‘I started to suffer from acne in my 30s ... sometimes I get a little down about it but you can not let it define you’
It was only recently that communications consultant Rachael Bishop began to have acne — a condition often considered a teenage problem. Rachael, who lives in Greenisland with her husband and two children, tells Linda Stewart how she copes
Last week PR consultant Rachael Bishop put up a Facebook post celebrating her 'clear day'. Plagued with adult acne since her 30s, she posted a photo of herself looking fresh-faced and clear-skinned - but pointed out that she usually only gets to enjoy half a day of respite before the blemishes start to reappear.
And she was right. The next morning when she looked in the mirror, her skin was breaking out all over again.
But what did surprise her was the number of people who commented on the post - and just how many other people are also affected by adult acne.
"My skin was quite settled that day and I was quite pleased with myself," Rachael (42) explains.
"When I put it up, a lot of people said they couldn't see anything on my face and I pointed out that was because it was a clear day.
"But I was surprised at the number of people who responded. A couple of people were putting up their thoughts on how I could handle it, such as through diet or by stopping drinking milk. But I've tried all of that. It's there and that is it.
"I just have to find a way of dealing with it and I've been doing that over the years. Initially I thought it would just be a couple of months and then I would find a solution and stick with it."
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Many of us go through childhood with perfectly clear skin and then succumb to the affliction of acne in our teenage years when our hormone levels are fluctuating all over the place.
But the Belfast-born owner of Rachael Harriott Communications says she never had any problems with acne as a teenager - it was only when she reached her 30s that it suddenly appeared for the first time.
"I had no problems even when I was in my teens - my mum was very particular about looking after your skin and I always looked up to her skin in terms of that routine of cleanse, tone and moisturise," the 42-year-old says.
"She died at the age of 51 and even up until then, people commented on her skin. She was a good mentor in terms of looking after your skin. It wasn't until later in life that I had problems with it."
Now married to Craig (46) and living in Greenisland, Rachael has two children, Jake (16) and Evvie (11). It was during her second pregnancy that her skin breakouts started to appear.
"When I was pregnant with Evvie I started to get really bad skin. I just put it down to pregnancy but from my 30s onwards I've just had really bad skin," she says.
"It's not from neglecting that cleanse, tone and moisturise routine - I was doing that."
The breakouts tend to appear on the jawline and the frown lines over the nose and forehead, she says.
"I get it on the apples of my cheeks and then you feel all these little pimple things first of all and then they pop out. They can be quite angry looking. Some can be like hard lumps and some can be like psoriasis at times along the chin line. It's a real mixture.
"Some look like a pimple that you pop - but you can't. The best thing is to let it take its course, which has been my approach."
Rachael says when the acne first appeared during pregnancy it was very reminiscent of the kind of breakouts you get as a teenager.
"I was just like... hmmm... surely I should be over this stage by now," she says.
"You think acne is more of a younger person's problem, but I can't believe the amount of people that commented on the post - it's actually very, very common. There are so many women of my age who suffer from acne. It really surprised me.
"I've had it for 12 years now. You think it will go away, but it's still about."
Rachael says her doctor has been brilliant and has tried various treatments such as tablets and an antibiotic gel, but she hasn't used those for a while.
"I didn't want to be reliant on them - I tried to find other ways and means of managing it," she says. "My breakouts are very hormonally linked - I can see it straight away and coming up to a period, my skin is... boom. You know it's working on your body.
"It is what it is and you learn to live with it.
"I'm out and about all the time meeting people as mine is quite a sociable job. If people are working with me or dealing with me, they are dealing with me as a person, not my skin. You have to rise above it and not let it define you.
"It shouldn't disrupt you from everyday life, but there are times when it's a bit more noticeable and if you've got a big massive pimple and you're talking to someone, you think they are staring at it. I just try to have inner strength.
"There would be a couple of times I'd be looking in the mirror thinking 'not this again'. While make-up can mask it, there are times when the skin gets very dry and it flakes up and you can see a mass of dry skin.
"I do admit there are times I get a bit down about it and wonder what I can do to stop it. It usually stays around for a couple of days, then you have a clear day and then it starts back into it. I'm lucky if I get a day's respite from it.
"The last flare-up was sore and the pustules can be uncomfortable, but you just have to get on with it. It's par for the course - there are worse things in life."
Rachael says she hasn't used the antibiotic gel for a while and had just let things lapse, but is considering returning to the doctor to seek more help.
"I've noticed it's starting to scar," she says.
"I was at the make-up counter the other day and the girl said 'you can tell you look after your skin, but you can see the war you have with acne'.
"I have acne scars now and I am wondering should I get something done about it?
"It's been so long since the last time I went to the doctor - I've let things slide because I've been busy in work.
"I'm so used to it now that when I have a flare-up, I just get on with things, but recently I've been a bit more conscious of it and that's why I am going to get more advice.
"When it first starts, you are determined to get it fixed. But it's gone on for so long, you think it's par for the course and it's the way things are.
"I'm seeing more scarring now so I would like to get something done. But knowing me, I will probably just slide back into my routine and go 'okay, sure it's not a big deal'!"
Rachael has spoken publicly about adult acne before and she says she is amazed at how many people have responded.
"That is the one thing that surprised me is - how common it is," she says.
"When I put the Facebook post up yesterday, it gave me a bit of comfort to see that my schoolfriends and friends of a similar age are saying 'you are not on your own - I feel your pain'.
"There are other people with much more severe cases than me. Everyone is an individual and everyone has an individual way of dealing with it.
"I would say if you do feel concerned about it, go and get expert advice, rather than googling and making your own assessments about it. It's important to get the right information to deal with acne.
"Most of the time I am absolutely fine - there's just the odd occasion where I am like 'oh no'. I am a busy mum, I've got things to do for the kids. I've got a thriving business which I am grateful for and the main thing is I am very grateful for what I have and the opportunities I have."
Rachael says nobody ever comments on the acne. "My husband would never say anything - he knows better!
"My daughter would maybe make a comment, but she's at that age where they have no filter.
"She has the most beautiful skin but she's just on the cusp of all those hormonal changes. In my case, it's definitely connected to hormones."
In the past celebrities such as Cameron Diaz have opened up about their skin problems and actress Saoirse Ronan even allowed her acne scars to be visible when she was filming Lady Bird.
"As I've got older I feel pretty confident going make-up free," Rachael says.
"At the weekend if I have a breakout, I prefer to go make-up free."
While she admits the acne does get her down from time to time, she plays that down in front of her daughter.
"It's about making sure that, if she ends up having the same kind of skin, it's all about having the confidence in life to find the best way to manage it," she says.
"It's very important not to let her know how I feel sometimes about it - I don't want to pass that onto her."
NHS advice on adult acne
Acne can run in families. One study has found that if one or both of your parents had adult acne, you're more likely to get adult acne too.
More than 80% of cases of adult acne occur in women. It's thought that many cases of adult acne are caused by the changes in hormone levels that many women have at certain times. These changes can be caused by periods, pregnancy and polycystic ovary syndrome.
Other possible triggers of an acne flare-up include some cosmetic products, medications such as steroids, lithium or anti-epileptic drugs, regularly wearing items that place pressure on an affected area of skin, such as a headband or backpack, or smoking.
A combination of antibiotic tablets and topical treatments is usually the first treatment option for severe acne.
If this doesn't work, a medication called isotretinoin may be prescribed. Hormonal therapies or the combined oral contraceptive pill can also be effective in women who have acne.
For more information, visit www.nhs.uk/conditions/acne.
Celebrities who have battled acne