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Updated June 03, 2014.
Whether you have had acne since you were a kid, or you’ve developed pimples later in life, adult acne is a frustrating problem. But the acne treatment you used as a teen may not work for your adult breakouts. Fortunately, with proper care and a little time, adult acne can be successfully treated.
When pimples appear, most people set out for the skin care aisle first. If your acne is mild, you may be able to get it under control with over-the-counter products. The most common OTC acne treatments include
Unless your skin is super oily, stay away from skin care products marketed toward teens. These products are designed for the typically oily teenage skin, and may be too drying for adults whose skin produces less sebum. As adult acne has become more common, many manufactures have developed acne skin care lines specifically with adult skin in mind. Some brands include:
- L’Oreal Special Care Acne Response Daily Adult Acne Regimen
- Murad Acne Complex
- Dermalogica mediBac Clearing™ Adult Acne Treatment Kit
- Aveeno Clear Complexion products
- Neutrogena Healthy Skin Anti-Wrinkle Anti-Blemish products
Try an OTC product first, but if you’re not seeing good clearing within six to eight weeks call your doctor.
Retinoids are often prescribed for adult acne patients. They help to increase cell turnover and are great for slowing the formation of
microcomedones , the very beginning of a pore blockage. (Think of microcomedones as pre-pimples.) And many adults appreciate the fact that retinoids help reduce fine lines and wrinkles, making skin look younger. But these treatments also make the skin more sensitive to the sun, so wearing an oil-free, noncomedogenic sunscreen is a must. They can also cause skin irritation and peeling. If you experience this problem, try using a smaller amount. And if that still doesn’t work, try using it less frequently, like every other night instead of every night.
Common retinoids prescribed for adult acne include Differin (adapalene), Avage (tazarotene), and Retin-A (tretinoin). Renova is another treatment that contains tretinoin, but it is in a heavier, more moisturizing base. For those who tend toward dry or sensitive skin, Renova can be a good choice.
Many cases of adult acne also respond well to combination treatments, and there are many available. Combination therapies contain two different acne medications in one topical product, and work by treating several acne causes at once. Some popular combination treatments include:
- BenzaClin (benzoyl peroxide and topical clindamycin) (Duac is another drug with similar ingredients)
- Benzamycin (benzoyl peroxide and topical erthromycin)
- Ziana (tretinoin and topical clindamycin)
If acne isn’t improving with topical treatments, you may need oral medications. Of all the oral acne medications, isotretinoin (formerly sold as Accutane ) is probably the most widely known. Isotretinoin may be an option for those whose acne isn’t being effectively controlled with other treatments. But it is really is meant for those with severe or cystic acne , not for people who get the occasional breakout. Not everybody is a candidate for isotretinoin; your dermatologist can tell you if it’s a good option for you.
But isotretinoin isn’t the only oral medication used to treat acne breakouts. Oral antibiotics are also helpful in clearing some cases of adult acne, especially inflamed acne breakouts. Oral antibiotics are often prescribed along with a topical treatment, like Retin-A. Often the oral antibiotic is used just until acne is under control, and then is stopped. At that point the topical treatment alone keeps acne from returning. This is a good point to remember for those who are worried about taking oral antibiotics for a long period of time.
There are a few medications that are only for women. Oral contraceptives are sometimes prescribed either along with topical acne treatments or on their own. Birth control pills by themselves aren’t going to clear up serious cases of acne, but are often very helpful for women who get a few pimples around the time of their monthly cycle. Birth control pills help to balance hormonal fluctuations that impact acne development.
Spironolactone is an anti-androgen drug, and another medication that is sometimes prescribed off-label to treat hormonal acne. Again, it is used for women only. Spironolactone blocks androgen receptors in the body. Androgen hormones have been closely linked to acne development.
For some women, hormone replacement therapy (HRT) can help clear up acne breakouts. HRT is most often used to treat post-menopausal women who are also suffering from other effects, like mood swings, thinning hair, etc. HRT isn’t the first treatment choice for women who are dealing with acne only.
“Adult Acne: Effective Treatment Available.” AcneNet. 20 Sep 07. American Academy of Dermatology. Accessed 22 May 08.
Williams C, Layton AM. Persistent acne in women: implications for the patient and for therapy. American Journal of Clinical Dermatology 2006; 7: 281-90