Fighting Adult Acne

Even if you escaped zits as a teenager, you could have a bad bout later in life. Sometimes, teenage acne lingers for years. Or pimples suddenly appear in adults - mostly among women - even as late as menopause.

No one knows exactly how many adults have acne (most don’t seek treatment). However, a 2007 survey at the University of Alabama found that of 1,013 participants, nearly 51 percent of women in their 20s reported acne, as did 42.5 percent of men. Those numbers declined with age, but among participants in their 50s, about 15 percent of women and 7.3 percent of men said they still had acne.

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What’s the Problem?

Hormonal upheavals during teenage years are responsible for adolescent acne. Afterward, some women break out as their hormones cycle monthly or when they’re pregnant. Later, shifting hormone levels leading to menopause can bring back acne. Identifying causes in men is tougher. Anabolic steroids to bulk muscles can do it (here, acne gradually goes away after steroids are stopped). Shaving can lead to folliculitis, a disorder that resembles acne, but isn’t: a hair in the middle of a pimple is the tip-off.

Other causes:

• Quitting birth control pills: The pill can clear up skin, but acne can return when you stop taking it.
• Medications: Acne is a side-effect of anticonvulsants, corticosteroids, progestin-only birth control pills, and others. Ask your doctor about an acne-free alternative.
• Family history: This may lead to half of all cases of adult acne.
• Stress: When women are under stress their bodies produce more androgen, a hormone that stimulates oil production leading to acne.
• Hair and skin products: Avoid oily ones.
• Smoking: A 2010 Italian study linked adult acne to cigarette smoking.

Take note: Adult acne sometimes signals polycystic ovary syndrome (PCOS), a serious medical problem. (Other signs include excess facial hair in women, thinning hair on the head and irregular periods.) Another possibility: adrenal gland disorders. See a doctor for testing and treatment.

Want to reduce breakouts? A few adjustments to your diet can help improve your complexion.

Clearing Up Your Skin

Try these tips to prevent and control breakouts:

• Wash gently: Use a mild facial cleanser with salicylic acid to dislodge debris in pores. Wash only twice a day, more can irritate skin.
•  Choose “non-comedogenic” or “non-acnegenic” skin products.
• Don’t squeeze or pop pimples - this can cause infection and scarring.
• Use powder cosmetics (less irritating than cream products).
• Try non-prescription retinoids (these vitamin A derivatives are good for blackheads, bumps under the skin, acne, and wrinkles). They make skin more likely to burn, so don’t forget your sunscreen. 
• Use a product containing salicylic acid or benzoyl peroxide to dry oily areas and zap bacteria.
• Take off your makeup at bedtime: otherwise, it can clog pores and worsen acne.
• Keep your hands off your face - they can transfer dirt and oil. So can cell phones and landline receivers. Try to keep your hair off your face, too.

Beyond Home Remedies

Stubborn cases may need a dermatologist’s expertise. Here’s a rundown on today’s treatments:

• Prescription skin medications combining benzoyl peroxide and an antimicrobial drug.
• Prescription drugs to control hormonal swings: These include birth control pills, hormone replacement therapy and spironolactone, which prevents production of excess oil and lowers androgen production.
• Oral antibiotics plus a retinoid applied to the skin.
• Accutane: For severe acne only; this powerful drug can cause birth defects. Warning: avoid if you’re pregnant or could become pregnant.
• Chemical peels: These use glycolic acid or salicylic acid to remove dead skin cells and unclog pores. Possible side effects: blisters, scarring and infection.
• Microdermabrasion: Crystals from a hand-held device exfoliate and polish skin and unclog pores; however, this process can worsen skin that’s easily scarred.
• Laser and light therapies: These treatments target bacteria that foster acne inflammation or shrink oil glands or both. The jury is out on the effectiveness of light therapy for home use.

In addition, new products from cosmetic and skin care companies claim both anti-acne and anti-aging effects. They’ve already have bumped up the $386.8 million market for anti-acne products, and more are in the works.

Learn the basics of healthy beauty and skin care.

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