Adult Acne

Adults Get Acne, Too

Most of us thought we'd be done with acne when we entered the adult world. No more zits, no more nightly applications of benzoyl peroxide. No more anxious mornings, knowing you'll have to face the world with a pimple on your forehead.

Unfortunately, it's common for adults to have acne, too. The pattern changes: teens tend to get pimples on the forehead, nose, and upper cheeks, while grownups tend to get them on the lower part of the face. But they're the same pus-filled bumps that made you crazy as a teen. In most cases, acne will disappear for good by age 40 or so, but a few people will continue to have it into their 50's.

Causes

In most cases, adult acne has the same cause as teenage pimples. Oil-producing glands in the skin, called sebaceous glands, become clogged with oil and dead skin cells. A bacteria called P. acnes infects the clogged pores and leads to the production of pus. Doctors think that natural hormones called androgens contribute to the development of acne. These hormones increase during puberty.

Sometimes, adult acne has a specific cause.

• Pregnancy, when a woman's hormonal balance changes, can set off an outbreak.
• Certain medicines, such as steroids and lithium, can cause acne as a side effect.
• Pressure on the skin, caused by tight clothing or bra straps, can lead to a specific type of acne called acne mechanica.

Most of the time, though, there's no obvious reason for adult acne. It's just one of those things, a combination of genetics and bad luck.

Treatment

The same treatments that work for teenage acne can also help adults. However, adult skin tends to be drier, so drying treatments aren't always a good idea.

• Benzoyl peroxide helps remove excess oil and also kills P. acnes. Its side effects can include excessive dryness and scaling of the skin. It also makes the skin more sensitive to sunlight. Many experts tell adults to avoid benzoyl peroxide for these reasons.
• Salicylic acid helps keep pores from clogging. It's found in both acne products and in some anti-wrinkle creams. It can cause mild skin redness.
• Resorcinol and sulfur, which are usually combined, keep pores clear and remove excess oil. They can cause peeling and redness.
• Alcohol and acetone, sold as "astringents," remove dirt and oil. They can be too harsh for dry or sensitive skin.

For More Serious Acne

If over-the-counter treatments fail, a doctor can prescribe stronger medicine. The first choice is usually antibiotic cream or antibiotic pills. A cream made with retinoids, which are derived from Vitamin A, can also help.

If first-line treatments fail, isotretinoin (brand name, Accutane) is an option. This medicine changes how the sebaceous glands function. It can cause severe birth defects, so women of child-bearing age must be very careful not to become pregnant while taking it.

For some women, birth control pills can keep adult acne under control. Birth control pills can also cause acne, though. A doctor can help you decide if contraceptive pills might work for you.

Prevention

We all heard myths about acne as teens, and many people continue to believe them as adults. You may be happy to learn that acne isn't caused by chocolate or potato chips, and it's not a result of failing to wash your face. However, there are some things you can do to help prevent adult acne.

• Avoid oily makeup. Look for products labeled "noncomedogenic," which means they won't clog pores.
• Wash gently. Use a gentle soap and wash twice a day, more often only if your face is dirty or if you've been sweating. Hard scrubbing and harsh soaps can irritate skin and make it look worse.
• Keep hair sprays and gels away from your skin. They often contain ingredients that can make acne worse.