Why is Adult Acne on the Rise?
by Dr. Diana Howard
More than ever before, adults are enduring the challenges of oily and acneic skin conditions. Clinical studies indicate that between 40 and 55 percent of the adult population age 20-40 are diagnosed with low grade, persistent acne and oily skin. According to the Journal of American Academy of Dermatology, 54 percent of women older than age 25 have some facial acne.
Research at The International Dermal Institute indicates that acne arising in adulthood is more likely to be inflammatory, with fewer comedones than teenage acne and lesions predominantly located around the mouth, chin and jaw line. Likewise, adults often have sensitized skin, or a combination of skin conditions in addition to their acne, which makes treatment more challenging than the treatment of teens, who generally have more resilient, uniform and oily skin.
What is Acne?
Acne is often described as a disease involving the sebaceous follicles and hair follicles of the skin. It occurs in people who have a genetic predisposition; if acne runs in the families of both parents, three out of four children may suffer from it.
Sebaceous and hair follicles are associated with a sebaceous gland that produces sebum, a complex mixture of lipids. In the hair follicle, the hair acts as a wick, transporting sebum and other cellular debris to the surface of the skin, where it is ultimately removed. Inflammation or infection is rarely associated with this type of follicle, unless the hair becomes ingrown or the opening of the hair follicle becomes clogged.
The sebaceous follicle, usually lacking a hair or containing only a rudimentary fine hair, is generally associated with the disease acne. Activity of the sebaceous gland is stimulated by many factors, including the onset of puberty, hormonal fluctuations, pharmaceutical agents, stress, using inappropriate products on the skin, heat, friction and humidity.
Why Is Adult Acne On The Rise?
Triggered by hormones, acne can occur at any stage in our lives. The primary aggravating factor leading to adult acne is chronic stress. We all know that acute stress can cause a breakout from time to time. But chronic, continual stress increases hormone levels, which can lead to an increase in oil production.
One reason why adult acne is on the rise in the female population is because of the additional responsibilities that have increased women’s stress levels. The pressure to work outside the home to help maintain a steady family income while maintaining a functioning household is unique to this generation of women in their 20s, 30s and 40s. Combine workplace stress with household responsibilities, cosmetics that contain known skin irritants and monthly hormone fluctuations and you have a perfect breeding ground for the formation of adult acne.
Adult acne can be aggravated by internal and external factors. Internally, the psychological effects of adult acne can contribute to continued flare-ups and breakouts. When adults are frustrated by the signs of acne on their skin, it causes additional emotional stress, which contributes to a continued increase in excess activity of the sebaceous glands and leads to the continued cycle of breakouts (and the need to “pick” or “squeeze” breakouts places even more acne-causing bacteria on the skin).
Some dermatologists choose to place female clients suffering with adult acne on oral contraceptives. Oral contraceptives contain estrogen and progestin, which can help decrease the androgen activity responsible for adult acne. While often effective, this does leave clients open to the side effects that accompany oral contraceptives, including bloating, nausea and an increased risk for blood clots and strokes.
Dermatologists may also choose to put clients on a specific type of steroid, such as prednisone, to reduce the stress-related hormone reaction. However, steroids taken internally or applied can aggravate acne, not to mention that any kind of prolonged use of steroids can have adverse effects on one’s health.
Controlling Adult Acne
As professional skin therapists, we must recognize that chronic stress is often the trigger for adult acne. Speak with your clients about their symptoms as well as their lifestyle to outline a professional treatment program and a home care regimen that will maintain clear skin.