Adult Acne Treatments At A Glance
- Best Results4-10+ weeks
- Treatment Recovery0 days
- Procedure TimeNA
- Skin SpecialistNurse, Dermatologist
- Duration of ResultsMonths-Years
- Back to WorkNA
Adult acne treatments
Acne is not just a teenage problem and may present in the late 20s through to the early 40s. This form of acne is more common in women, and maybe related to hormonal changes. Adult acne usually presents along the jawline and chin area. In severe cases acne lesions can be seen on the shoulders and trunk. Acne can range from a few pimples through to cysts & scars. Stress can be a contributing factor.
FactsFacts on adult acne
- This form of acne is very common and affects up to 15% of the population
- Hormones and stress contributes to adult forms of acne
- A simple skin care regime forms the basis of acne treatments
- Controlling hormonal influx & oil production can improve or cure hormonal related acne
- Stopping the oral contraceptive pill can worsen or cause adult acne
- Acne scarring is frequently seen however easily improved
What is adult acne?
As the name suggest, adult acne occurs in adult life. It may present as a relapse of teenage acne, or may occur as a sudden outbreak later in life. Acne lesions usually occur on the chin, and jawline area, but can involve the cheeks, neck and trunk. In females, hormonal changes often contribute to adult acne.
Why do I get acne at this age?
Several factors contribute to adult acne, including genetics, hormones and stress. Using harsh facial products such as exfoliants and tones can also worsen acne, and strip the skin of protective oils.
Adult acne is usually multifactorial. For unknown reasons genetic factors activate oil glands at a certain age. These oil glands are more responsive to hormones such as progesterone, testosterone, and insulin. Additionally stress with work, kids and life can flare acne up.
In some female patients, coming off the oral contraceptive pill is the cause. Remember, if you acne has been well controlled on the pill, coming off the pill may cause uncontrolled hormones to stimulate oil glands. This results in acne.
What treatment options do I have?
Adult acne is different compared to teenage acne- your favourites including Clearasil & Proactive (BPO) that worked in your early years just aren’t effective anymore.
Several effective treatment modalities are available to patients.
- Creams & antibiotics can work in 30-50% of cases. Unlike teenage acne, antibiotics don’t usually cure adult acne.
- Anti hormone treatments. This group of tablets include the pill such as Cyproterone acetate or Drospirinone. Another excellent anti-hormone tablet is Spironolactone. Anti-hormone treatments work in over 75% of adult acne cases, however it does take 2-3 months before patients notice a difference.
- Chemical peels can decongest blocked pores, reduce blackheads and improve skin texture and skin tone. We advise either Glycolic Peels or Sal. Acid peels for acne control.
- Treatments directed at the oil glands. This is the best method of treating adult acne however side effects need to be considered.
Treatment options for adult acne should be tailored to your lifestyle. For example, if you are contemplating pregnancy within 7-8 months of initial acne treatments, drugs such as Accutane or Roaccutane – Oratane are not advisable.
If you suffer from hormonal acne and pregnancy plans are not an issue, anti-hormones such as spironolactone maybe appropriate. Females in the 40s can also benefit from low dose Roaccutane – Oratane as a method of decreasing oil production.
Phototherapy with blue or red light can be effective in adult acne, and in reducing outbreaks during pregnancy.
Your dermatologist will find a solution for your acne based upon your life style, and your subtype of acne.
How do I know if I have hormonal type acne?
In many cases, adult acne is hormonally mediated. This condition is very common, and occurs in both women and men. In women, hormone acne usually occurs around the chin, jawline and cheek areas and present as deep lumps and cysts. In some cases acne follows a cyclical flare up with period cycles and stress.
Hormone acne is frequently seen when patients cease the oral contraception pill, or change to another form of contraception such as Depo or the Implenon.
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How long will I have to be on anti-acne medications?
Good question, that is hard to give a direct answer. The duration of treatment will depend on many factors, most importantly your genetic make up. Most patients will need treatment for at least 6 months.
As a guide- Accutane-Roaccutane patients require 6-12 months of treatment, on average.
Anti-hormonal medications can be continued for 2-3 years, depending on lifestyle factors.
Most dermatologists endorse diets for acne, as in some situations avoiding trigger foods may make acne easier to control without the need for tablets and drugs. In some situations avoiding trigger foods may improve acne, but the overall change may not be significant in the scheme of things. Regardless, it is worth a try!
Other things to consider BEFORE seeing a medical dermatologist include zinc sulphate vitamins, oil gland vitamins including vitamin A, biotin, niacinamide, tea tree oil, green tea & the famous cure everything –witch hazel. If you are inclined to try these natural remedies, seek the help of both a dietician & a naturopath. If you are stressed, see a psychologist for help.
Dermatologists prescribe chemicals (hint). They are the last resort for patients who want ‘natural solutions’ but the first point of contact if you would like your acne treated effectively.
Chemical peels can improve this form of acne, especially if there are blackheads. We do encourage the use of adjunctive treatments if hormones are a contributing factor in adult acne.
The advantage of using chemical peels in this form of acne is that there will be an improvement in the skin’s texture and tone- ideal for ageing skin.
The best chemical peels for acne include BHA or salicylic acid, or retinoic acid peels. My clinical staff @cliniccutis will guide you.
What products should I use for acne prone skin?
Developing a simple but effective skin care regime is vitally important. Skin care is different at different stage of one’s life. As teenagers we don’t usually worry about wrinkles, pigmentation or loss of skin tone! Adult acne patients will also exhibit early stages of intrinsic & photoaging, on the background of acne, and in most cases acne scars. Treating all these conditions can be tricky. For a comprehensive overview of what to use visit the skin care section of this website.
As a guide-
Retinol or retinoic acid forms the cornerstone of management. Build your skin care around this.
NIacinamide or vitamin B3 can be used in conjunction with retinol. B3 reduces skin inflammation.
Benzoyl peroxide washes can be useful for acne. Caution with concurrent retinol use.
Ascorbic acid also known as vitamin C is helpful to reduce early acne scars, & treat dark areas of pigment, also known as post inflammatory hyperpigmentation. This skin vitamin should be used in the morning.
- Use a simple and gentle cleanser
- Avoid harsh exfoliants and toners
- Use a very light but highly protective SPF sunscreen
- Add anti-aging creams to improve skin texture and tone
- Consider active treatments to reduce pigmentation and start collagen production
What can I do to improve my scars and skin texture?
Adult acne is frequently scarring. Why? First of all acne lesions are deep seeded, often around the jawline & chin area. Secondly, stress is a contributing factor for adult acne. Associated with stress is the tendency to pick. Picking can lead to scars!
Controlling stress and the habit of picking is paramount to prevent scarring!
The second step is scar revision. Our treatment modalities will depend on your type of scarring.
Various techniques including fractional lasers, chemical peels, microneedling, RF, RF microneedling, Tixel & others can help stimulate collagen & reduce scarring.
What can I also do to improve my skin tone and texture?
Adult acne also occurs during the time of our lives when skin aging occurs. It’s frustrating to deal with acne at any age, but combined with photoaging & intrinsic aging, adult acne can have a compounding effect on one’s confidence and skin health. Fortunately there are a variety of treatments that can address both acne scarring & skin aging together. Scars and loss of skin tone (wrinkles) occur in the dermal layers of skin, treating scars often leads to an improvement in winkles.
I use many devices including Fraxel, LaseMD, Picolasers & many more tech to improve skin quality & reduce wrinkles.
Davin’s Perspective on adult acne management
Adult acne is very common and the incidence is increasing. The cause of this condition is multi-factorial. Genetics, hormones, stress, poor diet, and incorrect skin care all contribute to this condition. In some patients hormones may contribute to a greater extent compared to other factors. The typical patient with adult acne presents in the late 20s to late 30s and has deep acne lesions around the chin and jaw line areas. A tendency to pick is frequent.
Treatments are aimed at inhibiting oil production, targeting the end cause of acne- the sebaceous glands.
Dermatologists can investigate any underling hormonal issues such as PCOS. Rarely there are increases in prolactin, androgens, DHEAS & 17 hydroxy progesterone. If hormone profile is normal, chances are you have an intracrine dysfunction & not endocrine.
Treatment options include peels, LED phototherapy & tablets as discussed elsewhere on this site. Other options include inhibiting hormones. Anti-hormonal treatment is either with the Pill or an anti-androgen such as spironolactone. The second treatment is aimed at shrinking down the oil gland, that involves Roaccutane or Oratane. Treatment options will depend on many factors including pregnancy plans, previous success and failures, as well as patient lifestyle factors.
Scarring is prevalent in this subtype of acne, as there is often a tendency to pick. Early & effective treatments will mitigate permanent scars. A tailored approach gives the best outcomes.
Disclaimer: I am a procedural dermatologist. I do not treat medical conditions such as acne. My colleagues @cliniccutis can help
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