No, it’s not fair, but many adults struggle with acne. While many assume that acne is reserved for our teen years alone, the truth is that acne is a common and frustrating condition in adults, too. The good news is, there are many effective treatment options available, and we’ll review a few here.

 Adult acne, like acne in any stage of life, is often caused by a combination of factors. Hormonal fluctuations, genetics, stress, diet, environment, and skin care products.

 Adult acne can have many different presentations. Here are just a few examples:

Hormonal acne corresponds to changes and fluctuations in our hormone levels. Classic hormonal acne is usually distributed on the jawline, chin, and/or cheeks. Females who experience this kind of acne notice a predictable pattern in the timing of acne flares, oftentimes corresponding with their periods. But hormonal acne can also be caused by certain contraceptive methods (implantable hormonal rods, hormonal IUDs, contraceptive injections), pregnancy, and other hormonal therapies. Those with hormonal acne may experience some degree of acne all the time, but it tends to worsen at a particular point once or twice a month. Hormonal acne can range from blackheads, whiteheads, and pimples to deeper cysts, painful bumps under the skin. It can be particularly frustrating, especially for those that did not struggle with acne earlier in life.  

Some people are at a higher risk for being colonized with bacteria that can cause acne breakouts, particularly strains of a bacterium called staphylococcus aureus. Risk factors for bacterial colonization include:

• Healthcare exposure- recent hospitalization, living in a group home or care facility, recent surgery, dialysis
• Living with being in close skin-to-skin contact with someone who already has a staphylococcus aureus infection; sharing personal care items that come in contact with the skin
• Participating in team sports with equipment that is not cleaned frequently (football, wrestling, hockey)
• Weak immune system from chronic diseases or medications

Staph aureus-related acne tends to concentrate around the chin and mouth. Sometimes people will also notice that they will get sores, pimples, or fissures inside their nostrils. Staph aureus can also cause boils and abscesses on other areas of the body, which can be a clue for this type of acne being present. 

Some people with rosacea can have an overlap of acne as well, where they not only have central facial redness and flushing, but can develop pimples and pink-to-red acne bumps as the result of rosacea flares or specific triggers (alcohol, spicy foods, temperature extremes, sun exposure, etc).

The good news about adult acne, as frustrating as it can be, is that there are many treatment options available! Here are a few:

Medicated washes and leave-on products help combat different types of adult acne, particularly more surface-level and textural acne like blackheads, whiteheads, pimples, and pustules. Topical medications containing ingredients like benzoyl peroxide, retinoids, salicylic acid, and azelaic acid can target acne-causing bacteria, unclog pores, and reduce inflammation. If over-the-counter products are not doing the trick, check in with your dermatology provider, as there are many prescription-strength topicals available.

For moderate-to-severe acne, cystic/deep acne, acne leaving behind scars, and hormonal acne, prescription oral medication tends to be more effective, working from the inside-out where topical medication cannot penetrate. These treatments also tackle the underlying causes of acne, including reducing inflammation and excess sebum production.

Chemical peels, microdermabrasion, laser therapy, and photodynamic therapy done under the direction of a licensed esthetician or dermatology provider can target stubborn inflammatory acne, reduce scarring, and help improve overall skin texture. While cosmetic office treatments are unfortunately not covered by medical insurance, they can be a very effective option. Book a consultation now!

A healthy lifestyle can significantly impact acne. Avoid high glycemic index foods (the really sugary and processed stuff), manage stress levels, hydrate well, and shower promptly after exercise.  Make consistent skin care a habit like brushing your teeth, using only non-comedogenic (non-pore-clogging) products on your skin- that includes moisturizers, sunscreens, and makeup.  Making these small but effective changes can really make a difference for your skin!

The one predictable thing about life is that there will be change, and that includes changes in your skin! Treating adult acne is not an overnight process, but requires patience, persistence, and collaboration with your dermatology provider. Set realistic expectations with your dermatology provider about when you should expect to see improvement after making changes in your skin care routine (spoiler alert- typically 2-3 months). Regularly check in with your dermatology provider to let them know how your skin is doing and to tailor a skin care plan that will work for you. You can book an appointment with one of our dermatology providers or our esthetician to address your adult acne concerns. We’re here to help!