Acne – Adult

What is adult acne?

Adult acne can be a continuation of teenage acne that never ended. This is called “persistent acne.” Or it can appear for the first time in people who are 30, 40 or even 50 years old. Acne that appears for the first time is referred to as “late- onset acne.”

What are the causes of adult acne?

Acne in adults can be triggered by several factors, including the following:

  • Hormonal activity. Hormones are the main culprit in the worsening of teen acne (when hormonal fluctuations are most active) and can also play a role in adult acne, especially among women. Hormonal fluctuations are common during menstruation, pregnancy, and menopause. Women who stop taking birth control pills might also get acne. Stress can also lead to hormonal changes and acne worsening. Under stress, the body produces more androgens, which stimulate sebum production.
  • Other medications. Anticonvulsants, corticosteroids, and certain medications can have several side effects, including acne. Do not stop taking your medication if this happens. Instead, talk with your doctor to discuss alternatives or adjusting the dosage. Oral contraceptives containing both estrogen and progestins are sometimes used to prevent acne in women, but progestin-only birth control may worsen acne.
  • Family history. You may be predisposed to have acne if members of your immediate family (such as a sibling or parent) have had acne.
  • Cosmetics. Oily lotions or hair product may promote acne. Choose products labeled “non-comedogenic” or “non-acnegenic.”
  • Another health problem. Acne can signal an underlying medical condition, including polycystic ovaries or problems with the adrenal system.

What are the available treatment options?

As with adolescents, acne treatment recommended by Dermatology & Skin Health is based upon several variables including:

  • Type of acne (comedonal, inflammatory)
  • Location your skin type (dry vs. oily skin)
  • Severity (mild acne, moderate acne or severe acne)
  • Gender (some treatments optimal for one gender and not another)
  • Responses to past treatments

Topical acne medications

Topical medications are applied directly to the skin to bring acne under control. For acne that doesn’t respond to benzoyl peroxide or other over-the-counter medications, your doctor may prescribe something stronger, such as a topical retinoid.

Topical retinoids are one of the most effective treatments for acne because they are believed to work at eliminating lesions at an early stage (called the microcomedone phase).* Topical retinoids may be used alone or in combination with other acne medications.

Long-term use of a topical retinoid may be prescribed to maintain clear skin. Brands of topical retinoids include Differin™ (adapalene), Epiduo™ (adapalene + benzoyl peroxide), Retin A Micro™ (tretinoin), Tazorac™ (tazarotene), or Veltin™ (tretinoin + clindamycin).

Oral acne medications

Your health care professional may prescribe oral antibiotics (minocycline, Solodyn), alone or in combination with other prescription-strength acne medications to fight p. acnes, the bacteria that makes acne lesions become more inflamed.

Some oral medications are prescribed to control the underlying hormonal trigger of acne among women. These hormonal treatment options include oral contraceptives (Yaz, Ortho Tri-Cyclen), hormone replacement therapy (HRT), and spironolactone (aldactone). HRT is not commonly used to treat acne in pre-menopausal women and should never be taken during pregnancy.

For the most severe, unresponsive cases of acne, oral isotretinoin (Amnesteem, Sotret) may be prescribed. Isotretinoin is one of the most effective treatments for severe acne, but it has serious side so treatment with isotretinoin requires working closely with a dermatologist.

What are some additional skin care tips for acne?

  • Clean skin gently. Use a mild skin cleanser twice a day, and pat skin dry. Harsh cleansers and astringents can worsen acne.
  • Do not pop, squeeze, or pick at acne lesions, as this can promote inflammation and infection.. Avoid touching your face with your hands. Keep hands away from your face, and wash your hands often, in case you do touch your face.
  • Limit sun exposure. Tanning only masks acne at best. At worst, sun exposure can lead to skin damage, especially if you are using an acne treatment that makes your skin more sensitive to sunlight and UV rays (this includes tanning booths).
  • Choose cosmetics with care. As mentioned above, choose non-greasy skin products, marked as non-comedogenic and water-based.
  • Be patient with your treatment. Find out how much time it should take for your acne treatment to work (generally 4-8 weeks), and then stick with it. Stopping treatment early may prevent you from seeing good results or even cause a relapse of symptoms.

Schedule treatments in New Hampshire or Massachusetts

Acne during adulthood is very common, and Dermatology & Skin Health, located in Dover, Newington & Londonderry, NH and Peabody, MA, can help. We provide acne medications and we also offer Levulan photodynamic therapy, Daavlin UV phototherapy, and VBeam laser treatments to reduce the appearance of acne. Book your appointment online or give us a Call (603) 742-5556 (Dover & Newington), (978) 525-0100 (Peabody), (603) 965-3551 (Londonderry), or (603) 742-5556 (Bedford).

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