How to Fight Adult Acne

Adult acne can really put a crimp on your life. Last year, for instance, Christine Janssen considered posting a new photograph of herself on her business web site but ultimately resisted the idea. “With my acne, I just wanted to put a paper bag over my head,” says Janssen, 41, who runs a Manhattan marketing research company.

Skin problems afflict almost everyone growing up, but some never outgrow it, says Jonette Keri, PhD, assistant professor of dermatology at the University of Miami Miller School of Medicine and chief of dermatology at the Miami VA Medical Center. She estimates that nearly 30% of women and 20% of men ages 20 to 60 (and beyond) are troubled by breakouts.

What Causes Adult Acne?
Adult acne is caused by sebum, an oily substance produced by the skin’s sebaceous glands. Sebum clogs pores, which attract bacteria and become inflamed. For most adults, breakouts are a result of hypersensitivity to androgens (male hormones). But an imbalance in both male and female hormones (estrogen) can also cause breakouts. For women, this can happen during pregnancy, perimenopause, and menopause. Some medications, such as corticosteroids, and cosmetics are also triggers.

How Is Adult Acne Treated?
Treating adult acne is tricky. Most acne medications are geared to teens' oily skin, a bad choice for drier adult skin. Effective treatment often requires a trial-and-error approach that takes time, Keri says.
Her recommendations include:

• Cleansers: Cetaphil and Aquanil are the most gentle. Avoid too-strong gels and products containing beads or granules, which are abrasive and can irritate and worsen sensitive skin.
  
• Creams and lotions: Use an over-the-counter retinol product to clean pores and help reduce fine wrinkles. Prevent discoloration and fade acne scars with products that contain salicylic and glycolic acids. And to spot-treat a breakout, use a product with benzoyl peroxide, which helps kill bacteria.
  
• Prescription medications: The topical antibiotic clindamycin helps fight bacteria in the skin; so does tetracycline, another antibiotic, taken orally. Oral contraceptives and spironolactone, a blood pressure drug, can help balance hormones.
  
• High-tech solutions: Laser and intense pulsed light treatments mainly target scars, but blue light therapy treatments kill acne-causing bacteria. These treatments are costly, though, so explore your other options first.
  

A Skin-Care Regimen for the Acne Prone

Believe it or not, there’s a trick to skillful face washing. To start, try to keep your face clean during the day. Then wash your face twice daily with the cleanser (if your skin is dry, try using water the second time). Use only warm water (hot water is drying). Wash for just 1-2 minutes (more can irritate your skin). And use your hands instead of a rough washcloth. (If you must wash with a cloth, choose one made for babies, so it’s as soft as possible.)

As for Janssen, she found that a doctor-prescribed regimen of gentle cleansing, oral antibiotics, and a retinol cream did the trick, and her new photo is now proudly posted on her web site. She says, “All my friends comment on how clear my skin looks.”