Answers for Adult Acne

By Deborah Jeanne Sergeant

Whether you have been breaking out since your teen years or acne has returned after a hiatus, adult acne can cause embarrassment and frustration. Fortunately, you have a few options for mitigating its effects.

It’s important to understand what causes adult acne. It’s more complex than you may think.

“It is a multi-factorial disorder that involves the hair follicle and sebaceous gland,” said Lori Ullman, dermatologist with University at Buffalo. “It peaks in adolescence and 35% of women and 25% of women in their 40s still suffer from acne. Some of those women had acne as adolescents and it continues. Genetics play a role. The number of pustules and size and activity of sebaceous glands are genetics. It runs in families. The severity and duration into adulthood. does run in families.”

Hormones appear to influence acne. Some women experience outbreaks related to their menstrual cycles and accompanying hormone shifts, as do women with polycystic ovary syndrome, which is hormonal in nature. “We often work with an endocrinologist,” Ullman said.

Stress hormones can also play a role, as increases in cortisol can worsen acne.

It’s easy to forget that the skin is an organ of the body. Lifestyle factors such as poor diet definitely affect the skin.

A generation ago, chocolate and greasy foods were commonly identified as causing acne. While there’s more to curbing outbreaks than banning these foods, the notion holds some truth.

Ullman said some people have linked adult acne to processed foods and dairy.

“Excessive intake of sugar and excessive iodine can worsen the problem,” said Mary Jo Parker, registered dietitian with Nutrition and Counseling Services in Buffalo.

Instead, she advises focusing on produce, whole foods and limited processed foods.

In addition to eating a healthful diet, the health of the gut itself can influence acne. Heather Carrera, a doctor of clinical nutrition in Pittsford, near Rochester, said that gut health is highly linked to skin conditions. “Acne is a good indication that the cells of the gut lining have spaces between them. If it’s leaky, undigested food particles can enter the blood stream. It shows up as skin condition,” she said.

Washing the face twice a day and removing make-up with a gentle cleaner before bed is essential, as it can otherwise clog pores and worsen acne. If regular at-home care isn’t working, seeing a dermatologist can help diagnose acne and suggest treatments and lifestyle changes that can help.

While zealous cleaning may seem a good idea, Ullman advised against it.

“That makes it worse,” she said. “Stay away from irritants and scrubs. Use gentle cleansers like Cetaphil or Aquanil. Stay away from anything that has oil in it. Look for something that’s oil free rather than noncomedogenic. Noncomedogenic means it doesn’t cause acne in the lab.”

For those with mild acne, over-the-counter products containing alphahydroxy may help remove the dead skin cells that trap the oil and debris causing acne, but Ullman warned that those products do increase sensitivity to the sun.

“You want to make the proper diagnosis with acne,” she added. “Sometimes, it can be confused with rosacea, which also has its onset in adulthood and often in middle age. It also manifests with pustules but more in the central part of the face. The bumps are fairly similar looking and aren’t blackheads and whiteheads.”

Talking with a dermatologist can help form an effective treatment plan.