Adult acne is a common skin condition affecting many people beyond their teenage years. Unlike adolescent acne, which typically improves with age, adult acne can persist or even appear for the first time in adulthood. This article looks at what causes adult acne, how it differs from teenage acne, effective treatment options, and lifestyle changes to help manage it.
What causes adult acne?
Adult acne is primarily caused by four main factors:
- Excess oil production
- Clogged pores
- Bacteria
- Inflammation
Several underlying factors can contribute to these issues:
Hormonal fluctuations: Women are more prone to adult acne due to hormonal changes during menstrual cycles, pregnancy, and menopause. Conditions like polycystic ovary syndrome can also trigger acne [1][2][4].
Stress: Increased stress levels can lead to hormonal imbalances, particularly elevated androgens, which stimulate oil production and can worsen acne [1][4].
Genetics: A family history of acne increases the likelihood of developing adult acne [1][3][4].
Skincare and hair products: Some cosmetics and hair products can clog pores, exacerbating acne [1][2][3].
Diet: High glycemic index foods and certain dairy products may contribute to acne in some individuals [1][3][4].
Medications: Some medications, including corticosteroids and lithium, can cause acne as a side effect [1][3].
Occupational acne: Exposure to certain industrial chemicals, oils, or dust in the workplace can lead to the development of acne, known as occupational acne [1][4].
Exogenous steroids: The use of anabolic steroids or other external steroid medications can trigger or exacerbate acne, often leading to a severe form known as "steroid acne" [1][3].
How is adult acne different from teenage acne?
While acne in teenagers is often linked to puberty and hormonal changes, adult acne has some key differences:
Location: Teen acne often appears on the forehead and cheeks, while adult acne often affects the lower face, including the jawline and neck [1][3].
Type: Adult acne tends to be more inflamed with fewer blackheads and whiteheads but more small red bumps and cysts [1][2].
Skin condition: Adult skin is usually drier and less resilient than teenage skin, which can make acne treatment harder [1][3].
Persistence: Adult acne is often more persistent and resistant to traditional treatments [1].
Hormonal factors: Hormonal changes, especially in women, play a more significant role in adult acne [1][3][5].
Effective adult acne treatments
Topical treatments:
- Retinoids (e.g. tretinoin): These help unclog pores and reduce fine wrinkles [1][4][5].
- Benzoyl peroxide: This has antibacterial properties [1][5].
- Salicylic acid: This exfoliates and unclogs pores [1][5].
- Topical antibiotics (e.g., clindamycin, erythromycin): help reduce bacteria on the skin and have anti-inflammatory properties [1][5].
- Anti-inflammatories (e.g., adapalene): helping to reduce redness and swelling associated with acne while preventing new acne from forming [1][5].
Combining topical agents, such as a retinoid with benzoyl peroxide or a topical antibiotic, can enhance treatment effectiveness. For instance, using clindamycin with benzoyl peroxide can address both bacterial growth and inflammation, while pairing adapalene with benzoyl peroxide can target multiple acne-causing factors simultaneously [1][5].
Oral medications:
- Antibiotics: These reduce inflammation and bacteria [1][5].
- Spironolactone: This is used for women with hormonal acne [1][5].
- Isotretinoin (Accutane): This is for severe cases [1][4][5].
Hormonal treatments:
Oral contraceptives: These help regulate hormones in women [1][5].
In-office procedures:
Chemical peels: These exfoliate and improve skin texture [1][5].
Light-based therapies: These include treatments like photodynamic therapy [1][5].
How hormonal changes affect adult acne
Hormonal fluctuations play a significant role in adult acne, particularly in women. Here's how hormonal changes affect adult acne:
Increased sebum production: Hormonal changes, especially fluctuations in androgens like testosterone, can stimulate the sebaceous glands to produce more sebum (oil). This excess oil can clog pores and lead to acne breakouts [1][4][5].
Menstrual cycle: Many women experience acne flare-ups before or during their menstrual periods due to hormonal fluctuations [1][5].
Pregnancy: Hormonal changes during pregnancy can trigger acne outbreaks in some women [1][5].
Menopause: The hormonal shifts that occur during menopause can also contribute to acne in older women [1][5].
Polycystic ovary syndrome (PCOS): This condition, which involves hormonal imbalances, can cause persistent acne in women [1][5].
Estrogen and progesterone imbalances: Low levels of estrogen or fluctuations in progesterone can lead to wider pores and increased oil production, contributing to acne [1].
Stress: Increased stress levels can lead to a rise in cortisol, which can aggravate oil glands and hair follicles, potentially causing breakouts [1][4].
Insulin fluctuations: Changes in insulin levels can increase androgen production, which in turn accelerates skin cell growth and sebum production, potentially leading to acne [1][4].
Lifestyle changes to help reduce acne
To manage and prevent adult acne:
- Use non-comedogenic skincare and makeup products [1][3].
- Maintain a consistent, gentle skincare routine [1][4].
- Avoid picking or squeezing acne lesions to prevent scarring [1][3].
- Manage stress through relaxation techniques or exercise [1][4].
- Consider dietary modifications, such as reducing high glycemic index foods and certain dairy products [1][3][4].
When to see a dermatologist for adult acne
If over-the-counter treatments aren't effective after a few months, or if acne is causing emotional distress or scarring, it's advisable to consult a registered Consultant dermatologist [1][4][5]. They can provide a personalised treatment plan and may use a combination of therapies for optimal results [1].
How to tell if acne is hormonal or bacterial
Hormonal acne: This type of acne often flares up in sync with hormonal changes, such as menstrual cycles or stress. It tends to appear on the lower part of the face, like the jawline and chin, and can be persistent and deep [1][4].
Bacterial acne: This type is caused by bacteria and often results in whiteheads, blackheads, and inflamed pimples. It's usually more superficial and can appear anywhere on the face [1][4].
Adult acne is a complex condition with various contributing factors. While it can be frustrating, a combination of medical treatments, skincare practices, and lifestyle modifications can effectively manage and improve adult acne. With proper care and professional guidance, most cases of adult acne can be successfully treated, leading to clearer, healthier skin [1][4].
How HealthHero can help
At HealthHero, we provide expert dermatology consultations and personalised treatment plans to help manage and treat adult acne effectively. Visit our dermatology consultation and online prescriptions for acne pages to learn more about how we can assist you.
