And that totally helps for me prevent getting any sort of crazy acne.

How many days are you using that for?

I will use it every other day for that seven days prior to my period. And then I'll use it the first couple, because it seems like after the first few days after I start, most of my symptoms kind of dissipate.

Your adult acne symptoms?


Yeah. And so, I mean, if you were more tolerant where you could take it every day. And so-

Which a lot of women are. A lot of women, I work with, they want their retinol every day. If they aren't using their retinol every day, they are not happy with their skin.

They want it now.


Yes. They want it every day. And I agree, that's fine. It's not a problem to use it everyday if your skin can tolerate it. How do you know if you can tolerate it? Well, if you don't tolerate it, it means that your skin is going to get a little bit kind of... a little bit chafed, almost. Irritated.

There's all kinds of... some people get bumps. So that's why it's so important to start with one of the lower percentages of the retinol-

Yeah. Start low and build up.

... and then build up.

Or, if you have something and you like it, it's a product and it's only one percentage, right? There's only one formulation of it. What I usually recommend is I start every other day or every third day. Right? And then if they could tolerate every third day, go to every other day and when they could tolerate every other day, go to every day. Now, if it's the opposite and you start every second or third day and you don't tolerate it, you start to by that second application two or three days later, you start to feel irritated. Then go a little bit further apart.

Once a week maybe.

Spread the interval out. Every fourth day, every fifth day, every six days. But the most important thing is with this type of stuff, is that you got to use it long-term so don't be discouraged if when you're using the product, you start to get irritated.

It only means that you have to kind of separate the interval a little bit further. So maybe every seven days is the sweet spot for you. And once you get to that, stay on that for a while, three months, four months, five months, it sounds like a long time.

It's not.

But these compounds are things that you should be using for life because not only do they make your skin look better, they make the dermis thicker, they thin out the dry stuff. So they there's less of that. So your skin has a dewier feel to it, dewier look. But they also decrease the risk for skin cancer.

Which is so important.

Yeah. And it's really kind of long-term improvement.

So that's why what's great too at Smazy Academy, we can talk... everyone's in a community together and there's a message board and we can talk together about how it works for us, which is great.

It's an open forum. But no hate.

It's an open forum. No hate.

Let me tell you something. You get on this forum, you start hating on people. I'm booting you right off, okay? I don't want that. We're here to support each other. I'm serious.

It's going to be, I know, it's going to be all positive.

Look, we want debate and opinions, right? But be respectful of everybody. Right? Right?

Yeah. They will be. They will be. Our members are going to be the best.

There's enough hate in this world.

Our members are going to be the best.

See, no, listen, we want to foster a nice environment, right? Where you can feel comfortable asking questions. And we'll moderate-

And not feel judged. No judgment. No judgey eyes.

Well I will judge on certain things. Like if you're not wearing sunscreen...

Well you'll give your opinion.

I'm going to give you a very stern finger like this.

And tell them what they should do, but you won't necessarily judge them.

There I go, wagging my finger. Okay? I got to let people know that I'm not happy. All right? But a little bit of judgment's okay. I guess that's doing the right thing, right?

As long as it's nice. Constructive criticism.

Yeah, constructive. We want the best for you.

That's right. Okay. So let's go to number two. Now this is something that most people would probably already know, but maybe they aren't thinking of.

What don't they know?

That you need to wash your pillowcase frequently.

Oh my god. Who's not washing their pillowcase?

Well, listen.

God. Sorry.

There are several people-

Who? Do you know these people?

I do a lot-

You have personal friends that don't do this?

I do a lot of YouTube research Doc, and there's plenty of people online that never even thought that they should be washing their pillowcase frequently.

Oh my god, you sweat into that thing and drool into it all night. I mean-

Listen. You're speaking-

... your hair care products, all the crap you picked up walking down the street on your skin. I hope to God you're taking your makeup off, but if you're not, that's ending up on your pillow.

Well, you're jumping ahead.

Oh, maybe I am, but it's still important, dammit. It's very important.


Change that sheet. Listen, back in the day when I was in college, I may not have changed as frequently as I should've-

Well, those are some of the people we're talking to. They don't know that they should be doing this.

I was busy studying. I was trying to become a physician.

Sure you, yeah.

No, seriously.

I know you were.

I didn't have time for this stuff.

Yes, I know. But yes. The oil, drool, makeup, dirt and dust in your hair. If you are sleeping on that constantly, daily without washing it frequently, you're going to get acne break outs.

And if you're in a college dorm, the bong water-

I don't even want to know what those pillowcases smell like. I don't even want to think about it.

... the beer, all that stuff. Listen, college dorms are a different world altogether. It's like, you pay for the imprisonment in this box.

Yeah. They smell like locker rooms basically. But it's college.

Yeah but listen. It's a great experience you never want to do again, right? Okay?

Sure. But if they... here's a tip, if you're in college, just if you don't have time to wash your pillowcases, because a lot of people don't have a lot of time, have extra pillowcases set aside, washed, change it out, you could change it every day. It takes two seconds.

Listen, three pillowcases. What's it going to set you back? 20 bucks? 20 bucks?

I know. Not even, nowadays, you can buy-

Change it once a week. You get your laundry done like I did once every three weeks or when you ran out of underwear and socks, that was really the barometer. You ran out underwear and socks, dude, down at the laundry mat or down at the laundry room in the building.

So that's super important. So make sure you do that.

All right, get those nasty pillowcases off right now, after you turn off this thing, or if you're laying on your bed right now, roll over-

Go change your pillowcase.

Just think about this. Think about that. When was the last time you changed that pillowcase that your head is on right now?

I can answer. I can answer.


Last night.

How often do you change yours?

I have sets. I change them every day, okay?

Oh my god.

I might be a little... not my sheets, my pillowcases.

That is dedication.

Well, because I just don't like it. I don't like anything on my pillowcase.

Well see, the way I think about it, I've got in general, I got three to four pillows, right? Three usually. One ends up on the floor, right? And so, we average that out over a two to three nights. So maybe twice a week I change mine. Okay? Don't judge. It's enough.

I'm not. See-

But it's not going three or four months like some of you. Okay? Like you, right there.

So you're judging others based off of your [crosstalk 00:13:18].

Of course, I told you, disclaimer, I'm going to judge a little bit, because why not? I mean-

So let's change those pillowcases.

Why not?

We're going to do it? Okay. You're doing good.

It's easy.

Look twice a week is great. I'm fanatical. You don't have to be like me, but that's what I do.


I drool in my sleep. Sorry. I'm giving you a fact, TMI, but I don't want that on my pillow the next day. I don't like it.

We all have different tolerance for this stuff, but we don't want you going weeks without changing that thing, okay? All right.

So that's done. Okay. So number three, here's something else really important. Cleaning your makeup brushes. And not only that, being very careful of department store and makeup artist's makeup brushes.

Grossness. Sorry. Oh my God. I could tell you a story.

Let's hear.

I mean, well, I mean, I've had patients come in and they went to a makeup counter, right? And I don't know. They're like commandos, these makeup women, they come out of the woodwork. They jump, they'll grab the woman, almost against her will, throw her in the chair and like, "Let me do a makeover." Like, "All right." So I see this, you walk through a department stores and-

You want to try the newest products.

Yeah. And I see it from my perspective, because I walked by this stuff.

Of course, yeah.

They don't ever ask me. They're like, "There's no hope for this guy." So they get you in the chair. They do the little, they're doing the smokey eye, right? They're doing their Kabuki thing. They're doing their, was is it, the highlighter? Right? The what is that thing on the cheekbones?

It's highlighters.

Yeah the highlighters. Right? And so when was the last time you think they cleaned that brush?

Okay. Well, a lot of times they'll clean it right in front of you. But to me, that might not be "my type of clean." Just spray it with a little alcohol spray.

I don't know if that actually... oh that does not work. I'm sorry, those brushes, I mean, unless you're soaking those brushes?


Generally overnight, because listen, I have wipes in the office. These are medical grade wipes, okay? And-

Super intense.

Yeah. It takes a minute, they say one minute kill time. That stuff has to be on there for a minute. And this is stuff you clean the countertops and tables with. It has to be a minute on there for it to actually work. And so you wipe it, but I don't know, they're spraying a little isopropyl alcohol on that stuff. I don't think that that's killing it because unless they're getting all that makeup off with that spray, you're not getting rid of all that germ potential.

Right. So you get the germs on top of other people's dirt oil and debris which causes acne.

And viruses.

Oh yeah, and viruses.

I don't know what's scarier in this world, bacteria or viruses.


But I think that viruses just terrify me. Because viruses, I mean, they can live for quite a while on things. And one of the things-

How long? How long can they... you don't even know or?

Well, the herpes simplex virus could probably live about 24 hours on surfaces.

Oh, great.

Or maybe more if it's more of a moist environment.

There was that word.

If it's a really, well... this is medical, I mean.

I know, okay go ahead. Go ahead.

So on the brushes. And so if somebody has got a cold sore, right? They're shedding virus. So obviously I would hope that the makeup artist is not using it on person with active cold sores, but a person who is not even with them-

But isn't it contagious even when it's not... hasn't came out yet? Like 24 hours or so?

Exactly. You can actually spread herpes simplex virus, aka cold sores, right? Even when you don't even have a sore, there's a prodromal phase in the virus is coming out of the skin. And then even after it's crusted over and dried, you may still be contagious for up to three to seven days, right?

Okay, that's scary.

So you may have no outward signs of it, or the person, really the person who used the brush beforehand, may not have had active signs of this. But then they're going to let some stranger take a brush and run it all over your face. I've never seen this. You people are crazy.

I'm not. I'm not. I've been in television for years. I've done so many different live shows. And even with the makeup artists, when they're there, I bring all my own brushes and all my own makeup.

If I ran up to you on the street with a milkshake and said "Hey, have a sip of my milkshake. I just used the straw." Would you use that? No. I mean, come on. So why are... if I ran around with a toothbrush, said "Hey, we washed this for you." What's the difference? It's going in your mouth or you're just wiping it all over your face, around your eyes, around your nose. Is that any better? I'm sorry. No.

Not happening. Not happening. So when we're talking about our own makeup brushes, put aside all of the horrible things that we can get from the makeup counter brushes, our own brushes still have lots of dirt, debris, bacteria, so they need to be cleaned as well.

Dirty, dirty, very, very dirty. Dirty! It's Christina Aguilera dirty.

I have several sets of brushes because it's a pain to clean them every day.

Not that she's dirty, but there's that song. Dirty! Right? Right?

I think so, is that how it goes?

Yeah. Something like that. So, so, okay.

Clean those suckers.

No. So the ones that you have at home?


I mean, we all know you're Miss neat and perfect at home listening along with us, but come on. I mean, there's bacteria everywhere. Okay?

My thing is time consumption. I don't have time to clean them afterwards. And I don't like whatever cleaner, even the cleaners that are out there. So I have several sets of brushes and I rotate them in and then I clean them all in one day.

Yeah. You should probably have two sets of brushes and kind of, you shouldn't let them sit for more than a week. You should clean your brushes once a week, kind of make it like a house cleaning ritual.


And then, the other thing that you should do is that things like mascara, which the brush you're not cleaning, you should only allow it to be around for about a month because mascara actually has sugar in it that becomes food for bacteria. So you can actually get bacteria in mascara and they're clinical case studies of women who've used mascara that had bacteria and they got severe, horrific eye infections from old mascara. So I generally recommend women throw out their mascara every month.

Throwing them away. Every month. Okay. So let's go on to number four. Number four is a big one, I think. We're talking about stress. Now stress alone is not really the cause of acne breakouts, but it can trigger them and then age, hormones, and all of that, just add to that.

Listen, our bodies are these incredibly complex symphonies of cells. So under stress, the way these cells function is different. So you release stress hormones like cortisol and cortisol is a very potent sort of a drug that affects our body. And it may trigger a cascade of other hormonal changes and it changes the pH of our skin, making it more advantageous for the bacteria to grow. So that's sometimes where you may want to consider a toner, things like witch hazel, things like that that become an astringent.

Yes, which is so important.

And so you're kind of fighting back against the hormonal change. You're fighting back against that stress change that's occurring in the skin, but the stress is going to-

So that's number five.

... stress is going to put acne all over your face. And I've seen it with patients get acne elsewhere, on their chest, their backs.

Oh, back's no fun either.

Yeah, for sure. So stress, how do you decrease stress? It's not easy. I mean, we can all give our little tips, but I mean, meditation, yoga, exercise, great stress reducer.

Exercise is great. Your diet is very important. So let's touch on when we're talking about hormones for number five, a way to decrease adult acne is checking your hormone levels.

For sure. If you think for some reason, suddenly you've just become acne prone, there may be a hormonal imbalance. There may be something going on that your OB GYN or your endocrinologist needs to look at. And then, there's an interesting thing that we've seen a couple of times this year in our practice, and it's not fear-mongering, but I mean, I've seen some patients who have bad breast capsular contracture, breast implants that got hard, like rocks, like coconuts. And they have acne elsewhere in their skin because there's this chronic inflammation going on in their breasts. So I've removed some breast implants with the capsules and kind of done what we needed to do for the patient and her acne got better.

Oh it's amazing.

So it just goes to show you any stress in the body.

Any stress on the body does it.

Whether it's autoimmune stress, hormonal stress. If for some reason something's changed, like you went 30 years and all of a sudden you're breaking out all the time. You need to get in to get checked, may be hormonal, may be something else.

Absolutely. So number six Doc, we're talking about your diet and what you eat. Now, greasy foods is a big thing, but studies have shown that they don't actually cause acne when you're ingesting them, but they do make your skin oily. And that in itself can cause breakouts.

Well I mean, the body has to synthesize those oils from other fatty acids and triglycerides. So it's not like you're creating acne. There's nothing about oily fatty foods that creates acne. But what it does is actually kind of feeds the factory of the body that's making the oil. And we all know that if your skin is oilier, there's more of a chance for your pores to be clogged, it's more of a chance for the bacteria to have a nice environment to grow in. And it just gives a better sort of basically, a Petri dish.

Breeding ground? Right.

Yeah, a Petri dish. So it just, if you cut down on the greasy, oily foods, more natural foods, healthier foods, try air steaming or air frying, instead of frying in oil. And that tends to cut down on the risk for acne.

I always do a little bit of baking and then just a teeny bit of olive oil. Olive oil is my go-to with cooking. And it's great.

That's a very healthy fatty acid, long chain fatty acid that isn't really used as much in the body's mechanisms for creating oil on the skin.

All right. Okay, so let's go over our six tips again about what to do to help prevent adult acne. Of course, number one is use the best skin care products, including a retinol.

Of course. And you can find those at Smazy dot com.

You certainly can. And Smazy Academy, we can help you choose the right ones. Number two is wash your pillowcase frequently.

Do that, please. It just makes me gross thinking about a pillowcase that hasn't been washed in a year.

Number three is clean your makeup brushes and watch out for department store makeup brushes.

Oh my god, please guys, be careful out there.

Number four is try not to stress.


Yes, of course. Just do your best, right? I always, whenever I'm stressing, think of all my positives instead of my negatives, always.

Well, get a good night's sleep, exercise drink a lot of water, cuts down on stress for sure.

Number five, check your hormone levels. And number six, your diet and not eating as many greasy foods.

For sure. I love it. So those are six tips that you guys can employ to keep yourself from having adult acne outbreaks.

So thank you so much for listening to this Smazy Academy podcast.

We really appreciate your feedback. So if you go ahead and put a review in at Apple podcast and screenshot it, go ahead and email it to us at info at Smazy Academy dot com. And what we're going to do is every month we're going to enter those people into a contest for $200 in free skin care products.

That's great. That's a lot.

That's awesome.

We appreciate your feedback and we'll see you again soon.

Thank you.