Acne in adults: find out how to treat it – 01/11/2024 – Balance

I rarely had pimples when I was a teenager. Now I have them all the time, and it’s embarrassing. Why am I getting acne as an adult?

When you reach adulthood, you probably think that pimples are gone for good. But dermatologists say it’s common to have acne in your 30s, 40s or older — even if you never had the problem as a teenager.

Adult acne can come as a shock, says New York dermatologist Carmen Castilla, and can be more embarrassing than when you were younger.

The good news is that while the cause of adult acne isn’t always as common as it was when you were a teenager, says Ross Radusky, a Dallas dermatologist, it can be treated at any age.

Causes of adult acne

All cases of acne occur when pores are clogged by oil, dead skin cells and dirt, according to the American Academy of Dermatology (AAD). But when you get acne as an adult, it can be caused by several factors that didn’t come into play during your teenage years:

HORMONES: Teen acne is typically caused by hormonal changes during puberty, according to the AAD. But normal hormonal fluctuations that occur later in life may also be to blame for most adult acne cases, explained Dr. Lauren Ploch, a dermatologist in Aiken, South Carolina.

The skin produces more oil when hormones fluctuate, and this excess oil can clog pores and interact with bacteria on the skin, causing acne.

Hormonal acne is common among women throughout their lives, especially during the days around menstruation, during pregnancy or menopause, or when starting or stopping oral contraceptive use, according to the AAD. Men with naturally high testosterone levels may also be prone to acne.

MEDICINES: Acne can be a side effect of certain medications, including some mental health medications like lithium, or corticosteroids like prednisone, Ploch said. Testosterone medications, birth control pills, some seizure medications and certain supplements, such as B vitamins and whey protein, can also cause acne, she said.

GENETICS: Acne is sometimes a lifelong problem for people with certain skin types — for example, if you have naturally oily skin or slower skin cell turnover when you retain dead cells that clog your pores, Ploch explained. These problems can intensify with age and hormonal changes, she said. A family history of adult acne could mean you’re more likely to get it, too, Castilla said.

STRESS: Stress increases levels of the hormone cortisol, which increases skin oil production and can cause breakouts, Radusky said. Stress-related acne usually goes away once the stressor subsides. Stress can also affect other areas of life, including sleeping and eating habits, which can also contribute to acne, Ploch said.

Treating adult acne at home

You can usually treat mild acne with over-the-counter topical products.

A benzoyl peroxide wash can be a good place to start, as it has antibacterial and skin-drying properties and helps unclog pores, Ploch said. Adapalene (a retinoid medication) and azelaic acid (a medication that kills bacteria and cleans pores) can help clear up acne, Castilla said. Products containing salicylic acid also help exfoliate the skin, which promotes the renewal of dead cells and prevents clogged pores.

However, Radusky said, because skin becomes drier as it ages and loses collagen, these products can be too drying and irritating for some adults. In this case, he recommends using products with glycolic acid, a gentle chemical exfoliant, to increase cell turnover without drying out the skin.

It can take four to six weeks to see improvements with over-the-counter products, so it’s important to use them consistently, Castilla said. Look for moisturizers, sunscreens, and cleansers labeled “oil-free” or “noncomedogenic,” Ploch said, that won’t clog pores.

When to see a dermatologist

If the drugstore products aren’t working; if you notice scars or dark spots on the rash; or if your acne is hurting your self-esteem, see a dermatologist, Radusky said.

He can help determine the cause by reviewing your medications, diet, allergies, stress, medical conditions and more. A dermatologist can also be sure that your breakouts are indeed acne.

“There are a lot of acne copycats as we age,” Radusky said.

For example, he said, rosacea sometimes resembles acne, and a type of fungal infection called malassezia folliculitis can also cause pimple-like breakouts.

Based on the cause and skin type, Castilla said, dermatologists have many treatments to offer, including prescription topical medications and topical or oral antibiotics.

Spironolactone, an oral medication that blocks certain hormones in the body, is sometimes recommended for severe hormonal acne in women. And isotretinoin, commonly known as Accutane, is an effective oral acne medication, although it can cause serious side effects, including birth defects and depression. It’s most commonly prescribed for “deep, painful acne cysts and nodules,” according to the AAD.