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The Truth About Adult Acne

Adult acne is on the rise. Learn why, and the treatments available, from 3 top dermatologists.
Are you breaking out like a teenager even though you're way past puberty? You're not alone. "Adult acne" is on the rise, experts report, and the American Academy of Dermatology estimates that over 20 percent of women aged 20-45 suffers from acne, sometimes for the first time in their lives. We ask three dermatologists why, and what to do about it.

What is acne?

Although we tend to use 'acne' as a blanket term, there are actually different forms of acne. "There is inflammatory acne and there is non-inflammatory acne, which involves blackheads and whiteheads," explains Dr. Benjamin Barankin, a Toronto dermatologist and Medical Director of the Toronto Dermatology Centre.

Most women get the odd spot here and there (especially during that time of the month), and as annoying as that may be, it's actually pretty normal. But if you're getting persistent breakouts, you could be suffering from adult acne. To diagnose the condition, dermatologists will look for comedones (essentially blocked pores that may present as a blackhead or whitehead -- the primary lesions in any form of acne, says New York-based dermatologist Dr. Mohiba Tareen.

What causes adult acne

Acne can happen for a number of reasons, and while it's not clear why the incidence of adult acne is on the rise, one of the main triggers is believed to be stress, which increases the production of male hormones (androgens).

Dr. Barankin agrees, and lists high stress levels, together with being overweight, irregular periods, a family history of acne and eating high glycemic foods, as the most common factors amongst his older female clients.

Flare-ups can also be the direct result of using products with pore-clogging ingredients, birth control pills that contain high doses of androgens, exposure to bacteria from cell phones and fingers, and failure to remove makeup properly as common culprits, adds Dr. Debra Jaliman, author of Skin Rules: Trade Secrets From A Top New York Dermatologist.

Treatment options

If adult acne is plaguing your life, here's some good news: It can be treated. The first step is to see a dermatologist to get a firm diagnosis and work out the most effective line of treatment. Options include:

Topical treatments

Topical treatments involving benzoyl peroxide and salicylic acid can work well:

Benzoyl peroxide. This kills the acne-causing bacteria, which can't survive in oxygen-rich environments, explains Dr. Tareen. With less of this bacteria present, acne breakouts are diminished. This is helpful for treating inflamed red bumps. It also works to exfoliate dead skin cells and eliminate sebum, both of which help to reduce the number of blocked pores and pimples. One caveat: Benzoyl peroxide can sometimes dry out the skin and leave it red and flaky. You can get around this by using benzoyl peroxide as a face wash -- which gets rinsed off -- to minimize skin irritation, says Dr. Tareen.

Salicylic acid (BHA). Like benzoyl peroxide, salicylic acid breaks down and exfoliates dead skin cells. It works particularly well on blocked pores because it penetrates the hair follicle and helps to stop the pores from getting clogged, says Dr. Tareen. Other plus points include anti-inflammatory and anti-bacterial properties to reduce redness and kill bacteria.

Oral treatments

"For more severe acne, topical therapies don't work so well so we would then consider a prescription of oral antibiotics, oral contraception or other hormonal treatment, or isotretinoin," says Dr. Barankin.

Treating acne: Patience is key

Finally, having a realistic expectation is a must in your quest for clearer skin. "It takes one month from starting a therapy to begin to see results as you have to wait the month for the old acne prone skin to exfoliate itself and reveal the new, fresh skin," says Dr. Tareen. She's seen patients who make the mistake of jumping from product to product when they don't see instant results, but trying too many things at once can overwhelm the skin and lead to irritation. Bottom-line: Whichever acne treatment you decide to go for, be sure to give it time to work.

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