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While Erin Kennedy thought she left acne behind in her adolescence, she expected to get rid of it by the end of her 20s — and when she still had it in her 30s, she wondered, “Why me?”
Then she started opening up to other women about it — and realized she wasn’t alone. “I guess women don’t go around checking each other’s acne,” says the 33-year-old from Phoenix. “Nobody really talks about it. Women are getting better at covering it up.”
Doctors are seeing more women, well past puberty, with adult acne, says Dr. Bethanee Jean Schlosser. She recently spoke at the annual meeting of the American Academy of Dermatology in San Diego about the increasing number of women in their 20s and 50s doctors say they are diagnosing with adult acne and the role that hormones play.
“Women have this distorted view that they’re the only one suffering from it. But it seems people are more proactive with getting care,” she tells TODAY.com.
Dr. Schlosser, the director of the Women’s Skin Health Program at Northwestern University Feinberg School of Medicine, points out two studies that show adult acne in women is quite common:
The first study, conducted by the University of Alabama in 2008, asked women whether they had outbreaks, and revealed that more than half of the women in their 20s reported having acne and more than a quarter of women in their 40s.
The study also discovered that post-adolescence, women are more prone to acne than men.
In the second one, researchers diagnosed clinical acne by examining photos of women. The 2011 clinical study by the Massachusetts General Hospital found that 45 percent of women between the ages of 21 and 30 had clinical acne, about a quarter of those between the ages of 31 and 40 — and more than 10 percent of women between the ages of 41 and 50.
As comparison: More than 80 percent of both girls and guys suffer from adolescent acne, Dr. Schlosser says.
So why is acne following women past adolescence?
Hormones, says Dr. Diane Berson, who has a private dermatology practice in New York.
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When hormone levels change, we break out, she explains. That’s why both males and females get acne when puberty hits. After that, men (who can get acne from surges in testosterone from stress) suffer from the skin condition less because their hormones don’t shift like women’s do, the doctor says.
“With their first period and then on a monthly basis with the period, then when we get pregnant. We have a chance of hormone fluctuation after going on or off birth control and then perimenopause and menopause,” says Dr. Berson, who is also an assistant professor at Weill Medical College of Cornell University in New York. “Women are always in hormonal flux in their lives — so they’re prone to acne.”
Dr. Schlosser reassures that most women with adult acne have perfectly normal hormone levels. However, should a woman have an irregular period, hair growing where it shouldn’t or even a deepening voice, she would be a good candidate for a hormone-level check, she advises.
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It’s the male hormones called androgens, which are present in both men and women, that can actually cause acne.
“Hormones influence oil production and cells maturing,” says Dr. Schlosser.
A domino effect starts with shedding skin cells clogging the pores, which traps oil produced by oil glands. “Oil is a food source for bacteria, which multiplies and grows and results in inflammation,” the doctor explains.
The result: Zits.
It’s not clear whether more women have adult acne or more are just seeking out their doctors for help, Dr. Schlosser says.
Doctors, she says, can target treatments to the severity and type of acne. Mild or moderate acne is often treated with topical retinoids in women who aren’t pregnant or trying, the doctor says. To reign in androgens, Dr. Schlosser may suggest hormone therapies such as the pill or spironolactone (an anti-androgen). Other medications tackle bacteria or inflammation.
“With acne, it’s important for patients to understand that there are no quick fixes, and none of the therapies used to treat acne work overnight,” Dr. Schlosser says.
How to beat adult acne
Kennedy, who has skin issues during that time of the month, has stuck with her natural regimen of drinking plenty of water, never leaving the house without SPF — and always, always removing her makeup. She also scrubs with a fancy Clarisonic electric face brush, applies moisturizer and don’t forget the eye cream!
And what about her husband, Robert?
“He doesn’t have a regimen," says Kennedy. "He just uses his body wash on his face."
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