It's easy to associate acne with youth. Hormonal changes, pubescence, teenage oily skin, stress, and poor (takeout) diet in our early 20s—these are all things commonly linked to pesky breakouts, or worse, cystic acne. So when acne continues to rear its ugly head in our late 20s, 30s, or even 40s, it's like our skin is playing some kind of sick joke on us. Why is adult acne even a thing? It seems like an oxymoron, if you ask us.
Approaching the rest of our lives with hope and optimism, we asked some top dermatologists at what age does acne finally go away? Because, you know, it does eventually stop, right? Unfortunately, dear readers, we have some bad news…
"If underlying factors are not addressed, acne may not stop at all," explains Dr. Carl Thornfeldt, founder of Episciences. "Twenty-six percent of 40-year-olds and 12% of 50-year-olds suffer from acne, and 10% of females have oily skin from puberty on through their whole life." According to one review, 26% of women aged 31-40 suffered from acne, while 12% of 41-50 year-old women had clinical acne, and the majority of female adult acne sufferers had persistent acne from adolescence on.
Curses! So why does this happen? There are actually a number of factors. Allow us to explain.
"There are several causes of adult acne including hormonal fluctuations, stress, and genetics," says Dr. Dennis Gross. "Adult acne usually begins in the late 20s to early 30s. Stress is a catalyst that can play a role in aggravating the condition. Genetics plays a large part as well. Hormonal changes as a result of pregnancy can affect adult acne, worsening or improving the condition. Another hormonal change that can affect adult acne is stopping the usage of birth control pills, as well as premenstrual hormonal fluctuation. Also, perimenopausal hormonal changes or fluctuations may change the oil chemistry of the skin, which can lead to adult acne."
Dr. Thornfeldt says acne may be caused by the skin's allergy to yeast. If you thought yeast issues were only something that happened, well, down south, the skin can also experience yeast overgrowth, which causes aggravation and breakouts. This may be a result of greasy lotions and oils, naturally oily skin, oral contraceptives, and stress, to name a few factors.
"Diet and lifestyle play a role in everything with the body from arthritis to wrinkles. Lifestyle isn’t the cause of adult acne, but it's an influential factor. Everyone must consider diet, sleep, and exercise, and minimize pro-inflammatory foods in their diet, like sugar and dairy. Gluten is controversial, but sugars and dairy are the biggest factors and people must cut back," explains NYC-based cosmetic dermatologist Dr. Paul Jarrod Frank.
Avoid inflammatory foods such as caffeine, coffee, and starch to try to prevent breakouts.
Oil (Both the Presence and Absence of It)
Speaking of oily skin, aside from yeast allergies, overly oily skin, as we know, becomes easily plugged and inflamed. Even when we get older and we feel our skin is drying out, the absence of oil can cause acne (it's a losing battle, really). Says NYC dermatologist and founder of namesake brand, Dr. Dennis Gross, "When acne occurs, the oil is too thick and waxy for its own good. Instead of flowing freely through the pores, it becomes blocked and forms a plug. Adult acne is also often associated with dry skin, which can exacerbate an existing acne condition. When the skin is dry, the dead skin cells flake off and can further block pores that already have an oil flow problem incubating the bacteria and leading to acne. These clogged pores, aka flat acne, may result in the form of blackheads, or they may simply appear as enlarged pores on the skin's surface—this is generally the beginning stages of acne."
Okay, enough of the bad news. How do we actually get rid of adult acne? Thankfully, all doctors interviewed say there's hope.
Benzoyl peroxide is an organic acid in the peroxide family that has been used to treat acne because of its keratolytic, moderate comedolytic, and antibacterial properties, which include the reduction of P. acnes and Staph. aureus on the skin.
Dr. Gross says to look for exfoliating, pore-clearing OTC products. "To treat acne most effectively—yet gently—start out by using over-the-counter anti-acne remedies that contain either exfoliating, pore-clearing salicylic acid or bacteria-banishing benzoyl peroxide, such as my All-Over Blemish Solution (discontinued). I recommend looking for products that contain bisabolol, an active ingredient derived from chamomile extract that helps soothe redness and reduce inflammation. Sulfur is also a powerful ingredient that controls the oil that feeds the bacteria and can be found in Clarifying Colloidal Sulfur Mask ($42)."
Sulfur is a natural element that is an essential component for all living cells. Sulfur-based products tend to work best for mild-to-moderate acne, primarily whiteheads, blackheads, and papules.
Azelaic acid is a dicarboxylic acid synthesized naturally in the body by yeast or created in a lab. It works to exfoliate the skin, decreases keratin buildup, and has antioxidant and anti-inflammatory properties.
Dr. Thornfeldt also recommends products that address bacterial and yeast-causing acne, like his Epionce Lytic Plus Tx cream ($54). "[It contains] salicylic acid, azelaic acid, willow bark extract, and zinc pyrithione," he explains.
Lastly, Dr. Frank says if the acne is more aggressive, a visit to the dermatologist may be in order. "Oral treatments such as pills can be more effective than topical treatments. Accutane is more aggressive, and most dermatologists would agree that Accutane is underused. It's the only 'magic' pill we have. There is no cure for acne, and unfortunately, many patients show up and have already developed scarring of the skin. A patient should never get to the point when they have scarring of the skin. Accutane must be taken seriously, prescribed, and monitored."
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