Adult Acne is Treatable

Have you ever looked in the mirror and declared, “I should not have wrinkles and pimples on the same face!” If so, you’re not alone. Acne: it isn’t just for teenagers. In fact, many people are plagued by adult acne into their 30s, 40s, and even 50s.

According to a survey done by dermatologists at the University of Alabama- Birmingham:

• In their 20s, 50.9% of women and 42.5% of men in their 20s reported experiencing adult acne
• In their 30s, 35.2% of women and 20.1% of men reported adult acne
• In their 40s, 26.3% of women and 12% of men reported experiencing acne
• Even in their 50s, 15.3% of women and 7.3% of men reported experiencing acne

You may have noticed something about those numbers: they’re much higher in women than in men. That is probably because at any age, acne is hormonally related, and the fluctuations of a woman’s cycle can trigger breakouts.

How does adult acne differ from teen acne?

Adult acne differs markedly from the pimples of your teen years, both in how it appears and how it’s treated.

“In teens, you’ll mostly see hundreds or thousands of tiny bumps, blackheads, or whiteheads on the skin of the face, especially the forehead, along with occasional cysts on the chest and back,” says Amy Derick, MD, a fellow of the American Academy of Dermatology, who practices in Great Barrington, Ill. “That’s because teens’ skin tends to be a little stickier and they’re more likely than adults to get clogged pores.”

In adults, acne is more likely to appear on the lower part of the face, especially around the mouth and jawline. “It’s usually deeper nodules or red papules in those areas,” Derick says. “The fine little bumps of teen acne can still happen in adulthood, but it’s much less common.”

What can adults do about acne?

If you’re troubled by more than the occasional breakout, don’t try to treat yourself at the skin-care aisle of the local pharmacy.

“Most of the over-the-counter products involve salicylic acid and benzoyl peroxide, which are good for whiteheads and pustules, but not so much for deeper adult acne,” Derick says.

Talk to your doctor about prescription treatments. Your doctor may recommend one treatment, or suggest combining a cream with an oral medication.

You have several options:

• Prescription creams containing retinoids (derived from vitamin A) to help unplug follicles.
• Gel containing 5% dapsone, which is thought to help fight inflammation involved in acne.
• Combination creams that combine the cleansing agent benzoyl peroxide and antibiotics such as clindamycin.
• Birth control pills, like Yaz, which can regulate the hormonal fluctuations that spark breakouts.
• Oral antibiotics, which act as anti-inflammatories.
• A blood pressure medication called spironolactone, which is frequently used off-label to treat acne.

“We usually try to incorporate some type of retinoid into the mix,” Derick says. (Retinoids, like Retin-A, are related chemically to vitamin A.) “They keep the pores clear and the skin exfoliated, and they also help with wrinkles.”

How long do you need to take oral medications for adult acne?

“Sometimes you’ll only need it as the other topicals, like creams, are kicking in; other times you may need the medication a bit longer. Many people need them only when it flares, such as when they have a particularly bad period.”

What about laser and light therapies for adult acne?

There are several options, including Isolaz, a “photopneumatic” treatment that uses a suction cup apparatus to suck deep into your pores and deliver an intense pulsed light treatment to the hair follicles. Over time, the treatments shrink the skin’s sebaceous glands, leading to reduced oil production.

“Those treatments are good, although they’re still not standard of care,” Derick says. And they’re expensive -- several hundred dollars per treatment, and you need more than one. “Still, some patients are turning toward options like this because they want to be free of taking a pill, and putting on creams twice a day. It can also help with uneven skin tone, texture, and brown spots.”

Will your adult acne go away with time?

Probably. “As we age and our hormones settle down, the prevalence of adult acne does dissipate,” Derick says. “But you don’t have to wait for that. If adult acne is bothering you, see a dermatologist. We have access to the latest treatments, and you can get prescriptions so you don’t have to purchase expensive creams as the cosmetics counter. Adult acne is real, and you don’t have to just live with it.”

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