Judith Levin went through her teenage years pimple-free, but like nearly a quarter of Americans between the ages of 25 and 44, Judith suffers from adult acne. Like most adults, she imagined that once the teenage years were past, she would remain acne-free for the rest of her life. For many, adult acne can be physically and emotionally scarring.

TYPES OF ADULT ACNE
Most adult acne patients suffer from the same kind of acne as teenagers, acne vulgaris, sometimes called common or “true” acne.

Other adults experience acne rosacea, which produces patches of redness, dilated blood vessels, and swelling on the face, especially the nose and cheeks. This type of acne only affects adults, usually those in their 30s and 40s. Men are more likely to have swollen noses or cheeks, while women more often experience simple redness or flushed areas on the face. Noted film and stage performer W.C. Fields was the most famous sufferer. U.S. President Bill Clinton reportedly also has it.

ACNE VULGARIS
Common acne is an inflammatory condition in which facial oil or sebum, sometimes combined with other oils from the environment, gets trapped in hair follicles in the skin. This occurs as a result of the skin producing too much oil, because the skin around the follicles is too tight, or from a combination of the two.

Oil plugs that don’t become infected appear black and are called blackheads. Sometimes the oil plugs provide a home for common facial bacteria to grow. When this occurs, the lesions usually appear white in the center — whiteheads. The bacteria may trigger an infection response, resulting in inflammation. The inflammation can further tighten or even close the follicular opening, and a painful red or swollen pimple appears. Severe acne can produce deep, infected cysts and may result in scars that remains even after the lesions have healed.

Oil on the surface of the skin is probably the single most important factor. Contrary to popular myth, the oils and fats that we eat don’t cause acne. Rather, the oils and fats that end up on your face combine with those already produced by your own oil glands. Dr. Kathleen Behr, dermatologist, notes that “…you may not need to worry that eating high-fat foods at a fast-food restaurant will make your acne worse. The people who need to be careful are the workers behind the counter, who get oil on their hands and then touch their faces.”

Hormonal changes, like those that occur at the onset of menstruation, may also be a contributing factor, especially for women with a hormonal imbalance.

TREATMENTS
Treatment of acne vulgaris in adults is generally the same as it is for teens. It focuses on loosening or minimizing the oil plugs, and on eliminating bacterial infection.

Retinoid drugs such as Retin-A and Differin work by helping to loosen the oil plugs. Patients with sensitivities to retinoid drugs may be able to use treatments such as glycolic acids or benzoyl peroxide, but these are generally less effective.

Inflamed acne lesions may be treated by rubbing an antibiotic ointment into the skin. This helps fight the bacteria. Oral antibiotics may be prescribed for more severe cases.

If acne is aggravated by hormonal changes, then regulating the hormones, for example, by taking birth control pills, can help.

And of course, frequently washing hands and face with warm water and cleanser is still a simple and effective treatment.

WHEN TO SEE A DERMATOLOGIST
While acne itself isn’t life-threatening, you may want to consult a dermatologist, especially if you find that it affects your appearance self-image. Patients may confuse the lesions of adult acne with other more serious types of skin lesions. It’s important to see a dermatologist if you notice irregular blemishes anywhere on your skin, especially if they grow, bleed, or change color or sensitivity over time.