Fight back against adult acne

By Lila Havens, Staff Writer, myOptumHealth
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Remember the panic you felt when your face broke out right before the prom? In some people the problem doesn't end with the teen years. Acne is a fact of life for many women, lasting well into their 20s, 30s or 40s and beyond.

Just about everyone has pimples at some point in life. Usually, acne starts during puberty and goes away in five to 10 years. For some adults, though, (mostly women) acne never goes away. In others, it returns or occurs for the first time later in life, often around the time of menopause. This is sometimes called late-onset acne.

Adult acne can be embarrassing and tough to get rid of, but treatment can help keep it under control.

What causes adult acne?

Acne at any age occurs when excess sebum (an oily substance made by glands in the skin), skin cells and bacteria build up in the pores. Just what causes this to happen is not clear, but androgens (male sex hormones) seem to play a role. Androgens cause the oil glands to produce sebum. When androgen levels go up, more sebum is produced, which may cause acne to form.

Genetics also plays a part. Some people inherit a tendency to develop acne.

A number of things can trigger an acne flare, including:

Natural shifts in hormone levels, which occur around the time of your period, when you are pregnant or during perimenopause
Stopping birth control pills, which also affects hormone levels
Taking certain medications such as steroids and lithium
Stress, which causes the body to produce more androgens
Using oily cosmetics or sunscreen

Contrary to popular belief, acne is not caused by greasy foods, chocolate or dirt.

Some women who have adult acne also have excess facial hair, thinning scalp hair and irregular periods. These may be signs of a condition called polycystic ovary syndrome. If you have these symptoms, be sure to see a doctor.

How is adult acne treated?

You may want to start with nonprescription medications you apply to the skin, such as products that contain:

Benzoyl peroxide
Salicylic acid
Resorcinol
Sulfur

If over-the-counter medications don't help, see your doctor or a dermatologist, a doctor who specializes in skin conditions. Most cases of acne can be controlled with one or more of the following prescription treatments:

Prescription-strength benzoyl peroxide creams or gels, which may be combined with retinoids or antibiotics
Antibiotic pills such as tetracycline
Birth control pills or hormone therapy
Spironolactone, a diuretic that lowers androgen production

For severe, stubborn acne, a doctor may prescribe isotretinoinpills (Accutane). But be warned that this medicine can cause severe birth defects if you get pregnant while taking it. Women must use at least two forms of birth control while taking this drug.

Adult acne can be frustrating to deal with, and there is no quick fix. It may take six to eight weeks after you start treatment before you see any improvement. If one treatment doesn't help, you may need to try a different medication or a combination of treatments.

In addition, good skin care is essential:

Wash gently with a mild facial cleanser.
Don't scrub or pick at your skin. This can make your acne worse.
Use skin and hair products labeled "non-comedogenic." This means they are less likely to cause acne.

View the original Fight Back Against Adult Acne article on myOptumHealth.com

SOURCES:

American Academy of Dermatology. Adult acne: a fact of life for many women. Accessed: 12/01/2009
Collier CN, Harper JC, Cantrell WC, Wang W, Foster KW, Elewski BE. The prevalence of acne in adults 20 years and older. Journal of the American Academy of Dermatology. 2008;58(1):56-59. Accessed: 12/01/2009
National Institute of Arthritis and Musculoskeletal and Skin Diseases. Acne. Accessed: 12/01/2009