When you’re all grown up and still have acne

If you thought leaving your teens behind meant leaving acne behind, think again!

Unfortunately zits, spots and pimples are popping up when people are focussed on careers, relationships or teens of their own.

Acne will affect an estimated 85% of us at some stage of our lives. For most people, this will be in their teens but dermatologists have been noticing more adults, predominantly women, with acne.

According to Professor Kurt Gebauer, Fremantle dermatologist and All About Acne co-chair, adult acne (also known as hormonal acne) affects more females than males, and typically refers to those aged 25 and over. 

In fact, in western societies, one-third of total acne visits to dermatologists are made by women over 25 years.

“There are two groups who are affected by adult acne – those whose acne occurred in adolescence and followed them into adult life while others who were lucky enough to avoid the teen curse, suddenly find it later in life, but this is less common,” he added. 

What causes adult acne?

From hormones and family history, to stress and having children later in life, there are several theories about what causes adult acnePolycystic ovarian syndrome (PCOS) is one health condition that often causes acne.

“What we do know is that hormonal acne is different to teen acne. Teen acne is usually more severe in the oily T-zone of the face while hormonal acne features more on the jaw line, chin and neck.  However a recent international study has challenged this, suggesting female adult acne is found all over the face,” explained Professor Gebauer.

“Adult skin, particularly in females, is also drier and more fragile than teenage skin.”

The good news is the increasing number of acne treatments that are now available with some of them, specifically relevant for adult women.

Treatments for adult acne

Adult acne can be unexpected and frustrating but you can do something about it.

Hormonal therapy, which is mainly the oral contraceptive pill, tends to be used more often than oral antibiotics as some women are concerned by the thrush risk,” explained Professor Gebauer.

“Topical therapies include a wide range of creams and gels applied to the skin. They include antibiotics, retinoids and combination treatments These are effective but can be problematic if you’re a heavy user of cosmetics, tend to overuse cleansers and masks or have cosmetic procedures.  All of this can irritate the skin and lead to topical treatments not being applied appropriately and therefore less effective.”

Inappropriate use of skin care and cosmetics can make your acne worse or reduce the effectiveness of acne treatments so ensure to discuss this with your doctor.  Some newer treatments only require a once daily application which may help more people to use the treatment as required.

“There have been further developments with light therapies which may appeal to women who’d prefer not to take medications or have to worry about a daily treatment.  Cost is likely to be the key consideration with light therapies,” said Professor Gebauer.

Adult women can also have severe acne and oral isotretinoin remains the most well researched, evidence-based acne treatment we have.  It is a powerful medication and more recently, a low dose option has become available.

“Acne treatment needs to be tailored to the individual. Just because someone you knew had a great result with one treatment doesn’t mean it will work for you.

“Discuss your acne and how it’s making you feel with your doctor.  You may be all grown up but acne is a very visible condition and the potential psychological impact can be the same if you’re 16 or 36,” concluded Professor Gebauer. 

Find out more about treatments for acne

Dermatologist - MBBS, FACD, FACP Dr Gebauer is a consultant dermatologist predominantly in private practice in Fremantle, Western Australia. He also served as Head of Department at Fremantle Hospital, a State government teaching hospital. Dr Gebauer has ongoing interests in clinical research and trial work, having conducted trials in acne as well as a wide variety of other dermatological diseases.

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