Adulting is hard, especially when it concerns our skin. In fact, it may come as a shock to some that our breakouts tend to increase with age. As depressing as that info is, it’s not surprising, considering the stressful state of our world, compounded by a few other factors, such as side effects of medication and undiagnosed medical conditions. Even if you didn’t suffer from acne as a teen (lucky you!), the cold hard truth is you can still experience it as an adult.
Ahead, Melissa Kanchanapoomi Levin, MD, board-certified NYC dermatologist and clinical attending at NYU Langone and Mount Sinai Hospital, breaks down the science behind this shift and how to treat it post-adolescence.
Why We Break Out
Changing hormonal levels. Certain hormones, particularly testosterone, trigger increased oil production promoting acne. The surge in those hormones could be from your period, pre-menopause, menopause, starting or stopping birth control, a hormonal IUD (intrauterine devices), or eating hormone-enhanced foods (i.e. non-organic meat and dairy). “Women are more likely to deal with adult acne than men due to hormonal changes,” Levin says.
Stress. Turn on the news for two seconds and you’ll understand why. “Unfortunately, chronic stress elevates not only cortisol levels but also androgens. Stimulating androgen production causes an increase in sebum, which clogs pores and increases the overgrowth of a bacteria called P. Acnes,” Levin says. It then leads to inflammation underneath the skin or cystic acne.” In a recent study conducted by Differin, 90 percent of those surveyed reported they have experienced a breakout while stressed.
Overcleansing and overscrubbing. Too much roughness on skin can result in dryness and irritation. And unfortunately, aging skin is also drier (in part due to the cumulative effects of sun/UV exposure).
The Difference Between Adult and Teenage Acne
“Teens tend to break out primarily on their face, chest, and back, due to to the surge in hormones called androgens, which occurs during puberty,” says Levin. Adult acne is much more complicated because of the different hormones and other lifestyle factors involved. As an adult, there’s also a chance that your acne will overlap with other skin conditions such as rosacea.
How to treat it. Levin explains that the surge in dermatologists treating adult acne may very well be the shift in treatment options. “For many years, those with adult acne would often deal with their acne with over-the-counter remedies, but now, as dermatologists, we are able to offer many more treatment options, combined with in-office procedures to successfully treat and maintain those with adult acne.”
Some of Levin’s in-office treatment options are blue and red LED light therapy, which uses antibacterial and anti-inflammatory lights. There’s also radiofrequency microneedling to deliver heat energy down to the pores in order to essentially heat and ablate the oil glands to destroy oil production. Lastly, corticosteroid injections help decrease inflammation to reduce the size and pain of inflamed pimples or cysts.
Thankfully, there are still plenty of highly effective over-the-counter options, too. Of course, it depends on how severe or mild your acne is, so check with your derm before purchasing anything. Butiff you prefer to treat with an OTC, one of these options may get you in the clear quickly and effectively.