If 22% of Women Have Adult Acne, Why Is It Still so Hard to Treat?
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Acne is often considered a teenage gripe, something you either manage in high school or are fortunate enough to escape altogether. However, current data shows rates of persistent adult acne are high, particularly among women.
Data suggest between 12-22 percent of adult women will experience persistent adult acne, while a research study undertaken in France indicates as many as 41 percent of adult women will experience adult acne, half of whom will experience long terms side effects like scarring and discolouration in the form of dark marks.
Dr Cara McDonald, co-director and principal dermatologist at Complete Skin Specialists and St Vincent’s Hospital, says that of this cohort of acne sufferers, a small percentage will see a dermatologist.
“[At Complete Skin Specialists] we see many patients with adult acne, from hormonal spots to severe cystic acne,” Dr McDonald tells POPSUGAR Australia, “however of the 12-22 percent of adult women who suffer from adult acne, only about 20 percent seek medical assistance.”
Why We’re Not Seeking Treatment for Adult Acne
This seems very low when you consider most skincare brands and treatment clinics have anti-acne ranges. We asked Hannah English, a pharmaceutical scientist and skincare influencer, why this may be the case.
English notes that there is a general mistrust around medication and the medical approach, fuelled by a “free advice” culture online that favours natural solutions. “There’s a lot of misinformation like ‘you have to sort out your hormones‘ or ‘it’s because of your diet.’. It does impact people’s lives and how they feel about themselves, too, their confidence.
Still, sometimes people feel like it’s not a serious enough medical condition to see a doctor,” she says.
Dr McDonald says one thing we do know is people are more insecure about their skin than ever and have access to more “treatments” whether advisable or not. “With the advent of the internet, two things have happened,” she says, “one, is that women are more concerned with the appearance of their skin and how it compares to others, and two we can ‘research’ everything ourselves.”. This means while fewer people are going the medical route, they likely are still treating, or attempting to treat, their skin at home.
The Impact of Adult Acne
Acne is considered a disease. Indeed, it’s the 8th most prevalent in the world. And it’s been linked to several mental health disorders.,So so much so that many health professionals are suggesting dermatological treatment programs are paired with therapy.
Dr Michelle Rodrigues, (MBBS (Hons) FACD) is a Melbourne-based dermatologist and founder of Chroma Dermatology. Dr Rodrigues has observed the impact of acne on well-being. She believes it’s one of the primary reasons patients should seek medical intervention sooner rather than later. “’There are many patients impacted for years by the emotional complications of acne,” she says.
Dr Rodrigues tells us she sees patients who struggle with their mood, desire to interact with other people, and willingness to go out in public. This lines up with the connections between acne and acute anxiety. In the French study of 4000 women with acne, 90 percent experienced a “skin picking” behaviour linked to acne excoriée, a condition associated with OCD and body dysmorphic disorder. Other observed conditions, as alluded to by Dr Rodrigues, are social anxiety and agoraphobia.
Why Is Adult Acne More Common in Women?
Or, why are men getting off lightly? They may not be. Dr Rodrigues says it’s hard to say if acne is more common in women than men. “Women certainly present to the dermatologist more frequently than men,” Dr Rodrigues says, “however, culturally, it’s likely women are more bothered by [acne] and therefore more likely to seek assistance.”
Lifestyle factors make women more vulnerable to developing acne in adulthood, ranging from heavier makeup, more hair product, hormonal birth control and underlying health issues — of which acne can be a sign.
Why Is Acne so Hard to Get Rid Of?
If acne, with all of its associated mental health complications, has followed a large proportion of us from the school bus to the boardroom, why haven’t people figured out how to treat it? Anyone who has struggled with acne will know the long and expensive process that begins when you land at the dermatologist’s office.
Dr Rodrigues says a proper treatment that results in long-term freedom from acne involves a process of exclusion because the causes are so multifactorial. “A thorough history must be taken when looking at acne,” says Dr Rodrigues, “simple alterations in lifestyle and diet, or addressing underlying medical causes is critical.”
Dr McDonald adds that some people, whatever their gender, will always be more prone to acne because of genetics. “Dead skin cells that accumulate in a pore cause the red bumps we associate with acne,” she says, “these become inflamed or infected.” Skin cells naturally exfoliate on their own, but for some people, this process is faster than others, and some people have much oilier skin than others. These individuals will always be more sensitive to fluctuations in hormones or changes in diet and environment.
How to Treat Acne
There’s one big mistake we’re making when trying to tackle acne at home, according to Dr McDonald, it’s “trying to address breakouts rather than prevent them.” Once the acne has occurred, Dr McDonald says there’s a tendency to throw the kitchen sink at the problem. “People fail to realise that drying the skin out, over-cleansing, and failing to moisturise tends to make the skin more prone to oiliness and inflammation, thereby causing more breakouts,” she says.
So what ingredients should you be looking for in at-home care products? Dr McDonald says a daily product like La Roche-Posay, Effaclar Matte Anti-Shine Moisturiser ($36) is ideal, as it contains lipo-hydroxy acid. “The best solution is to find a product that gently breaks down dead skin cells, and unclogs pores while protecting the skin barrier and reducing inflammation. Ingredients like salicylic acid and lipo hydroxy acid, are ideal, as they give skin a micro-exfoliation and clear pores” she says.
Another ingredient English finds exciting is Zinc PCA found in Efflaclar Duo+ Anti-Acne Moisturiser ($36) along with lipo-hydroxy acid. She loves this ingredient because it combines zinc, which inhibits acne-causing bacteria and helps regulate oil production, and PCA. This compound is part of our own skin’s natural moisturising factors. She says, “when combined, the PCA helps the zinc to absorb and work better, plus zinc PCA helps to smooth out skin, which will aid in skin’s recovery.”
These skincare treatments can be paired with hydrating and skin-supportive ingredients, from hyaluronic acid to ceramides, niacinamide and Centella Asiatica. English concurs, “don’t fall into the trap of using an acne treatment serum, cleanser and moisturiser. That’s just attacking your skin at every step — one or two products is enough.”
When Should You See a Dermatologist?
When Should You See a Dermatologist?
“If the period of treatment your GP has prescribed has not worked over eight weeks,” says Dr Rodrigues, the GP will probably refer you to a dermatologist. Another indicator is that while your acne comes and goes — something people often take as an indication their acne is “mild”, the “consequences of the acne remain.” Dr Rodrigues describes these consequences as inflammation, scarring, pigmentation and hyperpigmentation or brown spots on the skin. “It indicates that the acne isn’t as controlled as you might think it is.”
A note on experts:
Dr Michelle Rodrigues is founder and director at Chroma Dermatology, senior consultant at The Royal Children’s Hospital and an Honorary Senior Lecturer at The University of Melbourne. Dr Rodrigues specialises in pigmentary disorders and pigmentary disorders, dermatology in skin of colour (pigmented, brown or ethnic skin) and laser surgery.
Dr Cara McDonald is co-director and principal dermatologist at Complete Skin Specialists. She specialises in skin cancer prevention and treatment, acne scarring, laser, surgical and cosmetic dermatology
Hannah English is a content creator, influencer and pharmaceutical scientist who specialises in breaking down the science of skincare for a consumer audience. She is the author of Your Best Skin: The Science of Skincare, you can follow her on Instagram and TikTok.