Medically reviewed by Vicky Davis, FNP
Written by Apostrophe Team
Last updated 4/1/2024
Acne is one of those teenage relics we'd be happy to never see or speak about ever again. In certain instances, however, this skin condition may cross the lines of adolescence to cause a little drama with adults who have made it well past their 30 or even 40th birthdays.
Adult acne may be a persistent form of acne — the type that refused to politely leave around the time you turned 20 and simply stuck around as you aged.
It could also appear as late acne, showing up when you are an already established, bill-paying grown-up.
In other circumstances, adult acne may be recurrent — emerging in your teenage years, disappearing for a little while, before returning to reclaim old territory in adulthood.
Unfortunately for faces everywhere, this skin condition is more popular than you would think, with almost 15 percent of women affected by adult acne.
We'll be sharing how to get rid of adult acne. But first, let’s look at the causes of adult acne and any practices that may worsen its appearance.
Women have a higher chance of developing adult acne when compared to men, especially after hitting the big twenty-five.
This may be for a number of reasons, some of which include:
In addition to producing seismic mood swings — periods, pregnancies, perimenopause, and menopause may also lead to a fluctuation in hormones.
For many women, the appearance of acne across the skin is a not-so-gentle reminder of an imminent period. This is usually brought on by changes in hormone levels.
While it is less clear how menopause contributes to the appearance of acne, it is most likely due to the drastic drop in estrogen levels during this change, while excess amounts of androgens remain. This causes a condition known as hyperandrogenism which can lead to acne flare ups.
Perimenopausal acne has similar causes which lead to excess sebaceous gland stimulation that can lead to acne flares.
An increase in androgen levels is just one of the many changes women will experience while pregnant, but it is the change most likely to lead to or worsen adult acne.
Other conditions like polycystic ovarian syndrome (PCOS) can also cause an androgen imbalance in the body, which may lead to acne.
When your body is placed under considerable stress, say you're struggling with work deadlines, or perhaps you’re primarily responsible for the care of a sick/aged loved one, this stress can sometimes manifest on your skin, which is why acne may appear to worsen when you are under strain.
It isn't exactly clear why this happens. It may be because glucocorticosteroids, which fight inflammation and can worsen acne, are released when we are stressed, along with adrenal androgens which we've seen can contribute to acne formation.
Both compounds may also increase sebum production in the body, a known cause of acne.
Corticotropin-releasing hormone, which helps to manage your body's stress response, is also released during stressful times. It can increase sebum production and can contribute to the conversion of androgens to testosterone in the body.
If you have adult acne, now would be a great time to stop what you're doing and gather your skin, hair, and make-up products together.
If the labels do not reveal that they are non-comedogenic, non-acnegenic, oil-free, or that they will not clog pores, then these may be contributing to your breakouts.
Comedogenic, acnegenic, and oily cosmetics can clog your pores, worsening your chances of developing acne.
Adult acne may sometimes be a result of the genes you're dealt with in life. There appears to be a genetic predisposition to adult female acne. Your chances of developing adult acne may be higher if your mother experienced adult acne in her day.
In some instances, measures used to manage inflammatory diseases, depression, nerve damage, thyroid disorders, bacterial infections, etc., may come with the side-effect of some pesky adult acne.
Corticosteroids, lithium, vitamin B12, thyroid hormones, antibiotics, antituberculous drugs, and antiepileptic drugs are just some medications that can contribute to acne.
Adult acne is right at the bottom of things you'd want to see your body produce, but in some scenarios, it could be warning you of something serious happening within your body that you ought to know about.
Acne has been presented as a symptom of endocrine disorders like Cushing syndrome, congenital adrenal hyperplasia, androgen secreting tumors, and acromegaly.
It could also present in SAPHO as well as PAPA syndrome. SAPHO syndrome can lead to chronic inflammation of the skin, while PAPA syndrome is an autoinflammatory disorder of the skin and joints.
In your teens, treating acne may have involved slapping on some salicylic acid and hoping strongly for the best come morning. With adult acne, however, a little more care has to be observed.
This is because adult acne has an annoying habit of returning after treatment. Plus, to really stick it to this skin disorder — its severity, response to other treatments, any chances of skin, pregnancy, or any chances of skin irritation following treatment have to be taken into account.
To properly manage this skin condition, the following treatments may be applied:
Topical treatments are some of the most popular means of managing and treating acne. They include treatments like:
i. Retinoids: prevent dead cells from clogging pores and may also be effective in unclogging pores. This treatment can help to treat or prevent acne.
ii. Tretinoin: may be applied directly to the affected portion of your skin to promote the production of collagen and to help your skin produce new cells. This usually leads to acne reduction.
iii. Benzoyl peroxide: helps to kill acne-causing bacteria in the skin. It can also remove dead skin cells which can clog pores and cause acne. However, it may irritate the skin and should be used cautiously to minimize sensitivity.
iii. Azelaic acid: may help to fight off adult acne by killing the bacteria that causes breakouts.
Antibiotics have been used for years in the treatment of acne. They help to kill off the acne-causing bacteria that reside in your skin.
Antibiotic treatments come with caveats because adult acne may reappear after they are discontinued and pregnant women are advised against this treatment to prevent issues with fetal growth.
A number of oral and topical antibiotics are available for the treatment of adult acne, so consulting with a dermatology team can help to determine the best option for you.
Excess androgens may be the culprits behind your acne due to their ability to stimulate sebum production.
To control their effects, hormonal therapy through birth control and anti-androgen treatments could be your best bet.
Birth control may help to decrease androgens in circulation due to their estrogen and progestin content.
Likewise, anti-androgen medication like spironolactone may slow down your body's production of androgens.
A really cool way to manage your acne is through blue or red light therapy. Blue light therapy helps to kill the acne-causing bacteria on your skin and may have anti-inflammatory effects.
Red light therapy helps with damage control, by helping to soothe and repair tissue damaged by acne.
Acne is a pain at any age, but it's particularly annoying to deal with when you're way past your teenage years.
Adult acne may be persistent, recurring, or may appear suddenly while you're an adult. Any number of reasons may be responsible for its emergence: androgens and family genes, certain medications, some skincare products, or even undiagnosed diseases.
To help manage your adult acne, consulting with a dermatology provider is a great first step to determining the appropriate care to take. Measures like topical treatments, antibiotics, anti-androgens, or light therapy may be recommended for the management of adult acne.
Zeichner, J. A., Baldwin, H. E., Cook-Bolden, F. E., Eichenfield, L. F., Fallon-Friedlander, S., & Rodriguez, D. A. (2017). Emerging Issues in Adult Female Acne. The Journal of clinical and aesthetic dermatology, 10(1), 37–46. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5300732/
American Academy of Dermatology Association. (n.d.). SKIN CONDITIONS BY THE NUMBERS. https://www.aad.org/media/stats-numbers
Rocha, M. A., & Bagatin, E. (2018). Adult-onset acne: prevalence, impact, and management challenges. Clinical, cosmetic and investigational dermatology, 11, 59–69. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5798558/
Khunger, N., & Mehrotra, K. (2019). Menopausal Acne - Challenges And Solutions. International journal of womens health, 11, 555–567. Retrieved from: Https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6825478/
Bozzo, P., Chua-Gocheco, A., & Einarson, A. (2011). Safety of skin care products during pregnancy. Canadian family physician Medecin de famille canadien, 57(6), 665–667. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3114665/
Chiu, A., Chon, S. Y., & Kimball, A. B. (2003). The response of skin disease to stress: changes in the severity of acne vulgaris as affected by examination stress. Archives of dermatology, 139(7), 897–900. Retrieved from: https://jamanetwork.com/journals/jamadermatology/fullarticle/479409
American Academy of Dermatology Association. (n.d.). ADULT ACNE. https://www.aad.org/public/diseases/acne/really-acne/adult-acne
Pontello, R., Jr, & Kondo, R. N. (2013). Drug-induced acne and rose pearl: similarities. Anais brasileiros de dermatologia, 88(6), 1039–1040. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3900370/
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