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Adult Acne

A Fact of Life for Many

Adult acne can be particularly frustrating. Treatment that worked so well during adolescence often is ineffective. Over-the-counter topical medications tend to irritate the skin, making acne worse. Some try numerous treatments without success.

This lack of effectiveness can make one wonder if it really is acne. After all, do adults in midlife and older get acne?


Types of Adult Acne

The truth is that acne can persist well into one’s 30s, 40s, and even 50s. Dermatologists call acne that does not clear by one’s mid-20s persistent acne. Often causing deep-seated, tender, inflamed pimples and nodules, this type of acne is more common in women. Persistent acne tends to form on the lower face, predominately around the mouth, on the chin, and along the jawline.

Adults also develop late-onset acne. Again, women are more susceptible. People who have not had acne for years can suddenly see deep-seated, inflamed pimples and nodules. Even those who have never had acne get late-onset acne. For some women, acne becomes a problem during menopause. Adult-onset acne generally forms on the chin, jawline, and around the mouth. Lesions can appear on the chest and back.

Why Adults Get Acne

Regardless of age, acne develops when excess sebum (an oil that our bodies produce to naturally moisturize the skin), skin cells, and bacteria accumulate. Researchers have discovered that the following may trigger this in adults:

  • Fluctuating hormones. Acne is typically associated with the hormonal swings of puberty, but any time hormones fluctuate, acne can flare. Many women are familiar with the once-a-month breakout. Hormonal swings also occur during pregnancy and menopause, causing acne in some women.
  • Discontinuing birth control pills. Some women get acne when they stop taking birth control pills. The pills may have been keeping their acne at bay.
  • Taking certain medications. Birth control pills that contain oestrogen and progesterones often help control acne in women. When a birth control pill contains only progesterones, it may make acne worse.

    Acne is a possible side effect of other medications as well. These include anticonvulsants, corticosteroids, and sobriety drugs. Never stop taking a prescription medication because acne develops or worsens. Talk with the doctor who prescribed the medication. Ask if a different medication can be prescribed that will not cause acne to flare. If only one medication can be prescribed, talk with a dermatologist about ways to control the acne. Do not stop taking the medication.

  • Family history of acne. In one study, researchers found that 50% of the adults with acne had a first-degree relative (parent, sibling, or child) who had acne. This suggests that some people may have a genetic predisposition to acne.
  • Stress. Studies indicate that stress may trigger acne in women. Researchers have found a relationship between increased stress levels and higher levels of acne in women with fast-paced careers. In response to stress, the body produces more androgens (a type of hormone). These hormones stimulate the oil glands and hair follicles in the skin. When over-stimulated such as during times of stress, acne can flare.
  • Products used on hair and skin. Some products such as oily sunscreens and hair greases promote a type of acne called acne cosmetica. When buying products to be used on the skin or hair, look for ones labeled “non-comedogenic” or “non-acnegenic.” This means that they are less likely to cause acne.

Acne Can Be Warning Sign

Acne also may be warning a woman of an underlying medical condition. When a woman’s acne is accompanied by excessive facial hair, thinning hair or bald patches on the scalp, and irregular periods, it may be a sign of polycystic ovaries (a condition that causes cysts to develop in the ovaries) or adrenal hyperplasia (a group of adrenal gland disorders). It also is possible that the woman has a hormone-secreting tumour located in her adrenal gland or an ovary. It is vital that women experiencing these signs and symptoms see a doctor. Testing can find the cause and allow the doctor to determine the best treatment. The acne will not clear until the medical condition is treated.

Treatment Available

Barring an underlying medical condition, most cases of adult acne can be effectively controlled with acne therapy. Yet, researchers have found that many do not seek treatment. Most believe treatment is not available. Dermatologists want people to know while adult acne can be stubborn, effective control is possible


What Causes Acne?

And more importantly, how do I get rid of it?

All types of acne — blackheads, whiteheads, pimples, and cysts — develop when pores in our skin become clogged. The culprit is sebum [see-bum], an oil in our skin. Our bodies make more sebum when our hormones surge.

This is why teens get acne. This is why women often breakout before their periods. Since hormones fluctuate in the years leading up to menopause, many women in their 40s and 50s get acne.

Why do people get different types of acne?

What happens inside the clogged pore determines the type of acne we see.

A blackhead appears when sebum and dead skin cells clog the pore. While the pore is clogged, its surface remains open. This lets us look into the pore and see a black color. Your dermatologist may call a blackhead an “open comedo” (co-me-dough).

A whitehead forms when the excess oil and dead skin cells clog the pore and block the opening of the pore. Because the pore closes, dermatologists call this type of acne a “closed comedo.”

The excess oil does more than clog pores. Bacteria that normally live on our skin, P. acnes, thrive in this excess oil. Immersed in excess oil, the bacteria can rapidly increase in number. As the bacteria multiply in a clogged pore, the pore becomes inflamed. Inflammation is what causes a pimple to look red, hot, and swollen.

When inflammation reaches deep into the skin, an acne cyst forms. This is the most severe type of acne. Cysts can be very painful. People often see permanent scarring after this type of acne heals.

Getting Rid of Acne

Thanks to advances in medicine, today, virtually every case of acne can be controlled. Many people with mild acne can see clear skin with good skin care and acne products available without a prescription. However, this won’t control everyone’s acne. Sometimes acne control requires a dermatologist’s help. Even severe acne can be successfully controlled with treatment from a dermatologist.

While treating acne may seem unimportant, research shows treatment has value. Treating acne can prevent additional breakouts and scars. It can improve a person’s quality of life. People living with acne can suffer from low self-esteem, anxiety, and depression. Acne can even discourage people from pursuing life's dreams. When acne is under control, a person’s confidence grows. Anxiety and depression diminish.


When to See a Dermatologist

You may feel awkward about seeing a dermatologist, especially if you’ve been told that acne is something you will eventually outgrow. To help you decide whether or not it’s time to consult a dermatologist, listed below are some statements.

Do any apply to you?

  • My acne makes me shy.
  • I am embarrassed by my acne.
  • My outlook on life is less optimistic since I developed acne.
  • None of the over-the-counter products and/or remedies I’ve tried has worked.
  • I am beginning to see scars after acne lesions clear.
  • I have painful, pus-filled lesions (nodules) in addition to blackheads and whiteheads (comedones), and reddened spots on my skin.
  • I have dark skin, and a patch that is darker than my skin appears when an acne lesion clears.

If you said “yes” to any of the above statements, seeing a dermatologist may be beneficial. Today, virtually every case of acne can be successfully resolved. Not only can dermatologists help resolve existing acne, they can also help prevent new lesions from forming and reduce your chance of developing disfiguring scars.

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