Exploring Adult Acne - Causes and Treatments

An Interview with Brian Keegan, M.D., Ph.D.

Adult acne is a topic rarely covered in traditional or social media. However, that’s about to change. In the article below, Brian Keegan, M.D., Ph.D., a board certified dermatologist at Windsor Dermatology, provides insight to managing adult acne, as well as debunks some myths associated with the condition.

Q: What causes acne?

A: Acne is caused when pores become clogged with dead skin cells and oils. The causes that contribute to breakouts can range from normal physiology to hormones or medications such as steroids, lithium and chemotherapy drugs.

Q: What causes acne breakouts in adults?

A: We’re coming to a better understanding of acne, but we’re still not sure if acne is the same in adolescence as it is in adults. For example, the medication Aczone appears to be more effective when treating adults for acne, as opposed to adolescents. This study and others like it suggest that all acne is not the same; we just have to identify these differences, which is only a matter of time.

Q: Can acne breakouts become serious?

A: Acne is serious on multiple levels. It’s not only a painful and uncomfortable condition that has the potential to leave marks and scars, but it also causes emotional and self-esteem issues. Often, people’s daily lives are affected. For instance, when clothing or makeup cannot cover their acne breakout, they may skip work or call out sick.

Q: Are there other issues associated with the emotional stress of acne?

A: Another serious factor contributing to the emotional stress of the condition is that acne is “less appreciated” by the media and insurance companies. Adult acne patients often feel alone or unique since there is very little media coverage about the condition. Also, medical insurance companies often cap the age at adolescence, or the early twenties, when a patient can seek treatment for acne, making treatment more difficult.

Q: Are there any myths about acne you’d like to debunk?

A: Many studies suggest that different foods like pizza and chocolate can cause acne, but there has never been any conclusive evidence to back up those claims. Another myth is that acne breakouts occur because you don’t wash your skin enough. That’s not exactly true; you can wash everyday, but still suffer from an outbreak. In fact, sometimes outbreaks can occur because people are too aggressive with their treatments.

Q: Would you recommend treating acne at home? If so, how?

A: There are many over-the-counter medications to help treat acne, however, they generally include one of two of the medications.  I recommend a wash with salicylic acid to help open pores and spot treatment including benzoyl peroxide to kill inflammatory bacteria.

Q: When should someone consult with a dermatologist about their acne?

A: If over-the-counter medications aren’t helping to control the outbreak, it’s a good idea to see a dermatologist since there could be contributing factors. Also, a dermatologist can prescribe oral and topical medications to help keep acne manageable or clear up the affected area completely.

For more information about adult acne, call Windsor Dermatology at 609-443-4500 or visit Windsor Dermatology to make an appointment.

Debunking Myths About Acne

By Brian Keegan, M.D., Ph.D.

Acne is the most common skincare problem seen by doctors—nearly everyone will deal with acne in their lifetime. Because of acne’s unsightly appearance, patients will turn to a number of seemingly fast and easy solutions. But let’s take a closer look at the real causes of acne and the right way to treat it.

Myth #1: “Acne is caused by eating chocolate.”

Truth: Acne is caused by sticky cells that don't exfoliate properly. This leads to clogged pores which are seen as comedones (skin colored bumps) and blackheads. When these pores are colonized with the bacteria P. acnes painful white heads and cysts will develop, which can lead to scarring. There are a few studies that suggest eating chocolate can enhance this process, however no solid evidence has led the medical community to make a decisive conclusion. It does, however, make logical sense that a healthy diet will contribute to healthy skin.

Myth #2: “Only teenagers get acne.” 

Truth: Hormones tend to accentuate the process by which acne appears, making its occurrence worse during teenage years. But, it is not exclusive to patients under 20. Many adults continue to experience acne, particularly women.

Myth #3: “All you need is a good over-the-counter treatment to cure acne.” 

Truth: We are all looking for quick, easy and effective treatments so we turn to over-the-counter products. These contain two active ingredients, salicylic acid to unclog pores and benzoyl peroxide to kill bacteria. But everyone’s skin is different. The best course of action is to schedule a consultation with a Windsor Dermatology physician to determine the treatment plan that’s right for your skin. 

Myth #4: “Acne medications are too harsh and have too many adverse side effects.”  

Truth: Historically, acne medications were very harsh to the skin or caused significant stomach irritation, however, significant improvements have been made with more recent medications. If your skin is irritated at first, you should see improvements after the first couple of weeks. Typical side effects associated with short-term and long-term use of medications are redness, scaling, dryness, stinging and burning where applied. A non-comedogenic moisturizer can help if your skin becomes dry. Unless major discomfort occurs, it’s best to keep using your medications to make sure you’re on the right path. Don’t hesitate to talk to your doctor if you have major discomfort or if you have any questions or issues. 

Our physicians have experience with the most up to date medications including:

Over-the-counter washes: Salicylic acid 2%  (Neutrogena Oil-Free Acne Wash), benzoyl peroxide (Clean and Clear Continuous Control, Proactiv)

·        Over-the-counter moisturizers: Cetaphil, CeraVe

·        Topical antibiotics: Aczone, Duac, Acanya, Plexion, Rosula

·        Topical retinoids: Ziana, Differin, Epiduo, Veltin, Tretin X, Tazorac, Atralin, Retin-A Micro

·        Oral Antibiotic: Solodyn, Doryx, Minocin, Oracea

·        Oral Retinoids: Accutane, isotretinoin (Amnesteem, Sotret, Claravis)

·        Oral Contraceptives: Orthotricyclin, Estrostep, Yaz

Myth #5: “If I just wash my face a lot and use a lot of medication, it will speed up the healing process.”

Truth: Use a mild, soap-free, fragrance-free cleanser and wash gently, morning and night. There’s no need to wash more than twice a day, and you don’t want to scrub hard. Also avoid alcohol-based cleansers, which can actually cause irritation and aggravate acne.

Using more won’t speed things up (sorry!), and it’s not a good idea to spot-treat. Stick with the right amount and stay consistent. It’s best to use your medications at the same time every day to help you stay in the routine and it’s important to not skip days. You should always follow your doctor’s instructions, but typically pumping a pea-sized amount onto your hand and spreading it evenly across your face works perfectly.

Myth #6: “If I pop the acne pimple, it will go away quicker.”

We know it’s tempting, but when you squeeze or pick at pimples, you can actually push the infection deeper into your skin and make matters worse. It can even cause scarring. Not good! Your best bet is to leave your pimples alone the best you can.

Let us help you figure out the best course of action to treat your acne. Schedule a consultation with a Windsor Dermatology physician today by calling 609-443-4500.