LOOKING in the mirror, Su Hodgson tried to ignore the burning feeling creeping across her cheeks as she applied another layer of foundation.
Despite the pain, she was desperate to hide the red bumps on her skin.
She had spent years battling acne, which usually afflicts teenagers owing to fluctuating hormones. But mum-of-two Su, 41, was 38 when she began suffering new breakouts.
She is not alone — around one in five women have had acne as an adult.
Reality TV’s Georgia Toffolo, 28, has told how this hit her confidence for years.
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And when movie star Scarlett Johansson, 38, launched her skincare range, The Outset, she told how skin issues in adulthood had affected her mental health.
Acne can strike any time. A study by online chemist click2pharmacy found one in 12 women aged 45 to 55 has the skin condition.
‘IF I SAW ANYONE I KNEW I WOULD HIDE MY FACE’
Personal trainer Su, is married to Mark, 51, the MD of a tech company, says: “Aside from a stint of average teenage acne, my skin hasn’t caused me any issue — then a few years ago I noticed a few small scaly patches on my hairline.
"Feeling alarmed, I saw my GP, who told me they were symptoms of rosacea.
“He prescribed medication but it didn’t help. But when the patches later went away on their own, I didn’t think anything more of it.”
But then, around six months later, Su started noticing small, scaly patches, not just on her cheeks but on her nose and forehead.
She says: “They weren’t like normal spots. They could be painful and boil-like, and eventually would scab, even if I didn’t pick at them — and make the skin around them flaky for days.
“I’d spend 20 minutes some days carefully tweezing the dead skin off my face, trying not to aggravate the rest of my skin.
“Otherwise, any make-up I used to try and hide my ‘raspberry’ face, as I called it, would just highlight the flakes. Layers of cover-up and foundation wouldn’t hide it.
"On a bad day, my face felt like it was burning and it went from red to purple. It made me feel miserable.”
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Her flare-ups coincided with the pandemic lockdowns when she had the stress of moving her business online while trying to home-school children, Freddie and Heidi, now ten and eight.
Su, of Teddington, South West London, says: “I wasn’t able to deal with the stress in my usual way, through exercise.
“I was also very self-conscious, sometimes, about going out in public.
"If I saw anyone I knew I’d hide the worst part of my face with my hand or tell them I was trying to solve the issue, as if they might worry they’d catch it.
“I did eventually find a colour-correcting cover-up make-up, Rosalique, which worked wonders, but nothing could hide the constant flakiness of my skin.”
Dr Justine Kluk, of the British Association of Dermatologists, says another trigger for acne in some women is the hormone testosterone, especially in the lead up to menopause.
She says: “There are hormone changes in the perimenopause — imbalances between oestrogen, progesterone and testosterone.
"Testosterone is a particular culprit for acne. It corresponds with the oil glands making more oil, causing more congestion, more blackheads, then more acne.
“In the lead-up to menopause, oestrogen levels are lower than they have been before, which means the other hormones might exert their effect in a stronger way.
“Another trigger is lifestyle, stress levels and the products we use.”
But last year, Su was diagnosed with acne rosacea — an inflammatory skin condition which can be chronic — then put on a treatment plan, and within just a week her skin had vastly improved.
She says: “I was prescribed Soolantra and Doxycycline and was just so immensely relieved and happy to see an improvement.
“I use medicated creams, serums for acne- prone skin, and take Efracea (medication) daily, as well as having £96 skin peels every six weeks.
“Now, the painful lumps, unsightly papules and flakiness are all but gone. My skin is smoother and calmer, and I have my confidence back.”
‘I FELT LIKE EVERYONE WAS LOOKING AT MY SKIN’
Holly Mason, 37, suffered with acne in her teens and took the contraceptive pill to keep it under control.
But when she stopped taking it at 27, it resurfaced with a vengeance.
Holly, who lives with company director husband Andrew, 40, and their daughters Hettie, five, and three-year-old Livvie, says: “I had acne from the age of 12 and went down the traditional route of antibiotics and topical treatments.
“As I got older, it didn’t subside but got worse, and in my mid to late teens it was around my chin and lower jaw, where it appears when your hormones are very aggressive.
“I tried medication, which worked while I was on it, but every time I stopped, the acne came back. Once I started on the Pill, my skin really cleared up.”
But Holly, who is now 35 weeks pregnant with her third baby, did not want to take the Pill long-term.
She says: “Like many women, I wasn’t happy being on the Pill for years and years, but when I was 27 and stopped taking it, my acne just came back.
“It was very tough. I was working in a professional job, in banking, and trying to impress clients.
“I’d spend all this money on expensive clothes and trying to look smart and professional, but the whole time I felt like I looked like a teenager with spots. I felt like everyone was looking at my skin. It really affected my self-confidence.”
According to dermatologist Dr Benedetta Brazzini, women are more than twice as likely as men to be diagnosed in adulthood, with 26 per cent of women aged between 40 and 49 suffering, and just 12 per cent of men.
She says: “Touching your face or picking at spots should be avoided because you want to avoid scarring.
“Choose an active ingredient that is designed for acne-prone skin, add it into your routine and see if it makes a difference.
“It may be a product that contains lactic acid or glycolic acid or it might be a retinol cream. Pay attention to your lifestyle and your stress levels, as that can impact the skin too.
“If you’re already following a good skin routine and your spots are still ongoing, go and see your doctor.”
It was a case of trial and error for Holly, until she found the solution to her skin woes.
She overhauled her diet and her lifestyle and began taking vitamins A and D, and DIM supplements, to tackle flare-ups.
Holly, of Farnham, Surrey, says: “I’ve always had a healthy diet but I made sure I was putting the right things into my body.
“I cut out chocolate and sweets, ate less dairy and drank more water. After about three months, I started seeing a difference.
“My spots were also caused by a sensitivity to testosterone — which I realised when I noticed an increase in body hair and thinning hair around my forehead, which can be a sign.”
In 2017, Holly set up The Skin Investment clinic to help other women combat acne, and it offers treatments for the scarring that acne can leave behind.
She says: “Clients appreciate that I’ve been there — I know the emotional pain they go through, and I can relate to the physical pain of those really large cysts under your skin which are really sore.
“My skin, now, is largely under control. Being pregnant means I can’t use some of the supplements which keep the spots at bay, so it’s not great at the moment.
“But I know what to do to treat it — and I want to help other women too.”
