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Treatments for Adult Acne in Women

If you are still having acne in your 30s, 40s and even beyond, you are not alone. Even if you never had acne as a teenager, you may start breaking out as an adult. Women tend to develop adult acne more often than men and some women may even get acne after menopause.

Causes of Adult Acne

Adult acne is the most common skin disorder among white Caucasians, affecting approximately 15% of the population. This problem usually runs in families. Pimples are clogged and inflamed pores caused by an overproduction of sebum (oil), which stimulates the growth of bacteria called Propionibacterium acnes. Most breakouts in adult women are due to hormone fluctuations. This is the reason why adult acne may flare during pregnancy, menstruation and menopause. Other factors causing acne include skin-clogging cosmetics, side-effects of certain medications, stopping or switching birth control pills and stress. Stress stimulates the production of the male hormone androgen (also present in women) which boosts sebum production.

Treating Adult Acne

For mild cases of acne, try over-the-counter products such as cleansers, creams and lotions first. Spot treatments with benzoyl peroxide, which reduces bacteria and removes dead cells to prevent comedones (whiteheads and blackheads) and washes containing salicylic acid, which helps to unclog pores are effective for many acne sufferers. You can also use retinoid lotions and creams to clear your skin and products containing sulphur for the occasional spot treatment.

Use cosmetics that are “oil-free”, “non-acnegenic” and “non-comedogenic” (which means that they do not clog pores) and opt for spray, gel or chemical-free sunscreens that are less likely to clog pores. Reduce the use of hair sprays or gels and avoid getting these substances on the facial skin. Avoid abrasive scrubs, which can cause skin irritation and worsen acne.

If you do not notice any improvement within a month or two, see your dermatologist or primary care physician. A combination of treatments may be required. Often, topical and oral antibiotics and topical retinoids, which unclog pores and prevent comedones from forming, may need to be prescribed. These prescription treatments include:

  • Antibiotics. When using antibiotics, your doctor may consider switching to a different drug after a certain period of time. Antibiotics work by diminishing the population of Propionibacterium acnes, but sometimes the bacteria may become resistant to the antibiotic treatment, causing acne to flare. An antibiotic which also fights inflammation associated with acne called doxycycline, especially its controlled-release form, is often effective. If patients stop responding to the antibiotic treatment, it is necessary to prescribe a different drug. To reduce the risk of antibiotic resistance, dermatologists limit use of antibiotics to a few months and then replace them with other non-antibiotic medications, such as topical retinoids.
  • Birth control pills and hormonal drugs such as spironolactone (Aldactone) may help to clear acne by suppressing the male hormone androgen. Spironolactone, which is also used to treat androgenetic hair loss and hirsutism in women, may not be used by men due to its strong feminizing effects. Three types of birth control pills that contain both estrogen and progesterone have been approved by the FDA to treat adult acne in women. They include Estrostep (estrogen combined with a progestin called norethindrone), Ortho Tri-Cyclen (estrogen combined with a progestin called norgestimate) and Beyaz, Gianvi, Loryna, Ocella, Safyral, Syeda, Yasmin, YAZ and Zarah (estrogen combined with a man-made form of progestin called drospirenone).
  • Isotretinoin. For severe or resistant adult acne, the oral retinoid isotretinoin may be prescribed. Although it is effective in treating adult acne in women, it requires strict monitoring, particularly in women of child-bearing years, due to its risk of causing birth defects. However, this risks only lasts while the woman is taking isotretinoin and for one month after.

Light therapy. Yet another treatment option for women as well as teens suffering from acne is the light therapy. This therapy includes techniques such as photodynamic therapy and photopneumatic therapy, combining the intense pulsations of light, which paralyzes hyperactive oil glands and kills bacteria, with vacuum cleaning of the clogged pores.

The treatment of adult acne requires patience. It takes a minimum of six to eight weeks to notice results (but at least three months for spironolactone), which can be frustrating. Moreover, your treatment may need to be changed several times. Hence, you must work with your dermatologist to find the right approach together. For information on acne at younger age read this article.

Where to Find More Information:
DermNet NZ