Acne: You don't always grow out of it, but there are options

NEW YORK — Acne isn't a problem that magically disappears when you turn 20. Even though it's thought of as a teen skin problem, many adults — in fact, most adults — suffer from at least occasional outbreaks of acne.

The dermatology and beauty industries have taken notice of those blemishes over the past few years and are increasing the number of adult-acne products they offer. The ingredients aren't that different from those in treatments aimed at teens, but manufacturers say adults are willing to spend more money even if they have fewer pimples.

Last fall, Clinique launched its Acne Solutions line, a three-step system similar to its classic skin-care sets but containing anti-acne ingredients.

"In talking to our own consultants at the [retail] counter, mature customers complain of acne ... and that led us to one of our major endeavors of the last five years," says Tom Mammone, executive director of research and development at Clinique, who says several studies backed the concept that more adults say they have acne.

Scott Scocimara, CEO of Therative, the company that makes the ThermaClear heat-based, anti-acne device, says he initially thought the product would be marketed primarily to teenage boys but that adult women have turned out to be the primary consumers. "The teen market is huge, but the more sensitive market to the individual pimple is the adult woman."

Adult acne is more common on the jawline, neck, chest and back, while teen acne tends to cluster on the forehead and cheeks, says Dr. Katie Rodan, one of the two dermatologists behind the skin-care brand Rodan + Fields.

"Pimples move south with age," Rodan says. "They'll be fewer in number but bigger in size."

Teen acne is typically blamed on hormonal changes, while stress can be a more likely factor for adults, she says.

But bacteria can be the real culprit, and adults can allow heated bacteria to fester on their skin anytime they do an activity such as bikram yoga or 30 minutes on the stationary bike at the gym and enjoy their smoothie before showering.

"You stew in your own sweat," Rodan says. "That heat you generate helps the bacteria, and adults tend to do more heavy, sweaty, gym-intense exercise."

"Showering after exercise is the easy part of curbing adult acne; living stress-free is much harder," she adds.

Dr. Mary Lupo, clinical professor of dermatology at Tulane University, who also consults for beauty brand Philosophy, says occasional acne can be treated with over-the-counter products that include benzoyl peroxide to kill bacteria or salicylic acid to unclog pores.

But for anything consistent, she recommends prescriptive treatments that will treat an existing outbreak and could help prevent future ones.

The estrogen and progestin in the Yaz birth-control pill and the anti-androgen action of the hormone-therapy drug Spironolactone, which suppresses oil output, are effective, says Lupo, as is Accutane. All of those, however, should be taken while under a doctor's care because there are potential side effects.

Laser treatments also can help active acne and acne scarring by stimulating collagen — a bonus is that they also can help with fine lines and wrinkles, she adds. But treatments average $250-$500, and patients typically need three.

The best treatment might be to accept that adult acne happens — and to know you're not alone, says self-esteem adviser and blogger Jess Weiner, who is featured in Seventeen magazine and other media outlets.

She is no stranger to an outbreak, she says, and she used to do her best to cover it up with topical treatments and makeup.

"The blemish becomes magnified, at least in your own mind," Weiner says. "It impedes you from feeling sexy, or fresh, or clean. ... Just like when you were in junior high, a bad case of acne can completely level your confidence for the day."

Recently she decided to change her approach, and she has seen an improvement. She goes out without concealer — and no one else seemed to notice, Weiner reports.

"I also figured out how to dress around my zits. I wear hats! Hats became the great distractor. I also wear my glasses a lot, scarves or cleavage-baring shirts because then people weren't looking at my face."