As if being an adult doesn't come with enough growing pains, the last thing we need to worry about is unhealthy skin. According to a poll conducted by Harris Poll Online, adults comprise 46% of dermatologists' acne patients. You may think that ugly breakouts and the bad scars they leave behind are reserved for your teenage years, but board-certified dermatologists Dr. Rosemarie Ingleton of Ingleton Dermatology and Dr. Carlos Charles broke down the causes of adult acne and how the same products that worked when we were teens might not be as effective as we age.
BREAKOUT BASICS

The appearance of acne is different at various life stages. In teenagers, acne shows up a little less aggressively, in the form of blackheads and whiteheads. In adults, breakouts are deeper and more cyst-like. These tend to be red bumps beneath the skin that can be painful to the touch. "Cystic lesions are more distressing to the patient because they tend to leave scarring and hyper-pigmentation," says Dr. Charles.

On a back-to-basics level, what's happening beneath the skin is hormonal. "A very common scenario for adults who develop acne is a woman who has been on oral contraceptives for several years and then comes off the pill," says Dr. Charles. The change leads to a testosterone surge in the body that causes the walls of the pores to become sticky. Skin cells can no longer move through the pores as they normally do to remove debris and regenerate the cell layers; the result is a roadblock below the skin. If it happens on one of the top layers of skin, you'll get a blackhead; if it's on a deeper level, you'll get whitehead; if it happens very deep, you'll get a cyst.

As hormones evolve, the likelihood of acne increases, and unfortunately this evolution spans well beyond our teens. "As we progress in life, acne has more of a hormonal drive," explains Dr. Charles. "A lot of my adult acne patients tend to be women because they have more hormonal fluctuation later in life," he says.

As women approach menopause, acne tends to slow down. This is because the testosterone surge decreases. As a result dermatologists often recommend anti-testosterone medications like oral contraceptives, which can help combat acne.

FOOD FABLES

Contrary to popular belief, diet isn't a major factor in combating adult acne. "A lot of patients tend to think that diet plays a big role and it remains to be proven in any clinical trials," says Dr. Charles, but watching what you eat may have some impact on your skin. "There are some small studies that says that foods with a high glycemic index, high sugar and fat content can drive acne somewhat," he says. Instead of food, for adults, factors like stress and a lack of sleep can cause acne flairs.

WARDING OFF BLEMISHES

Across the board, dermatologists agree: It's very important to steer clear of certain ingredients that can lead to acne breakouts. "Look for product labels that say 'non-comedogenic,'" says Dr. Ingleton. This specifically means that certain oils, lotions, and skin creams do not block pores; Cetaphil Daily Facial Moisturizer ($10.99, walgreens.com) is a great one.
"Products that we use to make our hair look good contains oils that over weeks rubs off onto our foreheads and jaw line causing acne breakouts," says Dr. Ingleton. If tossing your hair care products just isn't an option, Dr. Ingleton recommends using an acne wash that contains salicylic acid on a daily basis to keep pores clear. (Try: Neutrogena Oil-Free Acne Wash, Redness Soothing Cream Cleanser, $8, drugstore.com). These washes tend to be drying, so follow up with a lightweight moisturizer.

BANISHING BREAKOUTS

There are several treatment options for adult acne breakouts. For mild acne, a combination of benzoyl peroxide and an anti-biotic like clindamycin will do the trick. These are both prescribed by doctors. The benzoyl peroxide works to clear the blockage and the anti-biotic helps to clear any infections. Because adults tend to have deeper cystic acne, we do better with things that are taken orally. These are usually antibiotics that calm inflammation. "If I think that the person's acne is being driven by a hormonal pattern, I may even give some kind of anti-estrogen medicine like Aldactone," says Dr. Charles. "It's actually a blood pressure medicine, but I can give it in low doses and it works very well." Looking for an over-the-counter solution? Brazilian Peel glycolic peel by Advanced Home Actives ($78, sephora.com) is chemical-free and therefore safer to use at home, but all chemical peels are best monitored by a doctor.

Try not to be too harsh on your skin when cleansing; using mild products too frequently or over-scrubbing can actually aggravate acne instead of soothing it.

LIGHTEN UP

Dealing with acne scars can be the most traumatic part of breakouts, but clear skin is an option, even in severe acne cases. "Retinoids really are the cornerstone of treating acne for a number of reasons," says Dr. Charles. The topical treatment works tri-fold to help clear the blockage in the pores, clearing inflammation; most importantly, especially in skin of color, is that it helps with hyper-pigmentation and scarring. It lightens by physically removing pigmented cells from the skin.

For even deeper lightening, follow a retinod treatment with a salicylic acid or glycolic acid peel. Salicylic acid peels tend to work better for patients who have active acne because it gets rid of scarring while fighting the active acne. The glycolic acid peels help for people who really don't have a lot of new active lesions but want to get rid of some of the older scarring.

DIY DAMAGE CONTROL

As an alternative to doctor prescribed retinod creams, try an over-the-counter retinol medicine instead. Retinol is a weaker form of retinod so it does the same thing, just over a longer period of time. Dr. Charles recommends creams by Roc (try: Roc Retinol Correxion Night Cream, $21.99, ulta.com) and Olay (try: Olay Pro-X Discoloration Fighting Concentrate, $47, soap.com)
FULL COVERAGE

While the medication is working beneath the skin to clear up acne, try some of Dr. Ingleton's makeup recommendations for covering the outer scars. "Lightweight makeup will help to keeps pores clear. Brands like Bobbi Brown and Laura Mercier are good. At drugstores, Neutrogena and Almay makeup work well, too. Some even contain salicylic acid, which helps fight acne," she says. (Try: Almay Clear Complexion Liquid Makeup, $13, Walgreens.com)

Have you recovered from adult acne? Tell us your story!