Dealing With Adult Acne

A woman checks her acne in the mirror.

I'm in My Late 20s...Why Do I Still Have Acne?

Complexion problems, namely acne, accompany puberty and are virtually unavoidable. Luckily, acne goes away or greatly diminishes as people transition into the 20s. For an unfortunate few, acne becomes more of a problem from the third through the fifth decades. This seems to be more common in women and seems to have a hormonal basis.

Illustration of acne diagram.

Why Do I Still Get Blackheads When I Wash a Lot?

Acne begins with the development of a plug of hardened sebum that stops up the openings of the follicular pores on the face. These plugs seem to become darker with age, hence the term blackheads. When there is a layer of skin covering the follicular opening, the sebaceous plug usually does not darken and is called a "whitehead" by some. Once the follicle becomes clogged, it will enlarge as more skin and sebum is produced behind it. Bacterial contamination of this sebaceous mixture is common since bacteria normally inhabit the follicle. If stretched enough, the wall of the follicle ruptures. This enables this material access to the deeper tissues, which produces inflammation in the form of a pimple.

A doctor talks to a patient.

Do Birth Control Pills Cure or Cause Acne?

Depending on the oral contraceptive, some birth control pills have been shown to be of benefit in treating acne in adult women.

A woman applies makeup.

Could My Makeup Cause Acne?

There is no doubt that certain oily substances can induce the development of pimples. If one of them is a component of a cosmetic or makeup, this can be detrimental to the complexion. Choosing a cosmetic or makeup that is water-based is likely to avoid this possibility.

Photo of tired woman at the office.

Is a Stressful Job a Factor in Acne?

Almost everyone believes that avoiding stress is desirable. Since stress is part of daily life, this is obviously impossible. If one's complexion is bad because of acne, this will produce not only stress but also depression. The result can often be an urge to pick at the pimples. This always produces a poor result.

A woman eats chocolate.

What's the Truth About Chocolate and Acne?

There is no convincing evidence that diet plays a major role in acne. However, there are certain cultures that seem to produce acne-free individuals as they transition to adulthood. Exactly how much is due to genetics and how much is due to diet is conjectural. If you think a food is causing problems, avoid it.

A woman has cystic acne on her back.

What Is Deep-Cyst Acne?

Cystic acne is common acne in its most severe form. This form of acne is likely to result in permanent scarring. It is quite rare in adults. Most patients with cystic acne require aggressive medical therapy to prevent blemishes.

Photo of comedones and inflammatory lesions

What Other Kinds of Acne Are There?

Typical teenage acne, so-called acne vulgaris, is characterized by three types of lesions: the comedo or blackhead; the inflammatory papule; and the pustule or pimple. Drug induced-acne can be difficult to distinguish from other sorts of acne except for the fact that it was not present prior to taking the drug. Machinists exposed to insoluble cutting oils can develop comedones at the sites of exposure. Inflammatory lesions may be less prominent. Acne can also be a part of certain hormonal problems caused by the overproduction of androgens.

Photo of woman with acne.

Could My Acne Be Related to Anemia?

There is no relationship between anemia and acne.

Photo of family hugging.

Will I Be Stuck With Acne Forever?

Acne tends to resolve in most individuals as they age. When acne recurs in adulthood, it is important to rule out other causes for androgen excess. This group of conditions requires a series of blood tests for diagnosis.

Photo of woman looking in mirror and applying ointment to her acne

What's the Best Way to Treat Acne?

There are a number of over-the -counter medications that can be quite effective in treating mild acne. They include benzoyl peroxide gels and creams and salicylic acid preparations. These can be purchased quite inexpensively from most pharmacies. There is quite an array of acne treatments available only by prescription. These include topical and oral antibiotics, topical and oral retinoids, oral contraceptives, and steroid receptor-blocking agents.

A woman ties her hair back from her face.

What's the Best Way to Prevent Acne?

Ultimately, there is no way to prevent acne other than avoiding comedogenic cosmetics (including hair products), avoiding drugs that exacerbate acne, and adhering to a healthy lifestyle. A well-rounded diet, exercise, and plenty of sleep can't hurt.



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  • Anais Brasileiros de Dermatologia: "Acne and diet: truth or myth?"
  • Anais Brasileiros de Dermatologia: "The impact of acne vulgaris on quality of life and psychic health in young adolescents in Greece. Results of a population survey."
  • Cutaneous and Ocular Toxicology: "Comedogenicity in Rabbit - Some Cosmetic Ingredients/Vehicles"
  • Cutaneous and Ocular Toxicology: "Nutritional anemia in reproductive age women with postadolescent acne."
  • Dermatologic Clinics: "Vol. 30, Issue 1 - United States Skin Disease Needs Assessment"
  • International Journal of Dermatology: "Acne in the adult female patient: a practical approach."
  • Journal of Cosmetic Dermatology: "Acne Excoriée - A Patient's View"
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