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Back to Basics: How to Cure Adult Acne

Dermatologists weigh in on getting clear skin once and for all.
Backstage at J.W. Anderson Spring-Summer 2016. Photo: Imaxtree

Backstage at J.W. Anderson Spring-Summer 2016. Photo: Imaxtree

"Basic" may have adapted a negative connotation in recent years, but there's no shame in seeking advice on theoretically simple sartorial conundrums. In our latest column, "Back to Basics," we're here to guide you through life's most common (and important) fashion and beauty concerns. Here, we tackle the topic of dealing with adult acne.

Dealing with stubborn breakouts is a common part of the teen experience, but it’s also not totally unheard of to have another bout hit you a few years later as an adult. What's that thing about life not being fair? Just when you think you’ve put those days behind you, whiteheads and cysts come (literally) rearing their ugly heads.

Adult-onset acne can develop anytime between your 20s to as late as your 50s, and it has a positive correlation with a personal history of teenage acne. However, as with most medical ailments (and clothes, obviously), there is no "one-size-fits-all" treatment, and not all acne is created equal. (More on that later.) "For example, let’s say that a man and a woman, both of whom have a history of acne in their teens that was successfully treated with isotretinoin — a.k.a. Accutane — presently have adult onset acne," postulates Dr. Shereene Idriss, MD at Wexler Dermatology. "The man most likely needs a second course of isotretinoin, whereas the woman should be evaluated for hormonal acne since the treatment differs completely."

Types of acne range from mild (sort of, anyway) comedones — basically, your average whiteheads — to inflamed cystic bumps and everywhere in between. Mild acne can usually be treated with a topical containing benzoyl peroxide or salicylic acid, like La Roche-Posay Effaclar Duo or Dermalogica Overnight Clearing Gel. If that's not doing the trick, another course of action is prescribing either oral or topical antibiotics: "There are specific antibiotics that target the bacteria that causes acne, called p.acnes," explains NYC-based dermatologist Dr. Doris Day, MD, who penned a book on acne that is currently sold out on Amazon. Other options that Day suggests include laser treatments (like Isolaz, which combines bacteria-killing broad-based light in addition to profusion therapy that helps clear out the pores), or getting a chemical peel with a salicylic or glycolic acid base for intense exfoliation.

If you’re noticing breakouts concentrated along the chin and jawline that tend to get worse when you’re on your period, then your hormones might be the culprit. "For any female-pattern adult acne, we can add in a hormonal contraceptive like the Pill or a drug called Spironolactone, which blocks the hormone receptors that are responsible for acne flare-ups," recommends Day. Cases of severe nodular acne will require more than just topical medications, so increasing a dosage of oral antibiotics or going on an isotretinoin regimen will be the most effective plan of action.

To keep blemishes at bay, Day also suggests using an acne cleanser every day – not just when you’re experiencing a breakout. (We like Belif's Crystal Cleansing Foam Fresh) That being said, it’s also not a great idea to blitzkrieg your complexion with harsh ingredients. "It takes time for acne to clear and if you use too much medicine, you’ll get more irritation and it won’t get better any faster," says Day. 

This stuff rocks. Cetaphil DermaControl Oil Control Moisturizer SPF 30, $19, available at Ulta

This stuff rocks. Cetaphil DermaControl Oil Control Moisturizer SPF 30, $19, available at Ulta

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Another important tip? Don't skimp on moisturizer just because you've got acne-prone skin: Dehydrated skin (yes, it can happen even to oily types!) can cause ramped up sebum production, which in turn produces more clogged pores and pimples. Cetaphil's DermaControl Oil Control Moisturizer (pictured above) is formulated for sensitive, breakout-prone complexions and offers a dose of SPF along with lightweight hydration.

"The only difference in adult-acne [versus treating teenage acne] is that the patient has a much longer history that can often dictate how he or she might respond [to treatments]," says Idriss. But the best way to ward off breakouts, according to the derm? "Skin care, skin care, skin care! Use non-comedogenic products that won't clog pores, and adhere to a reasonable routine of washing your face daily with a gentle cleanser, and exfoliate your skin two to three times a week."

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