Adult acne: Understand the causes and curb it with simple treatments
“Doctor, why do I have acne at this age? Shouldn’t I have grown out of acne by now?”, is a very frequent question to dermatologists from women. It is bad enough that teenagers are plagued with acne but when it hits you in your adulthood it feels doubly unfair.
Acne, commonly seen in teenagers, gradually disappear after adolescence. At times, it may persist in adulthood. Unfortunately, in the last decade we are seeing an increase in number of people in whom acne appeared for the first time in their adulthood, after 25 years of age, namely, adult onset acne. Generally, more women are afflicted than men. Acne can cause psychological disturbances and has a negative impact on the quality of life of patients.
What causes acne in adults? There could be one or more interplay of the following factors:
> Fluctuating hormone levels/ hormonal imbalance: Androgens, a hormone that stimulates the oil glands increasing oil production creates skin that is more prone to pore blockages and breakouts. Women often experience fluctuating hormones around their menstruation, pregnancy, perimenopause, menopause and after discontinuing or starting intake birth control pills.
> Stress: It triggers the body to produce more androgens. This explains how acne can be an ongoing problem when we are under constant stress.
> Hair and skin care products: Have a look at your cosmetics, including cleansers, moisturisers, sunscreen, makeup, and hair care products. Certain products, especially those with an oil-base, can block pores and create an impaction within the follicle. It is important to use only those products which are marked as non-comedogenic/nonacnegenic/oil-free.
> Certain medications such as steroids, birth control treatments, hormone therapies and other medications can also cause acne. Talk to your doctor if you feel your prescription medications are triggering or worsening your acne.
> Undiagnosed medical condition such as Polycystic Ovarian Syndrome (PCOS) which presents as irregular menstruation, increased hair growth, weight gain, etc., in addition to acne, are signs to consult your doctor.
> Family history: People having a close blood relative suffering with acne seem more likely to get adult acne.
Your treatment options:
Acne treatment requires medication and psychological therapy, demanding time and good adherence. Topical treatment is usually enough for mild acne. Cleansing solutions or gel cleanser are recommended. Benzoyl peroxide, adapalene, clindamycin and azelaic acid are some examples of topicals.
In moderate to severe cases, oral antibiotics and retinoids are used. Retinoids can cause serious birth defects in child if consumed by mother during pregnancy. Women with symptoms of PCOS can benefit from additional hormonal treatment. Increased hair growth can be corrected by permanent laser hair reduction or electrolysis. Regular exercise has shown to have positive effect in reducing adult onset acne in many studies.
On a final note, do not be afraid to moisturise and use sunscreen as most of the adult patients have dry skin and have breakouts. They refuse to use moisturiser or sunscreen in fear of increased acne. This is counterproductive and potentially harmful to the skin. Look for ‘non-comedogenic’ products as they don’t clog pores. As for the sunscreen, products with zinc as the active sunblock agent is the best as it has drying and anti-inflammatory properties.
If you’re suffering with acne all you need is a good dermatologist and an adherence to treatment.