What to do About Adult Acne

I’m in my 50’s…why do I still have a “pizza face”?!?

When I was in my teens, my face was slathered in pimples. At least during that point in my life, my peers were also awash in spots.

Fast forward 25 years. I have a mortgage, a tween daughter and a full-time job. And I still have pimples. Only now I’m one of a handful of people my age who is still dabbing toothpaste on my forehead at night, still shopping for Clean & Clear, still searching for concealers powerful enough to hide the massive red spots that pop up seemingly daily (pro tip: save your money . . . even the experts couldn’t cover my chin pimple on my wedding day).

Turns out, I’m not alone (though it feels often like I’m the only adult going through this first world embarrassment). Adult acne develops in up to 22 percent of women and 3 percent of men, says Tsippora Shainhouse, a Los Angeles-based dermatologist in private practice.

And while teenage acne can be attributed nearly 100 percent to hormones, adult acne occurs for myriad reasons, from hormones to genetics, diet, stress, cosmetics and smoking. Adult pimples are also dispersed differently than the teenage genre (though when I was a teenager, there was rarely a spot on my face that my pimples didn’t target).

Where it happens

Shainhouse says that white women tend to break out on their cheeks and chin, while black women tend to experience acne along their hairline and cheeks. Black women are also at risk of acne keloidalis, or keloid scarring in the areas of inflamed acne cysts, especially on the chin, jawline and chest.

Why it happens

There are many causes of adult female acne.

Polycystic ovarian syndrome: Women with POS have elevated male hormones, irregular or anovulation and other clinical features including acne, Shainhouse says.

Stress and hormones are the two biggest adult acne triggers, says Kenneth Mark, a New York and Colorado-based cosmetic dermatologist. “Today, women in their 40s can be under more stress than when they were in their teens,” Mark says. “Juggling career, motherhood, marriage and a busy social single life can take its toll. Excess stress leads to production of androgen hormones and cortisol, both of which activate the sebaceous glands to produce excess sebum, which in turn causes acne lesions and flares.”

What to do about it