Overview
The American Academy of Dermatology, AAD, identifies four factors that lead to adult acne: an overabundance of oil, clogged pores, bacteria and inflammation. The acne cycle begins when extra oil blocks the pores. Bacteria thrive in the accumulated oil and irritate your skin to form whiteheads, blackheads, pimples or pus-filled cysts. Medical treatments for adult acne address one or more parts of the acne cycle.
Types
AcneNet describes two types of adult acne: persistent and late-onset. Typically, adolescent acne will subside by the time individuals are in their mid-20s, but persistent acne can continue for the next one, two or even three decades. Late-onset acne, on the other hand, begins in middle age or even later.
Triggers
According to AcneNet, medical treatment of adult acne begins with an examination of the triggers that lead to the flare-up. Women may develop acne blemishes when their hormonal levels rise and fall throughout the menstrual cycle, during pregnancy or with the onset of menopause. Acne in adults can be a side effect of drugs such as seizure medications, corticosteroids and medicines that reduce alcohol dependence. Stress can trigger acne lesions, as can some hair and skin products.
Mild to Moderate Acne
AcneNet states that over-the-counter acne products don’t usually work well for adult acne and may even make your skin worse. If you have mild to moderate adult acne, your doctor may recommend prescription creams, gels, solutions and lotions. A topical medication such as benzoyl peroxide is often prescribed and applied directly to acne blemishes. Your doctor may also prescribe an an oral or topical antibiotic, such as clindamycin or erythromycin. Other options include vitamin A derivatives called retinoids, which can be combined with clindamycin.
Moderate to Severe Acne
The AAD notes that oral antibiotics are the best option for moderate to severe acne, acne that doesn’t respond to topical treatments and acne that involves large areas of the body. Doxycycline, tetracycline and minocycline are often successful at clearing up stubborn adult acne.
Isotretinoin is the only medication approved by the U.S. Food and Drug Administration for the most severe form of acne that causes pus-filled cysts, according to the AAD. Isotretinoin can cause severe birth defects if a woman takes it during pregnancy, so women of childbearing years have to register with the FDA’s iPLEDGE monitoring program before a doctor can order the drug.
Considerations
If you’re a woman whose acne is triggered by monthly hormonal fluctuations, your doctor might prescribe oral contraceptives, or birth control pills, according to the AAD. Some women respond well to diuretics such as spironolactone, which helps reduce acne flare-ups associated with menstruation. If you have late-onset acne related to menopause, AcneNet recommends talking with your doctor about hormone replacement therapy.
