Hello,

I've felt tormented with adult acne for the longest time. I also had hormonal/teen acne from 16-18 years old. My skin condition might seem trivial to others around me, and even dermatologists and doctors. But on a personal level, it affects me. And happiness comes from within right? I appreciate others have it worse than me, and that there many other ailments out there which I don't have are far worse.

But I put my hands up and admit I am weak, skin troubles are my Achilles heal... I'll go through life's hardest events, and I'll persevere, but acne has left me so hopeless because I just can't solve it to my satisfaction, it's a genetic factor that is almost out of my control.

I can't deal with it on a psychological level because I've tried, and I've had plenty of time to reach achange in attitude but It just won't happen.

Now I want to get to the root cause of the issue, because some dermatologist, doctors and others just want to offer me products that do damage control, and not look at the underlying problems - maybe because it is too time consuming. But sadly for me and others, my whole life revolves around my skin issues. It's taken my life completely, and I hate admitting that but it will always be the truth.

There are many afflicted with adult acne and it sucks, but there are ten fold who have perfectly normal skin. And that's what I want, normal skin. What do they have that we don't?

You must be realistic with your goals for normal skin, normal is something you need to define for yourself, because you look in the mirror everyday. You should be able to tell what is normal for YOUR skin type, and genetic make up, with the help of a dermatologist to confirm nothing is abnormal or out of the ordinary.

The idea should be to set realistic skin goals, to minimize the amount of skin troubles you face, long-term and permanently... without the need for drastic life changes or skin care regimens.

Some factors that impact adult acne:

• Ancestral diet/ genetic predispositions resulting in nutrient deficiencies due to diet choices.... for example a second generation born who's parents migrated from a drastically different climate and diet structure
• Environmental, temperature, humidity, air quality, sun exposure, allergens, water quality (washing face)
• Stress/ Hormonal
• General diet patterns, cascading effects e.g. not enough fluid intake leading to dry skin leading to oil production, and environmental factors like air conditioned officeswhich can further dry the skin, which can further aggravate this process
• Lifestyle choices, being indoors, air conditioned environment vs fresh air, hygiene practises, washing face etc., changing pillows

Now there are many different diagnostic tests out there today that a human can perform to narrow down some of the factors described above, such as blood tests, nutritional and mineral screening, allergy tests, genetic screening, and the hotly debated, controversial topic of food intolerance tests. I am skeptic when it comes to food intolerance tests, and I find food elimination tests to be quite tedious, but far more reliable and accurate if done diligently.

I hope to be doing some of these tests very soon, and I have already taken some steps to improve my lack of nutrient intake. I've learnt that sometimes, it's not so much the bad stuff you eat (unless you really have an intolerance or allergy) but more of the important stuff that you are NOT eating which leads to deficiencies and possibly skin troubles. Took me a while to figure that one out, and honestly speaking - vegetarian and vegan diets don't cut it when it comes to optimal nutrient intake.

There are some things that plant based dietsjust cannot provide, especially in the form that is absorbed and utilized in the body, as with carotenes and plant vs meat based omega 3 (AHA vs EPA/DHA) for example. It may be that you choose to go vegan or vegetarian, despite your ancestral history being that of meat eating people! And so you spend your life dealing with skin troubles potentially as result of overcoming generations of eating patterns and genetic predispositions. Contrastingly, eating too much meat can be problematic, balance is key.

Take for Vitamins for example, you have water-soluble and fat-soluble type vitamins where each type influences how it is stored in the human body, and whether you should be taking it daily or bi-weekly. Some studies say a lack of a particular Vitamins causes skin problems, while TOO MUCH of another causes the same effect.

But as many of you already know, these myriad of factors can be a minefield to navigate..... luckily our human bodies are packed with critical information that can shed light on the underlying causes of all our ailments. But the price of diagnostic testing today is still somewhat expensive, but we still have many more options than we did in the past... and I have no doubt in the decades to come we will have enough information and facilities to solve this problem of acne permanently, as well as many other ailments that destroy our quality of life.

I am currently on Roaccutane/ isotretinoin, low dose-long term, and it's private prescription and I had to sign a waiver to get it, accepting that I take full responsibility for the drug consumption.I couldn't care less how dangerous it is, the alternative is worse for me, no matter how trivial people think my problem is. Does it work? Definitely. It is a miracle drug, and it's theclosest thing we have to a cure because of its GENE altering abilities, this thing really goes to the root of the problem.

But I am still getting problems here and there despite it's curing abilities, and so it has giving me time and motivation toinvestigate further. What makes skin acne prone? It can't be a permanent condition, there has to be some kind of trigger or underlying issue.

I've seen people, especially men, have good skin all the time, except for the once in a blue moon breakout, yet they have practically no hygiene practices or strict diet regimen that they follow. They just "wing it", and wake up/go to sleep looking normal and radiant.

I on the other hand, like many of you, change pillow case, cleanse, exfoliate, eat right etc., and I still get lots of issues despite breaking my back to live a clean lifestyle that is quite frankly draining.

This isn't the way forward, we are being slaves to our underlying conditions, when others don't even have to lift a finger on any skin care regimen. Even working out can be a nightmare for the acne prone, sweating, bacteria, breakouts, no matter how clean you try to be... and yet others go through the same thing and have NO issues whatsoever.

Some kind of a skin bacterial barrier or protective layer that kicks in for the non-acne prone, that prevents them getting breakouts no matter what. Immune system related? It's a minefield.

We should not have to resort to drastic skin care regimes, damage control products, or strict dieting to manage acne. It is a problem that should not even exist naturally, if we are living a natural, palaeo-centric lifestyle, natural diet, natural hygiene practices, no/minimal make up etc. (I am a guy btw)

I could write another 10,000 words easily. But I'll keep this brief for now, I just came here to ask for help and to offer help on getting to the root cause of this adult issue, andnot resort to damage control.

The root cause of adult acne will be different for each of us, but common for many of us. I am still searching for mine, I'll do whatever it takes.

Have you achieved long-term, perfectly normal skin? What was YOUR root cause?