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Adult Acne in Women

    • Just when you thought you were through your awkward teenage years, they’ve come back—in the form of adult acne.

      “Adult acne is more common than most people think. Fifty percent of women and 25 percent of men over the age of 18 will be affected by acne. Fortunately, there are effective treatments available,” says John Doux, M.D., who is a board-certified dermatologist affiliated with Eden Medical CenterOpens new window.

    • What is Acne?

    • During adolescence, our bodies begin producing chemicals called hormones in larger amounts that help our bodies mature. Teenage acne is caused by the effect of hormones on the tiny organs called sebaceous glands that lie beneath the pores on our skin.

      When stimulated by hormones during adolescence, these glands produce an oily, waxy matter called sebum that’s released into our pores to lubricate and waterproof our skin. The sebum is made up of fat, wax and dead skin cells.

      “Most teenage acne is generated by the body’s response to bacteria,” explains Dr. Doux. “First, sebum is overproduced. This excess combines with dead skin cells and clogs the pore where bacteria begin to grow. The body reacts by releasing white blood cells to fight the overgrowth of bacteria. This causes inflammation in the pore, creating a pimple.”

      But adult acne in women is driven by a more complex set of conditions.

    • Causes of Adult Acne

    • “Adults with acne fall into two groups,” says Dr. Doux. “The first group has overactive sebaceous glands that continue to produce sebum, usually in response to stress, well beyond the high school and college years.”

      For adults in this first group, pimples form close to the skin surface due to excess bacteria. As in the teen years, this type of acne tends to appear on the forehead, cheeks and chin.

      “The second group is predominantly made up of women with oil glands that are oversensitive to the hormones responsible for producing menstruation. During the hormonal surge right before menstruation, their sebaceous glands start producing too much sebum, which causes adult acne,” explains Dr. Doux.

      For women in this second group, this type of cyclical acne has different characteristics than teen acne:

      • Causes larger lesions because clogging occurs at a deeper level
      • Appears on the periphery of the face on the jaw line and neck
      • Caused by oversensitive (rather than overactive) oil glands
      • Coincides with menstruation

    • Managing Adult Acne: Overactive vs. Oversensitive Glands

    • Tips for managing adult acne include:

      • Using over-the-counter prescription creams and lotions, with benzoyl peroxide (to kill bacteria) or salicylic acid (to unblock pores)
      • Applying topical prescription medications, such as retinoids like tretinoin or adapalene, to unblock pores
      • Using noncomedogenic, oil-free cosmetics and other products that won’t clog the pores
      • Avoiding astringents and alcohol-based cleansers that may be too drying and irritating
      “However, these topical treatments won’t work for women experiencing adult acne due to oversensitive glands because this type of acne is caused by hormonal fluctuations,” notes Dr. Doux.

      For women with oversensitive oil glands, common treatments include:
      • Oral contraceptives
      • Prescription medications, such as spironolactone, which limit hormonal fluctuations
      “Spironolactone blocks the ability of your hormones to stimulate your sebaceous glands, reducing the amount of sebum produced. This helps to limit the frequency and extent of acne outbreaks with minimal side effects,” explains Dr. Doux.

      Acne at any age is distressing, but adult acne can be particularly hard to treat—especially for women. See your doctor who can help determine the cause of your breakouts and help you devise a treatment plan.

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