Breaking out can make you feel like a teen again but adult acne is very different.

Adult acne triggers and causes are not the same as teenage acne have to be addressed differently.

Learn why these blemishes aren’t simple – but still very treatable.

What is adult acne?

Hi, let me introduce myself. I’m Dr. Kristen Ma, ND and I treat a lot of adult acne. I’ve been treating skin conditions for over 20 years. And of all the skin conditions, I treat adult acne the most.

I enjoy treating it because it’s not hard to get results. But you do need to be committed. Patience is the hard part.

This thing with adult acne is that it is a sign of an internal imbalance.

Unlike the very familiar teen acne, it’s not a by-product of a natural hormonal shift. Let me explain.

When you’re going through puberty, your hormones are surging and your whole body is changing. This creates turbulence and hormonal spikes that your body is not used to. This turbulence causes angry, hormonal breakouts (along with lots of other angry hormonal changes). But there is an end.

Your hormones will level out and your body will settle….and your skin will clear up.

How is adult acne different from teen acne? (…and pregnancy or menopausal acne)

These are times or TEMPORARY hormonal turbulence that have very real end dates. Sure it doesn’t feel that way. When I had teen acne, I panic-treated my skin in 1000 very damaging ways.

But if we can keep the emotions calm, and we don’t scar ourselves, it’ll be a distant memory.

In teen acne, my goal would be to prevent scarring (*which is much harder to treat). Yes I want to decrease the acne too. But ultimately I want to minimize long term damage of this acute flare up.

This is the same with pregnancy acne and menopausal acne.

Adult acne is different. Chronic pimples are a sign something deeper is going on rather than a temporary, transient phase.

So, we need to ask:

1. If you’re not pregnant or perimenopausal, why are your hormones in flux?
2. Do you know which ones are imbalanced?
3. How does your lifestyle and life choices affect your hormones?

Sometimes it’s not the hormones you’d expect that are causing your acne. And, it can be stress hormones, sleep hormones and other hormones affecting your hormonal profile too.

This is my job. I work to investigate what is happening at the root cause of this skin flare up.

That’s if its even hormonal at all. Sometimes it’s an expression of inflammation reflected in your skin.

This can be due to digestive problems, thyroid issues (also endocrine), stress, insomnia or poor immune function. Rarely, it’s triggered by you using the wrong skincare for your skin type.

Whatever the cause, it highlights something that needs to change.

Unlike teen, menopause or pregnancy acne, it’s not the result of normal, transient hormonal fluctuations.

If you need help or support navigating this, I’m here.

 

The conventional approach to treating acne

So we’ve established that adult acne is usually not a normal, passing phase. It can be an expression of imbalance.

This can be hormonal, inflammatory – and sometimes a sign of the wrong topical care. How do we find out what it is?

To understand your acne, it’s helpful to understand it’s variations and complexity.

Let’s start by learning how the pimple formation lifecycle. When we understand it, we understand how and where treatments come from.

Acne stages and their treatments

How a blemish forms is broken down in these 4 steps.

1. Excess oil – our natural oil, also known as sebum, is considered one of the ingredients for acne. It is thought excess oil is the precursor for acne. This is why hormonal imbalances are looked at because certain hormones lead to more oil production. It is also why skin drying agents are so popular.

   However there are many people with naturally oily skin that do not break out. I have also seen many patients clear up when they start using a face oil or an oil cleanser. So, excess oil itself is not a sole culprit.

   When I had acne, I believed this and was so afraid of using oil on my skin for fear of more breakouts. But using drying agents is not the magic bullet. Often it results mostly in a lot of redness and irritation. I see acne as an expression of inflammation so adding to this isn’t helpful.

   Accutane

   This is also the reason for Accutane (Isotretinoin). This medication dries your skin by atrophying your sebaceous glands. This can be very effective but your medical provider will also go over the extensive concerns and possible side effects.

   Many people do not know that it can be temporary. I have many patients who have taken Accutane multiple times because it came back two years after their initial course of medication. I also have one patient who was taking it indefinitely at a low dose.

   But oily skin keeps our skin moist and youthful-looking. If we fear sebum, it means we have to make tradeoffs and resign ourselves to dry skin.

2. Pore cornification – This is just fancy wording for clogged pore. The pore gets blocked and is the next step towards a blemish.When a pore is blocked, oil is backlogged putting pressure on the pore canal, resulting in inflammation.

   But this is why so many acne treatments include peels. Lots of AHA, BHA and glycolics, lactics….we love acids! The problem is that it can strip your skin’s barrier. And without a healthy barrier we have a poor defense against infection (ahem, more acne).

   The question here is why do some people get clogged by oil and some not?

   The secret is in your skin’s hydration levels. Oil is not the issue. Oil with dehydration makes sebum thick, sticky and hard. It creates little corks of oil on our cores as oil secretes to a dehydrated skin surface and dries out.

   So, skin hydrating topicals and also internal factors such as poor sleep, lack of water intake, poor digestion and diarrhea, drying and hormonal conditions that dehydrate your skin are all to be examined.

If you need help identifying these, I’m here. Together we can discover more about your skin and body.

3. Backstop of bacteria. In step three, the clogged pore stops healthy oil secretion. Sebum backs up and creates a pool of pressure that is inflaming the follicle. This is ripe for infection – and when it eventually does get infected, it will result in a pustule.This is another reason why antibacterials are popular (topical and oral). I too use natural antimicrobials in some cases. However, it’s important to be mindful how antibiotics affect your microbiome and antibiotic resistance.
4. Pimple appearance – Finally! Yes, after all that a pimple forms. And this is the point in which many will try to dry out the blemish – or pick it.The issue is that in this process, you can increase the risk of scarring. Remember how I said scars are much harder to treat than pimples?

   I have a ton of thoughts on how to treat scars depending on their color, size, depth and age…. Ask me if you’d like HERE.

Adult Acne Solutions and Treatments

As you can see, adult acne can be a window into your internal body.

In my clinical experience, I find that adult acne is caused mostly by:

• Hormonal imbalances and conditions
• Poor digestion and food sensitivities
• Insomnia and poor sleep
• Constipation (poor waste and hormonal elimination)
• The need for liver support
• Stress

These are the biggies.

But also nutrient deficiencies, poor skincare, issues with immune system function (which also governs inflammatory response) that can worsen adult acne.

What is important is to go through your case with a fine tooth comb and discover what is happening and where.

While we focus on the vanity component of treating acne, it can also lead to a healthier, more resilient you.

If you need help or support navigating all this, I’m here. I’ve been doing this for over two decades because I’m passionate about helping people feel better in their skin – inside and out.

Get support today.