Best treatments for adult acne according to Dermatologists

If you thought your acne days were over when you entered adulthood, the truth is, adult acne exists, and it's on the rise! This means fighting acne on top of your extensive efforts to prevent aging signs for many women.

Unfortunately, more and more adult women are suffering from acne. Some of the latest stats show that more than 50 percent of women in their 20s and 25 percent in their 30s still struggle with acne. Thankfully, acne—even adult acne—is treatable! If you're still suffering from frequent acne flare-ups, read below to help understand what's causing them and what you can do to get your adult acne under control.

What is the difference between teen acne and adult acne?

Besides being extremely annoying, teen and adult acne are similar in that they can both appear in red papules, pustules, and even deep cysts. That being said, there are some discernible differences between the two conditions that are important to take note of;

• Location: One of the main differences between teen and adult acne is the breakouts' location (i.e., those friendly zits). Teen acne usually appears on the foreheads and cheeks, while adult acne tends to be more prevalent on the lower parts of the face, such as around the mouth, chin, and under the jawline.
• Persistence: While teen acne is usually easily treatable with the right topical products (and sometimes oral medication), adult acne tends to be a bit more stubborn and difficult to treat...but not impossible!
• Causes: The triggers of teen and adult acne are also different. While hormonal changes can play a part in influencing both conditions, adult acne is more sensitive to things like monthly cycle hormonal fluctuations as well as diet, lifestyle, and cosmetics.

What are the leading causes of adult acne?

While various factors can influence adult acne, we can thank our parents and the endocrine system—i.e., genetics and hormonal changes—the most.

Additional factors such as stress, certain medications & supplements, and using the wrong skincare and cosmetics (everything from cleansers, moisturizers, and sunscreen to makeup and hair products) can also trigger and exacerbate adult acne. What's even more frustrating is that a lot of our attempts to clear these breakouts—such as popping pimples, applying specific topical treatments, and even taking certain supplements (looking at you, Biotin!)—can make the acne worse by causing trauma and irritation to the skin and spreading the acne bacteria to other regions of the face.

What are the effects of using the wrong skincare products on adult acne?

In your younger years, you may have found that a basic skincare routine was sufficient to keep your skin clear, while some of us may have even washed our face with hand soap (or not at all!) in high school without issue. So it may be a frustrating surprise that your go-to products and even fancy creams and serums from drugstores or Sephora aren't helping. You may find the more products you try; your acne condition ends up even worse.

Using corticosteroids on the chin and around the mouth can also trigger acne lesions in this area. This specific type of acne, also called perioral dermatitis, can be very persistent and frequently require oral antibiotics treatment (minocycline).

The bottom line is that unless your skincare products are oil-free or clearly labeled for non-comedogenic or formulated acne-prone skin, they will likely contribute to your breakouts. A good rule of thumb? Ensure that all the cosmetics you use are labeled oil-free and non-comedogenic products, aka; products that do not clog pores.

What is the difference between adult acne and rosacea?

Rosacea is a specific type of adult acne. In contrast to the typical adult acne triggered by hormonal fluctuations, rosacea is more influenced by genetic factors, heat, alcohol, and excessive sun exposure. Regular hormonal adult acne is common in women in their 20s, 30s, and 40s, while acne rosacea appears in both women and men in their 40s, 50s, and 60s.

The location of the lesions in these two types of acne is also different. Adult hormonal acne is usually located on the face's lower parts (chin, around the mouth, and over the lower jawline). People with acne rosacea will have redness and pimples over the upper parts of the cheeks, nose, and forehead.

Does exfoliation help with adult acne?

Exfoliators are one example of a skincare product that's likely doing more harm than good for your acne. While it may seem like a good idea to exfoliate to slough away dead skin cells and prevent clogged pores, exfoliators tend to over-irritate the skin, damaging the skin's protective layer and ultimately causing more breakouts down the line.

If you find it hard to part with your favorite exfoliating brush or treatment, you don't have to consider a complete breakup. But as long you're experiencing blemishes, you'll want to take a break from these products. Once the acne has improved, you may be able to re-introduce gentle exfoliators back into your routine.

Can you treat adult acne with over-the-counter medications?

It is certainly possible to treat—and even completely clear—adult acne with the proper over-the-counter medications, so there is no need to run straight to your dermatologist to get a prescription drug (s). That being said, because adult acne is usually more persistent and, therefore, a bit more challenging to treat, the best results typically require a multi-pronged approach:

1. Topical Treatment: The first, most important step to treating adult acne is finding an excellent topical routine with medical-grade acne treatment medications suited to your skin type and acne severity. The skin of women with adult acne produces less sebum than teens' oily skin. To keep the skin well moisturized, women with adult acne should look for milder hydration cleansers that will not overdry their skin.
   The best topical anti-acne treatment ingredients for women with adult acne are 2.5% benzoyl peroxide for inflamed acne lesions and salicylic acid and retinol for comedonal and mild acne. To help find the right products for your skin, take the free MDacne skin analysis.
2. Cosmetics: Switching to oil-free makeup and cosmetics to ensure they don't hinder your skincare products' effects. If possible, wear less makeup (or none!) to help clear acne faster.
3. Diet and Lifestyle: Committing to lifestyle changes known to help improve adult acne, such as improving your diet, stress reduction, exercise, etc.

What are the best ingredients to treat adult acne?

Salicylic Acid & Benzoyl Peroxide: The same ingredients used to treat teen acne are usually very effective at treating adult acne too! The key is to use the correct formulas, concentrations, and application techniques for your skin. Salicylic Acid (2%) and Benzoyl Peroxide (up to 2.5%) can be very effective for adult acne with inflamed pimples.

Micronized active ingredients: While traditional Salicylic Acid and Benzoyl Peroxide are usually very effective, they can also be irritating for many. New, micronized forms of these ingredients (smaller particles), such as those in MDacne products, can penetrate deeper into the skin pores for better efficacy with less irritation.

Natural Ingredients: While natural ingredients can seem very appealing, they, unfortunately, have little effect on treating acne, particularly persistent adult acne. That being said, natural ingredients like aloe vera, vitamin c, and other plant extracts can be a great addition to acne medications to help increase the efficacy of these ingredients, reduce irritation, and improve the skin's ability to heal more quickly.

Retinoids: Retinoids are a family of products derived from vitamin A. These retinoids are used as an oral treatment for acne (i.e., Accutane and Isotretinoin) and as topical treatments (prescription and over-the-counter) for mild acne. Retinoids (0.25% - 0.5% OTC) are more suitable for people who experience a few whiteheads and blackheads and not as much for inflammatory and cystic acne.

People with adult acne should avoid gel-based topical retinoids (i.e., adapalene found in Epiduo and Differin), which tend to be more drying and irritating and opt for cream-based preparations instead.

Newer, milder retinol formulations that combine retinol (0.25%-0.5%) with niacinamide allow a gradual adjustment of the skin to retinol with the dryness and irritation typical to older retinoids.

What are the best natural oral supplements to help with adult acne?

The root cause of hormonal acne is an imbalance of estrogen, progesterone, and testosterone, which affects the skin's oil-producing glands. Many women with adult acne feel that their acne is influenced by the menstrual cycle.

It is possible to modify the hormonal causes of acne in 3 ways. With birth control pills, spironolactone, a non-hormonal drug originally used to lower hypertension, or a special kind of natural oral supplement called DIM. DIM (diindolylmethane) is a naturally occurring nutrient found in cruciferous vegetables such as broccoli, cauliflower, cabbage, and kale. DIM is not a hormone. Instead, DIM works to balance the body's natural response to estrogen. It does this by adjusting the activity of metabolic enzymes and estrogen receptors, reducing the amount of toxic "bad" estrogen in the body.

What are the best oral medications to help with adult acne?

• Birth Control: You may have heard of people taking the birth control pill in their teenage years to help treat their acne. It turns out; that the same method can be used for adult acne since some oral contraceptives do hormone-balancing effects that have beneficial effects on acne. That being said, speaking with your doctor or gynecologist first is important, as birth control may not be the best choice for everyone. Additionally, not every hormonal birth control has a positive effect on acne, and some can even worsen the condition. Check out the best birth control pills and IUDs for women with acne before talking to your provider so you can go to your appointment informed.
• Spironolactone: Another great oral medication to help with adult and hormonal acne is a drug called spironolactone. While this medication is non-hormonal, it can help balance hormones by blocking male hormones (androgens) like testosterone, contributing to oil production and ultimately causing acne in excess.
• Accutane: Accutane (Isotretinoin) is considered the most potent, most efficacious medication for the treatment and long-term prevention of acne. That being said, Accutane is a very intense drug with many potential (sometimes severe) side effects. For this reason, it should be considered a "last resort" treatment for acne that does not respond well to topical treatments and/or other oral medications.

Best skincare products for adult acne

Now that we know the most effective ingredients to treat adult acne (Salicylic Acid, Benzoyl Peroxide, and Retinoids), how do we choose from the various acne treatment products?

The challenge in acne treatment is that even the right ingredients in the wrong formulation, doses, or application can get in the way of effective treatment.

When choosing products for people with adult acne, one should consider that adult skin produces less sebum and is oily than the skin.

That's why we believe it is essential to customize your treatment to your skin type, acne severity, persistence, and sensitives for the best results.

While you may be able to find the right combination of products with trial and error, this can be a frustrating and lengthy process...not to mention expensive! MDacne works differently by providing personalized acne treatment based on at-home skin analysis. The skin analysis is free, and you can try your first customized acne treatment kit for just the shipping cost ($9). MDacne products combine medical-grade ingredients with plant-based ingredients, such as green tea and vitamins E and C, which help reduce irritation, which is super important for people with adult acne and sensitive skin. Click here to take your skin analysis and get your free trial!

*Remember: once you find the right products—from MDacne or elsewhere— it's super important that you commit to your treatment plan. As a general rule for acne treatment, you should see initial improvement with your products within 4-6 weeks and optimal results in 12 weeks.

Additional tips to help with adult acne:

While an effective topical treatment—and for some, the addition of oral medication—is the essential part of the effective treatment of adult acne, there are additional things you can do now to help take your treatment to the next level;

• Stop Touching & Picking: While it can be tempting to extract pimples to get rid of them, and heal faster, resist the temptation to pop, touch, or pick. The chances are high that you'll do more harm than good the more you touch your face.
• Improve Your Diet: Certain dietary choices make acne worse. . Check out this blog to learn more about which foods to limit and which you should add to your diet!
• Make Lifestyle Changes: Because adult acne has a significant hormonal component, stress can seriously exacerbate the condition by spiking cortisol levels and throwing off the delicate hormone balance. The challenge is that when you have acne, you tend to stress out even more, causing a vicious cycle. Make sure you find ways to reduce daily stress, such as exercise, yoga, deep breathing/medication, and most importantly...sleep!
• Patience: Finally, while we know it's super hard to be patient treating adult acne when you wanted it gone, like yesterday, it's so important to be patient! Any effective acne treatment—both oral and topical or in combination—takes time to show improvement in the skin. It's essential to be patient, stay hopeful, and stick it out. Switching your routine every other week will only make things worse! If you do not see significant results after 3-4 months of your treatment, you can assess and make changes accordingly.
• Change your COVID mask: Single-use surgical anti-COVID masks are actually made of plastic. Wearing these masks for several hours every day can cause acne pimples around the mouth and on the chin -a location similar to adult acne breakouts.

​References:

Adult female acne: a guide to clinical practice. An Bras Dermatol. 2019;94(1):62-75.
A review of diagnosis and treatment of acne in adult female patients. Int J Women's Dermatol. 2017;4(2):56-71.
Adult-onset acne: prevalence, impact, and management challenges. Clin Cosmet Investig Dermatol. 2018;11:59-69.

For more information about adult acne, click right here!

To find the right acne treatments for your unique skin, take the free skin assessment by clicking here.