Q I am 34 years old and still struggling with adult acne.  I have tried several leading ranges for blemished skin but they have not really helped.  Do you have any advice? A The best thing we can do in this instance is to ask help from a man who really does know -  clinical pharmacist Shabir Daya of Victoria Health, who has helped countless people with this problem.

He says:  ‘Adult acne is on the increase.   Although the most common cause of acne is hormonal imbalance – the reason teenagers are so often affected - recent research suggests that stress is also a key factor because it stimulates the production of the male hormone testosterone.’

‘Testosterone stimulates the sebaceous glands so they exude more sebum than normal.  As the follicles fill up, they can get blocked resulting in an acne breakout.  The spots can become pustules if the sebum is infected by bacteria that live in the follicles and on the skin’s surface called propionibacterium acne.’

Sebum production also increases when the blood is filled with toxins and hormonal waste by-products from excessive testosterone.  This inflames the follicles, making a bad situation worse.  It’s further exacerbated if the liver is congested and sluggish so it does not filter out the toxins and waste.  So encouraging the liver to perform more efficiently is vital.’

Shabir believes that an inside-outside approach is the best way to address all skin problems.   This is what he recommends for you:

‘Swanson Burdock Root capsules, one capsule twice daily.  Burdock improves liver function and also has powerful diuretic properties: increasing fluid output by the kidneys helps to filter out the impurities from the bloodstream.  It is a powerful broad spectrum antimicrobial helping to eradicate a wide range of bacteria and fungi from the body. So it may help to block the propionibacterium acne (see above) and as well as the ‘bad’ bugs in the gut that also contribute to skin inflammation.’   

‘Topically, I recommend iS Clinical Active Serum and Pro-Heal Serum Advance.  Using serums addresses the concerns without blocking the pores and having too much product on your skin.  Active Serum contains glycolic acid from sugar cane, lactic acid from bilberry and salicylic acid from white willow, which combine to encourage the controlled exfoliation of the skin without dehydrating the skin. Salicylic acid also deep-cleans the pores and removes the debris within the sebaceous glands.’

‘Pro-Heal Serum Advance + can be used to spot treat cystic acne because it provides maximum levels of antibacterial, antimicrobial and antioxidant protection with anti-inflammatory ingredients.  Pro-Heal Serum Advance + offers the antioxidant vitamins A and E, plus L-ascorbic acid, a form of vitamin C.  It also includes olive extract for its natural antibiotic property, together with zinc sulphate, which enhances skin healing and may reduce sebum production.

‘Many people use just Active Serum on its own, which is often sufficient.  Active Serum provides some hydration but if this is not enough, you could use iS Clinical Hydra Cool Serum morning and evening as well.'  

‘A wholesome fresh low GI (glycaemic index) diet is wise; there are plenty of books outlining a low GI eating plan, including The New High Protein Diet by Dr Charles Clark, which has worked for many people.’

• Swanson Burdock Root by Swanson/£11.50 for 100 capsules - buy here

• iS Clinical Active Serum/£59 for 15 ml - buy here

• iS Clinical Pro-Heal Serum Advance +/£63.50 for 15 ml - buy here

• iS Clinical Hydra Cool Serum/£42 for 15 ml - buy here

• The New High Protein Diet by Dr Charles Clark/£16.50 - buy here