"Why do I still have acne when I'm not a teenager anymore?!" This is a question we hear from our patients every day. In fact, it's very common for acne to persist into adulthood. Although acne is often thought of as a puberty problem, it can affect anyone at any age.
Adult acne shares many similarities with teenage acne in both cause and treatment. But adult acne also has some unique features.
What Are the Causes of Adult Acne?
Adult acne, or postpubertal acne, is acne that develops after the age of 25. Adult acne is largely influenced by the same factors that cause teenage acne. Four factors directly contribute to acne: excess oil production, "sticky" skin cells clogging pores, bacteria, and inflammation.
- There are also a number of indirect factors that affect the above direct factors, including
- A woman's hormones, stress, and menstrual cycle all affect oil production
- Hair, skin, and makeup that can clog pores
- Diet can affect inflammation throughout the body.
- Some medications, including corticosteroids, anabolic steroids, and lithium, can also cause acne.
Many skin conditions, including acne, can be a sign of systemic disease. For example, hair loss, excessive hair growth, irregular menstrual cycles, rapid weight gain or loss in addition to acne, or rapid onset of acne without a history of acne can all be signs of an underlying medical condition, such as polycystic ovary syndrome, or another endocrine disorder. Tell your doctor if you develop any other symptoms. He or she may recommend further evaluation.
How to prevent outbreaks?
Like most things in life, acne isn't always fully under control. However, we can give you some great tips to help prevent breakouts:
Never go to bed with makeup on.
Check labels: When shopping for makeup and skin care products, be sure to look out for words like "non-comedogenic," "oil-free," or "non-pore-clogging."
Avoid facial oils and hair products that contain oils.
Some acne spots are not actually acne, but post-inflammatory pigmentation changes caused by previous acne lesions or the picking of acne or pimples. Rain or shine, apply sunscreen with SPF 30+ daily to keep these areas from darkening.
There is some evidence that certain dietary changes can help reduce the risk of acne. For example, a meta-analysis of 14 observational studies involving nearly 80,000 children, adolescents, and young adults showed an association between dairy products and an increased risk of acne. Some studies have linked foods with a high glycemic index (which cause blood sugar levels to rise faster) to acne.
With this in mind, it's important to be wary of misinformation about diet and skin. As physicians, we look for scientifically sound and data-based information; the evidence linking diet to acne is only beginning to emerge. In the future, the effect of diet on acne may be better understood.
What is the most effective treatment option?
Acne treatment options vary, depending on the type and severity of acne. Topical tretinoin transforms skin cells faster, prevents clogged pores, and is an important part of any acne treatment, with the added benefit of treating fine lines, smoothing, and brightening the complexion. Oral isotretinoin (Accutane, other brands) is the closest you can get to "curing" existing acne and is used to treat severe acne. Women who may become pregnant need to take special precautions when taking isotretinoin because it may cause serious harm to the unborn child.
Women with hormonal acne that intensifies with their menstrual cycle may take a drug called spironolactone to control testosterone levels. Oral contraceptives can also help regulate hormones that cause acne.
Sometimes in-office light-based treatments, such as photodynamic therapy, may be helpful. Chemical peels, also done in the office, can help treat acne and eliminate post-inflammatory pigment changes.
Simple, cruelty-free skincare is important for anyone with acne. Choose products that are gentle and safe for acne-prone skin, and avoid products that are harsh and can exacerbate your acne situation. It's also important not to pinch or squeeze the acne lesion, as this can exacerbate discoloration and scarring.
With proper evaluation by a board-certified dermatologist and determination of a treatment plan, nearly all cases of acne can be successfully treated. After all, adulthood is stressful enough without acne!
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