What’s Different About Adult Acne?

Acne isn’t just a problem for teenagers. Many adults also have acne. Around 80% of adult acne cases affect women, thought to be because of changing hormone levels during periods, pregnancy, medical conditions such as PCOS, or as a side effect of medication.

Acne develops when dead skin cells and natural oils (sebum) block up tiny hair follicles in the skin. Bacteria work their way into the plugged-up follicles and start multiplying. When the body’s immune cells move in to attack the bacteria, the results of the battle are the classic symptoms of acne – swelling, redness and spots.

Adult acne differs markedly from the spots of your teenage years, both in how it appears and how it’s treated.

In teenagers, you’ll mostly see lots of tiny bumps, blackheads or whiteheads on the skin of the face, especially the forehead, along with occasional cysts on the chest and back. That’s because teens’ skin tends to be a little stickier and they’re more likely than adults to get clogged pores.

In adults, acne is more likely to appear on the lower part of the face, especially around the mouth and jawline. It’s usually deeper nodules or red papules in those areas. The fine little bumps of teen acne can still happen in adulthood, but it’s much less common.

Reasons For Adult Acne 

Some adults continue to get acne well into their 30s, 40s, and even 50s. It is even possible to get acne for the first time as an adult. Dermatologists call this “adult-onset acne.” It is most common among women going through menopause.

Women tend to get adult acne more often than men do. If you’re getting acne as an adult, it is likely due to one or more of the following reasons:

Fluctuating hormone levels can lead to breakouts.

Women often experience fluctuating hormones: 

• Around their periods 
• During pregnancy, peri-menopause, and menopause
• After discontinuing (or starting) birth control pills 

Stress: Researchers have found a relationship between stress and acne flare-ups. In response to stress, our bodies produce more androgens (a type of hormone). These hormones stimulate the oil glands and hair follicles in the skin, which can lead to acne. This explains why acne can be an ongoing problem when we find ourselves under constant stress.

In my personal experience, stress has been the largest factor in my adult acne flare-ups.

Family history: Does a close blood relative, such as a parent, brother, or sister have acne? Findings from research studies suggest that some people may have a genetic predisposition for acne. People who have this predisposition seem more likely to get adult acne.

Hair and skin care products: You likely already do this, but if you have adult acne, you should read the labels on your skin care and hair care products. Make sure that you see one of the following terms on every container:

• Non-comedogenic 
• Non-acnegenic
• Oil-free
• Won’t clog pores

You want to make sure your moisturizer, cleanser, sunscreen, and all other products contain one of these terms. These products are least likely to cause acne. 

Medication side effect: Acne is a side effect of some medicines. If you suspect that a medicine is triggering your acne or making it worse, continue taking the medicine — but talk with the doctor who prescribed it. Ask if acne is a possible side effect. If acne is a possible side effect, ask if you can take a different medicine. If you cannot take another medicine, you may want to see a dermatologist who can help you control the acne.

Undiagnosed medical condition: Sometimes, acne is a sign of an underlying medical condition. Once the medical condition is diagnosed and treated, the acne often clears. 

Treating Adult Acne

Acne medications help by interrupting this process in different ways. Some over-the-counter and prescription acne creams help by unplugging the follicles. Others – such as antibiotics – kill the bacteria that move into the follicles and reduce inflammation. Oral retinoids such as isotretinoin work differently by reducing the amount of oil secreted by glands in the skin.

There is no single best acne or spot treatment. Some people do well using one acne cream, while others need a combination of approaches to control their acne.

Most of the over-the-counter products involve salicylic acid and/or benzoyl peroxide.

For Adult Acne, I Recommend Looking For Products With Benzoyl Peroxide

Benzoyl peroxide is non-prescription drug that works to destroy acne-causing bacteria in your pores. Also known as BPO, it works primarily as an exfoliating agent by increasing the turnover of the skin and removes the mixture of sebum and dead skin cells from the pores.

There are many BPO product options available to consumers.  Not only are there numerous brands, but it also comes in a variety of concentrations.

Benzoyl peroxide is a powerful ingredient that is effective against all kinds of acne lesions (blackheads, whiteheads, and big, red, cystic pimples). It is bactericidal, meaning it kills bacteria, rather than simply slowing down their growth.

Benzyol peroxide acne treatments can also work very quickly, improving acne as early as five days after starting treatment. It’s a great first line treatment for acne, but it’s also helpful to use in combination with antibiotics. In fact, benzoyl peroxide has the ability to prevent antibiotic resistance.

One thing to watch out for with benzoyl peroxide is that it can bleach dark fabrics.  It can also cause drying, peeling, and redness if it’s not delivered in the right amount, surrounded by the right mix of ingredients. It may take some experimentation to see what concentration or frequency of use your skin tolerates best.

The Benefits of Benzoyl Peroxide

• It kills bacteria.
• Benzoyl peroxide works quickly (as soon as five days!).
• As an added bonus, benzoyl peroxide prevents antibiotic resistance.

The Downside to Benzoyl Peroxide

• It can cause dryness, peeling and redness.
• It can bleach fabric.
• In some cases, benzoyl peroxide can cause post-inflammatory hyperpigmentation (a.k.a. dark spots).

Note – I’m a staunch believer of the fact that there’s no quick acne treatment, and studies have proven this. So if you’re thinking that a benzoyl peroxide based product can cure your acne overnight, I’m afraid you’ll be disappointed.  You’ll  have to be patient and let the product work for at least 2-3 weeks.  It can be very effective at clearing up adult acne, but it takes a little time.

Recommended Benzoyl Peroxide Products

 CleaRx, Differin (uses retinoid), Proactiv, and Murad all have excellent reputations and high quality product lines.  Any one of these can work well on adult acne. 

As a personal recommendation, I like CleaRx products.  They have worked really well for clearing up my adult acne (even the cystic bumps on my jaw – which are a nightmare).  CleaRx contains the maximum OTC (over-the-counter) strength 10% benzoyl peroxide along with other acne fighting ingredients, so  Give CleaRx a chance on your toughest acne before you see a dermatologist. 

I also find them to be the  cosmetically elegant (spa-like), and pleasant to use, which, while not as important as effectiveness, also matters to me.  For me, CleaRx and stress management are the best ways to manage my adult acne.  I feel like CleaRx really helps bring my skin back in balance, and helps me to keep my flare-ups to an absolute minimum.