Adult Onset Acne
What is it? Why ME? How do I treat and correct?
In previous posts I have addressed acne in general, but I have been receiving many requests from friends and followers on why at 30 or 40+ they are NOW seeing acne. In some cases it was the return to teenage breakout angst, and for many others, this is a NEW sitch; one that they would have never expected.
Adult acne affects 25% of all adult men and 50% of adult women at some time in their adult lives.1-2 One third of adults affected with facial acne also have acne on other parts of their body. These are the official statistics, but from my personal and professional experience, every one at some point will have a zit or two in their adult lives. To be exact, if you have ever had a blackhead, technically you have experienced acne (grade 1).
Almost anyone can develop acne or have an acne recurrence in their 20s, 30s, 40s and beyond.1-2 Dermatologists report seeing more adult acne patients than in previous decades. An article in the International Journal of Cosmetic Science in 2004 stated, “Recent epidemiological studies show that there appears to be an increase in post-adolescent acne, and that the disease is lasting longer and is requiring treatment well into the mid forties.”
Acne, it can be the bain of your existence, and can cause depression and social anxiety in an adult the same way it can in a teen.
The exact causes of Adult Acne are unknown; some of the known causes include but are not limited to an increase of antibiotic resistant bacteria, hormones, cosmetics, and stress. Many women often have to deal with premenstrual flare ups often around the mouth and chin area.
Before we look at treatment options, let’s look at what the pore looks like when it is healthy and functioning normally. See Figure 1
The pilo- sebaceous as shown above consists of the pore opening (osteum), the hair follicle, and sebaceous gland.
Propioni Acnes Bacterium is the main culprit in causing acne vulgaris (pimples). It is a common resident of the pilo-sebaceous glands of the human skin. The bacteria release lipases to digest a surplus of the skin oil (sebum) that has been produced. The combination of digestive products (fatty acids) and bacterial antigens stimulates an intense local inflammation that bursts the hair follicle. Then, a lesion forms on the surface of the skin in the form of a pustule (Whitehead). See Figure 2
Since acne is caused in part from an infection, it can be suppressed with topical and oral antibiotics such as clindamycin, erythromycin, or tetracycline. Some other forms of therapy include chemicals that enhance skin removal (i.e. aha’s, bha’s, enzymes, etc.), introduce an aerobic environment (i.e benzoyl peroxide) or slow the production of sebum (Retin A and Accutane).
You may have to find a combination of options that work best for you, but keep in mind that you MUST HYDRATE and PROTECT. This is crucial to repair function of the skin. You may want to use an oil free hydrator with the added benefit of exfoliation. Look for AHA’s like glycolic acid, lactic acid, azaleic acid (for my people of color).
Some of the best spot treatments that I have found are both naturally derived- Salicylic Acid (bha) in 2% strength is phenomenal for most skin types and colors (my people of color you may want to try this in the evenings only, as SA can be photosensitizing- making your skin more prone to burns).
My trick- ice 5 minutes prior to applying any spot treatment- this seems to stun the bacteria or at least slow it down; then follow with your spot treatment of choice. My other GO TO product for zits is SAMPAR Paris’ Prodigal Pen- made up of pure essential oils- lavender (anti-inflammatory, soothing), geranium (anti-bacterial, mood elevating- great since a zit can make us all depressed!), thyme (anti-bacterial, anti-fungal), savory (anti-bacterial), sage (anti-seborrheic, pore cleansing). All essential oils have some anti-bacterial properties, however, these are well known to combat and treat a zit in just 5 applications and poof it is gone.
Please know you are not alone in your fight. I will continue to seek out new and results driven treatments, products and tips.
To learn more about Your Skin, Your Skin Color, Your Skin Condition and how to treat, check out tabs above.
1. Cunliffe, W.J., V. Goulden, and G.I. Stables. “Prevalence of Facial Acne in Adults.” Journal of the American Academy of Dermatology. 1999 Oct;41(4):577-80.
2. Knaggs HE, Wood EJ, Rizer RL, Mills OH. “Post-adolescent acne.” International Journal of Cosmetic Science. 2004 Jun;26(3):129-38.
3. George R, Clarke S, Thiboutot D. “Hormonal therapy for acne.” Seminars in Cutaneous Medicine and Surgery. 2008 Sep;27(3):188-96.
4. Seirafi H, Farnaghi F, Vasheghani-Farahani A, Alirezaie NS, Esfahanian F, Firooz A, Ghodsi SZ. “Assessment of androgens in women with adult-onset acne.” International Journal of Dermatology. 2007 Nov;46(11):1188-91.
5. Williams C, Layton AM. “Persistent acne in women: implications for the patient and for therapy.” American Journal of Clinical Dermatology. 2006;7(5):281-90.
6. Bataille V, Snieder H, MacGregor AJ, Sasieni P, Spector TD. “The influence of genetics and environmental factors in the pathogenesis of acne: a twin study of acne in women.” The Journal of Investigative Dermatology. 2002 Dec;119(6):1317-22.
7. Cunliffe, W.J., V. Goulden, C.H. McGeown. “The Familial Risk of Adult Acne: A Comparison Between First-Degree Relatives of Affected and Unaffected Individuals.” The British Journal of Dermatology. 1999 Aug;141(2):297-300.
Cunliffe, W.J., and D.C. Seukeran. “Acne Vulgaris in the Elderly: The Response to Low-Dose Isotretinoin.” The British Journal of Dermatology. 1998 Jul;139(1):99-101.
Dumont-Wallon G, Dreno B. [Specificity of acne in women older than 25 years][Article in French] Presse Medicale. 2008 Apr;37(4 Pt 1):585-91.
Pace J. “Acne in adult women.” Skinmed. 2008 Mar-Apr;7(2):61-2.