Acne is not just a teenage problem and may present in the late 20s through to the early 40s. This form of acne is more common in women, and maybe related to hormonal changes.
Adult acne usually presents along the jawline and chin area. In severe cases acne lesions can be seen on the shoulders and trunk.
Acne can range from a few pimples through to cysts and scars. Stress can be a contributing factor.
Specialist Perspective on adult acne management
Adult acne is very common and the incidence is increasing. The cause of this condition is multi-factorial. Genetics, hormones, stress, poor diet, and incorrect skin care all contribute to this condition. In some patients hormones may contribute to a greater extent compared to other factors. The typical patient with adult acne presents in the late 20s to late 30s and has deep acne lesions around the chin and jaw line areas. A tendency to pick is frequent. Treatments are aimed at inhibiting oil production, targeting the end cause of acne- the sebaceous glands. We basically have two treatment options- firstly, inhibition of hormones. Anti-hormonal treatment is either with the Pill or an anti-androgen such as spironolactone. The second treatment is aimed at shrinking down the oil gland, that involves Roaccutane or Oratane. Treatment options will depend on many factors including pregnancy plans, previous success and failures, as well as patient lifestyle factors. Scarring is prevalent in this subtype of acne, as there is often a tendency to pick. Most patients with adult type acne will also have evidence of photodamage and skin ageing. I often combine acne treatments with fractional methods of skin resurfacing –revision. My favoured treatment is with the FRAXEL DUAL Laser in this setting.
Several factors contribute to adult acne, including genetics, hormones and stress. Using harsh facial products such as exfoliants and tones can also worsen acne, and strip the skin of protective oils.
Adult acne is usually multifactorial. For unknown reasons genetic factors activate oil glands at a certain age. These oil glands are more responsive to hormones such as progesterone, testosterone, and insulin. Additionally stress with work, kids and life can flare acne up.
In some female patients, coming off the oral contraceptive pill is the cause. Remember, if you acne has been well controlled on the pill, coming off the pill may cause uncontrolled hormones to stimulate oil glands. This results in acne.
Adult acne is different compared to teenage acne- Clearasil and Proactive is not usually a solution for adult acne. Several effective treatment modalities are available to patients.
Creams and antibiotics
Can work in 30-50% of cases. Unlike teenage acne, antibiotics don’t usually cure adult acne.
Anti hormone treatments
This group of tablets include the pill such as Cyproterone acetate or Drospirinone. Another excellent antihormone tablet is Spironolactone. Antihormone treatment work in over 75% of adult acne cases, however it does take 2-3 months before patients notice a difference.
Can decongest blocked pores, reduce blackheads and improve skin texture and skin tone. We advise either Glycolic Peels or Sal. Acid peels for acne control.
Treatments directed at the oil glands
This is the best method of treating adult acne however side effects need to be considered.
Treatment options for adult acne should be tailored to your lifestyle. For example, if you are contemplating pregnancy within 7-8 months of initial acne treatments, drugs such as Roaccutane – Oratane are not advisable.
If you suffer from hormonal acne and pregnancy plans are not an issue, anti-hormones such as Spironolactone maybe appropriate. Females in the 40s can also benefit from low dose Roaccutane – Oratane as a method of decreasing oil production.
Omnilux Phototherapy is a very poor treatment for adult acne, however it can be effective in reducing outbreaks during pregnancy. Specialist do NOT recommend phototherapy as a sole method of treating acne- especially in adult cases.
Your Specialist will find a solution for your acne based upon your life style, and your subtype of acne.
This is a Specialist Nurse led clinic for patients who suffer from mild to moderate acne, who often will benefit from advice on correct skin care and products. As part of our initial assessment we provide each patient with a complimentary chemical peel.
The Acne Solutions Clinic also offers the following services without the need to see a Dermatologist-
Chemical peels are a great method to unblock pores and refine your skin with little or no downtime. Ideal for blackheads
In many cases, adult acne is hormonally mediated. This condition is very common, and occurs in both women and men. In women, hormone acne usually occurs around the chin, jawline and cheek areas and present as deep lumps and cysts. In some cases there maybe a cyclical flare up with period cycles and stress.
Hormone acne is frequently seen when patients cease the oral contraception pill, or change to another form of contraception such as Depo or the Implenon.
Good question, and we have no accurate answer. The duration of treatment will depend on many factors, most importantly your genetic make up. Most patients will need treatment for at least 6 months.
As a guide- Roaccutane patients require 6-18 months of treatment, on a low dosing regime.
Anti-hormonal medications can be continued for 2-3 years, depending on lifestyle factors.
The dermatologist at the Acne Specialist Clinic do endorse diets for acne, as in some situations avoiding trigger foods may make acne easier to control without the need for tablets and drugs. In some situations avoiding trigger foods may improve acne, but the overall change may not be significant in the scheme of things. Regardless, it is worth a try!
Chemical peels can improve this form of acne, especially if there are blackheads. We do encourage using adjunctive treatments if hormones are a contributing factor in adult acne.
The advantage of using chemical peels in this form of acne is that there will be an improvement in the skin’s texture and tone- ideal for ageing skin.
Developing a simple but effective skin care regime is vitally important. Skin care is different at different stage of one’s life. As teenagers we don't usually worry about wrinkles, pigmentation or loss of skin tone! Adult acne patients will also exhibit early stages of intrinsic and photoaging, on the background of acne, and in some cases acne scars. Treating all these conditions can be tricky. As a guide-
- Use a simple and gentle cleanser
- Avoid exfolliants and toners
- Use a very light but highly protective SPF sunscreen
- Add anti-aging creams to improve skin texture and tone
- Consider active treatments to reduce pigmentation and start collagen production
Adult acne is frequently scarring. Why? First of all acne lesions are deep seeded, often around the jawline and chin area. Secondly, stress is a contributing factor for adult acne. Associated with stress is the tendency to pick. Picking can lead to scars!
Controlling stress and the habit of picking is paramount to prevent scarring!
The second step is scar revision. Our treatment modalities will depend on your type of scarring.
Specialists use various techniques including fractional laser, chemical peels and RF RadioFrequency to help stimulate collagen and reduce scarring.
Adult acne also occurs during the time of our lives when skin aging occurs. It’s frustrating to deal with acne at any age, but combined with photoaging and intrinsic aging, adult acne can have a compounding effect on one’s confidence and skin health. Fortunately there are a variety of treatments that can address both acne scarring and skin aging together. Scars and loss of skin tone (wrinkles) occur in the dermal layers of skin, treating scars often leads to an improvement in winkles.
Over the past few years fractional devices such as laser and RadioFrequency have proved to be effective in the treatment of acne scars and wrinkles. The advantage of fractional treatments is that there is minimal downtime for the client.