Pimples are for teenagers, right? At least, that’s what we were promised: At some point the acne that blighted us during our teen years would miraculously clear up and we would enjoy spot-free skin as adults. But that isn't always the case.
Adult acne. According to the American Academy of Dermatology (AAD), acne can develop and persist well into the 30s, 40s, 50s and even beyond. AAD statistics show that by mid-teens, more than 40 percent of adolescents have acne or acne scarring, severe enough to require medical treatment, and that 85 percent of the population will suffer with acne at some point. Acne that begins during teenage years and continues into adulthood is called persistent acne, whereas acne that develops in later years is known as adult onset acne. Dr. Jeannette Graf, a dermatologist and author of Stop Aging, Start Living, suggests that for around half of those prone to acne, it can be a chronic condition persisting throughout adult life.
Women and hormones? Women are more prone to both persistent and late onset acne that men are, according to the AAD, possibly due to the hormonal changes they experience throughout their menstrual cycles, pregnancy and menopause. Although use of a combined estrogen and progestin birth control pill may control hormonal imbalances and reduce flare-ups, a progestin-only pill may exacerbate the problem. Dr. Lawrence Gibson, a Mayo Clinic dermatologist, argues that a hormone imbalance does not cause acne, however. He says that although “some people with hormonal imbalances due to diseases such as polycystic ovary syndrome experience more problems with acne … the vast majority of those with adult acne have no measurable hormonal imbalance.”
Causes and triggers. Even if hormonal imbalances don’t cause acne, there is little doubt that a woman’s monthly cycle can trigger breakouts. Similarly, being stressed, sensitivity to greasy and sugary foods, and too many harsh chemicals on the skin can prompt the sebaceous glands to go into overdrive. The glands then produce too much oil, which gets trapped in pores along with dead skin cells, leading to pimples. And while in teenagers these pimples tend to be restricted to the oily skin on the forehead, nose and chin, in adults, acne is just as likely to appear on the dryer skin of the cheeks and jawline. As if to add insult to injury, adult acne tends to appear in larger, angry red lumps that remain under the skin, feeling tender and taking longer to clear.
Treatment. Graf recommends avoiding the harsher chemicals used to treat teenage acne and instead opting for more gentle treatments. A good cleanser with salicylic acid will exfoliate dead skin and prevent pores becoming clogged, she says, and a spot treatment containing benzoyl peroxide can be used to treat individual pimples. If over-the-counter treatments don’t do the trick, visit a dermatologist, who might prescribe antibiotics or topical creams for overnight use, combining a slow-release retinoid with an antibiotic. Laser treatments or cortisone injections are more dramatic treatments available, which, Graff says, may be expensive, costing a few hundred dollars per treatment, but may be cost-effective in the long run when the price of prescription drugs are taken into account.