We’re quick to think of acne as just another by-product of puberty, similar to bad bangs and hormonally-charged romantic decisions.
But the truth is, more and more adult women are struggling with acne they thought they’d be done with by now, or, even stranger, that they never even experienced as teenagers. In fact, one study found that 50 percent of women 20 to 29 years old and 35 percent of women 30 to 39 years old reported having acne.
This begs the question—will we ever break up with breakouts for good?
“Adult female acne patients are by far the most common type of patient I see in the office,” says Joshua Zeichner, M.D. and director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City. Typically, these patients fall into one of three broad categories, he says. There’s persistent acne, which is acne that started in adolescence and has continued into adulthood without interruption; there’s adult-onset acne that occurs in adults who never experienced breakouts as teenagers; then there’s recurrent acne that first develops in adolescence, goes away, then reoccurs in adult women, typically after the age of 25. The majority of these patients are between ages 25 and 35, but there is a second group of women in their late forties who experience acne in the pre-menopausal period, he says.The short version: If you're noticing lots of acne after your 25th birthday, you're not alone.
However, Zeichner says that pinpointing the cause has been challenging. Most adult female patients experience acne along the lower third of the face, jawline, and neck, indicating that the cause is hormonal, says Zeichner. This explanation of hormonal imbalance or fluctuation aligns with the fact that adult acne is statistically more common in women than men, according to a 2017 report. As you might have guessed, the majority of these women also report seeing acne worsen before their periods, further backing the idea that the cause is hormonal.
The authors of the report note that since all women experience hormonal fluctuations, the differentiator between those who suffer acne and those who don't may simply be genetics. Zeichner also speculates that contributing factors may be women going off of birth control pills after being on them for many of their younger years, stress, and/or changes in diet such as consuming a large amount of sugar or cow's milk.
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Treatment for adult acne is pretty similar to what you'd do for teenage acne. Zeichner recommends products with salicylic acid, such as Aveeno Clear Complexion Foaming Facial Cleanser ($8, walgreens.com), or benzoyl peroxide, such as Neutrogena Rapid Clear Stubborn Acne Daily Leave-On Mask ($10, walgreens.com), as the active ingredient. Salicylic acid is a beta hydroxy acid that helps remove excess oil and exfoliate the dead cells from the surface of the skin, while benzoyl peroxide kills the acne-causing bacteria. (Just FYI: benzoyl peroxide can bleach fabric, so use caution—and white towels!)
If your acne is persistent or severe, Zeichner says it's important that you make an appointment to see your dermatologist so you can work together to form a prescription regimen tailored to your needs. Your dermatologist may prescribe topical medications like Epiduo Forte or oral medications like the hormonal treatment Spironolactone, says Zeichner.