Best Treatment for Adult Acne
Nearly everyone has a condition known as acne vulgaris, or common acne, between the ages of 8 and 18. About 20 to 25% of people who have common acne as teenagers continue to have to deal with it in adulthood, but other kinds of acne do not appear until maturity.
The challenge of treating adult acne is that the skin does not grow as fast as it once did. Teens who use harsh acne treatments on their skin tend to get better despite their mistakes. Adults who use harsh acne treatments tend to get more irritation and more inflammation that can leave to formation of permanent brown pigmentation of the skin. A treatment that works in a few days for a teenager may take a few weeks for an adult. And some kinds of acne affect adults but are essentially unheard during the teenage years.
This article will discuss the most common forms of adult acne and what to do about them. Adult acne can be brought under control, but sometimes a completely different approach to treatment is necessary to get rid of blemishes for good.
- Nearly every one has acne as a teenager, but sometimes acne continues into adulthood. When this happens, it is important to use gentler products because the skin cannot repair itself as fast as when it was younger.
- Rosacea usually first appears after the age of 25. It is triggered by events that increase circulation to the skin in the center of the face, such as coming indoors from the cold, drinking hot coffee, or using skin care products that contain alcohol or menthol.
- Azelaic acid can treat both rosacea and common acne on the face.
- Sports acne appears on the chest, chin, and back of active adults.
- Sports acne can be prevented by wearing loose clothing, and it can be treated by showering immediately after perspiring heavily while working out or participating in a sporting event.
- Cystic acne can’t be treated by lancing, squeezing, or cutting. Use tretinoin topical to treat small cysts, or see your physician about stronger treatments.
- Senile acne occurs on tough skin. Salicylic acid may be just the thing for getting rid of blackheads caused by senile acne.
Is Adult Acne Common?
Adult acne has never truly been a rare occurrence, but over recent years there’s been a surge in the number of adults seeking help for acne. The International Dermal Institute says that up to 55% of women between the ages of 20 and 40 have persistent mild acne and oily skin. This unfortunately coincides with the time when women begin noticing wrinkles, age spots and other skin problems, too. Over half of all women above the age of 25 have acne in some shape or form. This rise of adult acne is a hot topic in the media and reported by many dermatologists and experts.
Adult onset acne is typically more common to occur in women who are facing menopause. But that’s not the only possible cause and if it’s acne that has simply persisted since a younger age, there are even more possible causes.
Changes in Hormone Levels
Hormonal fluctuations lead to increased levels of stress hormones, technically called cortisol. These excess hormones end up being broken down into the male hormone testosterone, forcing an abundance of oil through the skin’s pores… not a good thing when we’re talking about acne. And it doesn’t matter what causes the fluctuations in hormone levels. It could simply be hereditary or brought on by pregnancy, lifestyle (think drastic diet changes or stress levels), peri-menopause or menopause, PMS or starting/stopping the use of birth control pills.
When under stress, your body is likely to produce androgens, which are a type of hormone. This can result in the development of or increase in acne, as they stimulate both the hair follicles and oil glands in the skin. And it doesn’t have to be a monumental amount of stress or a life-altering event in order for this to happen. Daily stress, even mid-level stress, that could be from something as simple as stressing out about picking kids up from after-school events after a long day of work everyday can do it. Or trying to balance running your business and family time or your social life. You can’t entirely eliminate stress, but you can actively do something to alleviate it. A daily walk, or even making sure you get enough sleep at night so skin has a chance to regenerate can make a difference.
Adults with acne prone skin should be especially careful in choosing skin and even hair care products. Check the labels to ensure that they contain one of these phrases: non-comedogenic, non-acnegenic, oil free or statements that it won’t clog pores.
Acne sometimes comes as a side effect to medications. Just a few that are known to sometimes cause acne flare ups are anti-seizure medicines, lithium and corticosteroids. Of course, don’t stop taking your medication if you think this may be the case. But do bring it up to your physician and find out if your particular medication may be the cause of your acne. If so, they may be able to switch it out for a different one. If not, a dermatologist may be able to help you figure out the best way to get it under control.
Believe it or not, many experts say the recent rise in adult acne may be, at least in part, due to pollution and air quality. It’s not just the dirt and grit of the outdoors, but today there’s also the toxins, smog and chemicals, depending on where you live. You can’t very well lock yourself up in a clean, air filtrated room for the rest of your life, but be mindful about it and do a quick wash when you come back in from a long walk or day in town.
Chocolate. French fries. For years we were always told to stop eating these indulgences and acne would simply go away. While that may not be the case and it isn’t that simple, there is some research that shows diet can play a role in acne flare ups. Here are some tips about diet and acne that you may or may not know.
Water – Yes, of course, drink plenty of water. Eight ounces at least. Getting enough water is key in helping skin to stay hydrated, water-down any secretions and help prevent unwanted congestion in the pores.
Salt – Some doctors believe that salt can make acne breakouts worse due to the iodine found in your typical table salt. Minimize the amount of salt you use (less than 1500 mg daily) and with pre-packed foods, always try to find the low-sodium versions.
Dairy – Dairy products may be your enemy. More specifically, the low fat and fat free versions. A Harvard study conducted in 2006 showed that girls had, on average, 20% more risk of acne if they drank more than one glass of milk per day than if those who consumed less than one glass per week. Later studies show that the fat free version of milk may actually be the cause, possibly due to the higher amount of sugar. However, other experts believe it may be related to the hormones found in dairy products. Either way, if you have adult acne, it couldn’t hurt to try changing out your milk to non-dairy nut milks or 1%.
Starches – White bread and other high-glycemic-index carbs have a bad reputation when it comes to weight management, but they may also have something to do with your acne. The spike in blood sugar and insulin can increase male hormones that often result in a breakout. Keep hormones in check with plenty of veggies and whole grain foods. The same thing can happened with high sugar foods.
Sugar – Again, lots of sugar will raise insulin levels, leading to a rise in oil-boosting male hormone production that can worsen any acne problems.
What to Do When Teenage Acne Just Won’t Go Away
Sometimes teenage acne just never seems to go away. Usually young adults who have ongoing acne problems lingering from their teenage years have a kind of acne that is stimulated more by stress hormones than by sex hormones. The key to getting this kind of acne under control is to minimize stress on the skin.
That doesn’t mean you have to stress out about being stressed out. The kind of stress hormones that cause acne are identical to the stress hormones that are created during times of physical or emotional duress by the adrenal glands, but they are created by the skin itself.
Minimizing stress on the skin is accomplished by taking a kinder, gentler approach to skin care. If you use detergent soaps, stop. Any kind of cleanser that makes big foaming bubbles on your skin or that leaves the skin feeling cool or tingly triggers stress hormones. Most botanical ingredients in skin care products, especially cinnamon oil and menthol, do the same thing.
It is also important to avoid overheating the skin (steam treatments and saunas), shocking the skin (zit zappers like the hand held electrical device made by Zeno), and getting sunburn. These changes, with continuing daily cleansing and weekly exfoliation of the skin, gradually bring this form of adult acne under control.
Treating Adult Acne
Birth Control Pills & Medication
There are a number of birth control options and medication that may help. As we talked about earlier, adult acne cases in women in their 20’s, 30’s and 40’s is very much on the rise. So it only makes sense to assume there’s a good chance that you’re a woman. And in that case, it’s very possible your acne flare ups are related to hormones. If your breakouts seem to show up around specific times of the month, then there are a number of birth control pills your doctor may want to prescribe, including Yaz, Beyaz, Estrostep and Yasmin. Many of these are approved for the use in treating acne by the FDA. They may also help if you suffer from PCOS.
Another option may be Spironolactone, originally a medication for high blood pressure. Androgens are a class of hormones that prompt skin glands to boost sebum production, which often results in acne. Spironolactone works by blocking the receptors for androgens, as well as helping get rid of any extra testosterone buildup. It’s been shown to work particularly well for women with PCOS or those dealing with hormonal acne that may be extra sensitive to even normal levels of androgens, though it normally takes months to see results. Note that it’s used off-label, meaning the FDA hasn’t specifically cleared it’s use for acne.
Note: In most cases benzoyl peroxide should be used sparingly and occasionally because it can be very drying. If you’re going to use it, start with the lowest concentration possible and work your way up if needed, if your skin isn’t too sensitive to it.
In addition to cleansing your skin daily, exfoliation should also be done regularly to both prevent and treat acne. Using glycolic acid is often recommended, but not necessarily in a cleanser that gets washed off immediately. It’s better to use a product that will allow sufficient time for the glycolic acid to really absorb into the skin.
Sometimes you just need to get rid of a stubborn pimple fast. Benzoyl peroxide may be the answer here. Yes, we said it’s best used occasionally, so the occasional pimple emergency is a good example. Dab a little bit of a benzoyl peroxide dirctly, and only to the little trouble spot and let it get to work on that bacteria. The problem is some skin may experience redness, itching, peeling or inflammation when using a product strong enough to kill acne bacteria on contact, which would contain 10% benzoyl peroxide.
If it’s not an emergency though and you want a gentler way to treat a pesky pimple then consider tea tree oil. It’s been shown to be just as effective at killing acne bacteria as benzoyl peroxide, but it takes longer to work. Plus, it’s better for fighting inflammation.
What to Do About Rosacea
Rosacea is a form of acne that usually does not show up until the age of 25. Unlike common acne, which results from clogged pores, rosacea is caused by weak blood vessels just below the surface of the skin. When these blood vessels leak, the skin turns red. Larger leaks cause small, pimple-like red spots to break out on the face, and scar tissue can cause lumps and bumps to form under the skin, especially on the nose.
The way to keep capillaries from leaking blood is to make sure they are not subjected to more pressure than they can handle. When you move from the cold to a warm room, for example, circulation suddenly increases in the skin of your face. This change in blood pressure in the capillaries can cause immediate redness of the skin. The solution is to keep covered up when you are outside, or to keep indoor room temperature to a minimum to avoid stress on the skin.
Similarly, it is important to avoid other rosacea triggers, such as hot drinks, alcohol, spicy foods, perfumes, after shave, and any treatment for any skin problem that stings and burns. Treating the skin with products that contain azelaic acid—used strictly as directed—can resolve both rosacea and any problem with whiteheads and blackheads on the skin.
What to Do About Cystic Acne
Cystic acne usually strikes in early adulthood, and the young adults who get cystic acne typically were free of common acne as teenagers. In cystic acne, the skin grows over pores containing acne infection. They are not able to drain, so the cyst only grows larger and larger and more and more inflamed.
It is never a good idea to pick at, poke, probe, lance, or cut an acne cyst. The only way to deal with cysts (aside from going to a plastic surgeon) is to treat them with retinoids that stimulate the growth of the skin. It may be possible to do this with an over the counter form of Retin-A called topical tretinoin, or you may need to get a stronger retinoid drug that has to be used under the supervision of a dermatologist. It’s important to treat cysts while they are still small and relatively easy to treat.
What to Do About Sports Acne
Active adults often get sports acne, which is also known as acne mechanica. This form of acne occurs when sweat gets trapped under straps, bands, or elastic clothing. The sweat shrivels skin the same way that spending too much time in the tub or shower can shrivel skin. The shriveling traps acne bacteria in pores and acne follows.
The solution to excess sweat begins with making sure to take a shower after activities that involve sweating under restrictive clothing. Showering removes excess oil and dead skin. Then it also helps to use softer padding or looser straps to prevent future problems.
People of African descent are especially sensitive to sweat-induced acne. People of Japanese descent are especially sensitive to acne triggered by allergies to the elastic used in straps.
What to Do About Senile Acne
Sometimes older adults get blackheads that just won’t go away, especially where the skin is tough, such as on the back. Picking or squeezing won’t get rid of the blackhead. It only injures the surrounding skin.
When blackheads resist other forms of treatment, try exfoliation with a product containing salicylic acid, which may be labeled as “beta-hydroxy acid.” These kinds of products loosen the hardened sebum that holds a blackhead in place, while reducing inflammation to surrounding skin. It may take more than one application of a salicylic acid exfoliant to get rid of senile blemishes, but there is no danger of inflammation or infection of the skin.
Dealing with Spots and Scars
Some people will deal with reddish spots of skin where pimples were for months or even years after acne is long gone. Though it’s believed to be genetic, picking at them and squeezing them is only going to make matters worse. Early treatment is key. The best way to deal with leftover spots (hyperpigmentation), and this is good for all skin types, are skin peels carried out by an aesthetician that use glycolic acid or salicylic acid. See our article on hyperpigmentation for more information.
Acne spots that are indented or raised are a different story. There’s a difference between scars and hyperpigmentation (spots). While skin peels, exfoliation and microdermabrasion may help for leftover spots and minor scars, indented scars will likely need the help of a professional in the form of steroid injections, surgery, laser ablation and radiofrequency ablation. For more about serious scarring, see here.
But again, if it’s merely spots that are left behind, you can probably get rid of them with a little bit of time and dedication. Acne kits like Exposed Skin Care or even Proactiv may make it easier (and cheaper) to manage acne long term.