1. It All Starts With Imbalanced Hormones

• As a start, eat a well-balanced diet for all round good health.
   
• Foods to avoid for clear skin include all sugars and refined carbs (white bread, flour and rice, pasta, sweetened drinks, chocolate, cupcakes and cookies) - these can spike insulin levels. Rather focus on complex carbs which are rich in fibre such as oatmeal, brown rice, whole-wheat bread, starchy vegs (sweet potatoes, corn and pumpkin), beans, peas and lentils.
   
• Moderate saturated fat intake (e.g. junk foods, fried foods, dairy and fatty meat products) as this can cause insulin resistance and aggravate acne. Recent research has also found that skim milk can make acne worse in certain people so be careful of low fat dairy options (check if this applies to you by eliminating it entirely and see if your zits clear up).
   
• Include more lean meat, fish, chicken and nuts in your diet and only use healthy virgin olive oil in cooking and prepping salads. Most other processed oils are high in unhealthy omega 6 fatty acids which can worsen acne.
   
• Get enough sleep and exercise regularly.

2. Manage Those Stress Points

• Exercise regularly to work out all the aggro and get those wonderful endorphins coursing through your body.
   
• Try yoga, meditation or any other calming technique which appeals to you. Even long walks can help.
   
• Get your 7/8 hours of sleep every night. Lack of sleep triggers the stress hormone, cortisol, which causes havoc with your skin. They don't call it beauty sleep for nothing. Cortisol levels naturally fall and both your body and skin regenerate themselves while you sleep.
   
• And if you are battling to get to sleep because of worry, introduce a calming ritual before you go to bed. Turn off all electronics - the blue light interferes with your ability to fall asleep. Have a long relaxing hot bath to increase your external body temp. Try a hot drink, read a book, dab calming lavender essential oil on your temples and behind your ears. Whatever takes your mind off your worries.

3. The Link Between Digestive Health and Acne

• Minimise your antibiotic usage. Antibiotics are known to disrupt the good and bad bacterial balance in your digestive system. Sometimes you will need them - then ask your doctor to prescribe one which will have a minimal effect on probiotic bacteria.
   
• Reduce the amount of processed food you eat. Instead include a lot of fibre rich foods in your diet (fruit, vegetables, unprocessed/whole-wheat grains, beans).
   
• Up your intake of probiotic bacteria (the good bugs), either through probiotic supplements or fermented foods (an excuse to learn how to make home-made yoghurt!).
   
• Drink organic spearmint tea, the most potent anti-inflammatory of all the mints. A recent study indicated that 2 cups a day significantly reduced inflammatory acne lesions over a 3-month period.
   
• Try and reduce your stress levels (take up yoga).
   
• Get enough sleep.
   
• And if you suffer from any digestive related problems like constipation, flatulence, stomach pain or any other issue, seek help from your doctor.

4. Keep Track of Your Food Triggers

• Avoid dairy. The correlation between acne and dairy products is the strongest of all food types. Dairy increases the levels of both androgen and insulin hormones which have been proven to aggravate acne. The only exception is homemade yoghurt where fermentation reduces the one type of insulin. And the probiotics are also good for your gut health.
   
• Try gluten-free. While this is not a problem for everyone, there is evidence to suggest that gluten intolerance may trigger acne in some people.  If you suspect it may be a problem, then try a gluten-free diet for about a month and see whether or not your acne clears up.
   
• Avoid those foods which you know to be triggers. Like chocolate. Or fried chicken (sob!). Or if you can't resist, just live with the bump for a few days...

5. Be Smart – Use the Right Cream for the Right Spot

• Start with salicylic acid. This helps with the first problem by dissolving the skin debris that clogs pores and causes acne. Its particularly effective with blackheads, whiteheads and inflamed pimples, and helps a little with cystic acne (those ghastly blind spots which are very difficult to treat).
   
  Our product picks for salicylic based ranges: 
  BioNike Acteen, Garnier Pure Active, Eucerin Dermo Purifyer or Bioderma Sebium.  Look for any product that includes BHAs (Beta Hydroxy Acids) or salicylic acid.
   
  Aspirin (not paracetamol) is pure salicylic acid which is why crushing one and mixing it with a little warm water to apply as a paste can be a big help as a handy home remedy to fix pimples.
   
• Tackle the oiliness with a regular daily cleansing and weekly exfoliating routine again using products that contain salicylic acid which also helps control excess oil. Be careful of falling into the trap of over cleansing or exfoliating your skin to get that super squeaky-clean feel – this just overstimulates the sebaceous glands which respond by creating even more oil, which you don’t want. Adding in a clay mask once a week to absorb excess oil can also help.
   
  Other acne remedies like benzoyl peroxide will also help mop up oiliness and dry out an offending zit. The Benzaderm/Benzac starter pack includes everything you need for controlling acne-prone skin and clearing up pimples.
   
  A word of caution if you have a dark skin. You should first experiment with benzoyl peroxide as this can sometimes cause post-inflammatory hyperpigmentation (AKA dark spots). Rather stick to salicylic acid or sulphur-based products. Sulphur is particularly good at eliminating oiliness and drying out your spots. Try a world-wide perennial favourite that includes both sulphur and salicylic acid, Mario Badescu Drying Lotion.
   
  Good natural alternatives for controlling oiliness are argan and grapeseed oils.
   
• Then reduce the swelling. After washing, you need ice cold temperatures to constrict the blood vessels and bring down the swelling. Wrap an ice cube in a paper towel and ice three times for an hour in ten-minute intervals i.e. ten minutes on, ten minutes off.
   
  Hydrocortisone creams can also help reduce swelling and redness. And for natural alternatives? Both jojoba and lavender oils are well known for their anti-inflammatory properties.
   
• Kill the bacteria. Benzoyl peroxide is the most effective treatment here. It destroys the bacteria trapped inside the follicle causing inflammation and also has a mild peeling and drying effect. We recommend Benzac AC 5 Gel.
   
  Don’t fall into the trap of believing more is good. Seriously, a small thin layer over the spot is all you need – you want to avoid any skin reactions. However, benzoyl peroxide can be a problem for those with sensitive skin. A perfect natural and very effective alternative for those who can’t tolerate benzoyl peroxide is tea tree oil.
   
  Sulphur can also help by limiting the growth of bacteria but is more effective in drying out the offending spot.
   
  For the more serious bacterially induced spots (small red zits) you may need antibiotics.
   
• Reduce the redness. An over-the-counter hydrocortisone cream with a low dose of steroids can help shrink pimples and reduce redness. Wait for the benzoyl peroxide cream to dry first before you apply. And here you can layer on as much as you want – the more you use and the longer it stays on the more effective it will be.
   
  If you want to try a natural alternative, eucalyptus oil, known for its anti-inflammatory and anti-bacterial properties, is a good option particularly for sensitive skins.

6. Different Treatments Work For Different Acne Types

• With blackheads, you have a couple of options.  Firstly, you can treat yourself to a deep cleansing session (with a qualified aesthetician or derm). The second option is exfoliation by using speciality treatment products (think mild scrubs, salicylic acids , and even retinols). Just don't OD and try everything as your skin could become over sensitive and react by producing more unwanted oil. Stick with one treatment only.
   
• Whiteheads respond best to classic acne treatments like benzoyl peroxide, salicylic acid or sulphur based products to help dry out the zit. If you are inclined to sensitivity, stick to salicylic acid which is the gentlest of all these options.
   
• Those small red zits (known as papular pustules) are a form of cystic acne and generally do not have a head. They are highly inflamed, bacteria rich and require a different approach. They respond best to antibiotics - you will have to visit your derm for these - although a topical antibiotic cream can also help. Or you can use an anti-bacterial treatment like benzoyl peroxide. Hydrocortisone cream can also temporarily reduce swelling and inflammation but won't make them disappear completely.
   
• Monthly hormonal breakouts on your chin and jawline or the odd pimple which appears after you've eaten one of your trigger foods are best treated internally. A visit to your doctor for a birth control script (and to rule out any other underlying conditions) or avoiding the bad foods are your best remedies here. In the meantime, follow a regular salicylic acid regimen or try the aspirin trick for a dose of pure salicylic acid to get rid of the offending spot.
   
• The absolute worst are blind pimples. Also known as cysts, these monsters are those painful underground ones which don't have a head and you pretty much have to wait them out (help them along with a little salicylic acid or benzoyl peroxide). Any picking can lead to potential scarring or sebum leaking into the skin which causes even more breakouts - so best leave them alone. They will only get worse. If you have a big event or hot date and can't wait for the week or so for them to disappear you can visit your derm for a cortisone injection which should clear them up within about 24 hours. Just don't do it too often as this can also lead to scarring or skin depressions.

7. You Gotta Be Kidding…