Acne does not discriminate against age, lifestyle, or skin type. It's no longer just an awkward phase you experience in high school, and knowing how to treat acne at every stage will make all the difference. So to help you identify the differences and learn how to treat each one, I tapped board-certified dermatologist Dr. Melissa K. Levin for her knowledge in the subject. Grab a mirror and a notepad, because she has some schooling to do.
Let's start at the beginning. What even is acne?
"Whether you are a teen or an adult, acne happens when a pore in our skin gets clogged. It begins with dead skin cells, then when there is an increase in sebum, or oil, the dead skin cells get stickier and get trapped inside the pore. This results in a whitehead, which is a closed pore, or a blackhead, which is an open pore."
But while all congestion can lead to breakouts, it's not the only cause.
What Is Teenage Acne?
"Teens tend to break out primarily on their forehead, nose, chin, cheeks, chest, and back (locations on the body with a higher concentration of pores and oil glands) due to to the surge in hormones called androgens, which occurs during puberty," explains Dr. Levin. "Androgens cause an excess production of sebum (a waxy oily substance) that can clog pores and increased outbreaks. This can lead to anything from blackheads, whiteheads, papules, pustules, and for more severe causes, cysts and nodules."
What Is Adult Acne?
When you're out of the teenage years, you may picture yourself as invincible from zits, but unfortunately, you're not (don't shoot the messenger). "Fluctuations or imbalances in hormones leads to outbreaks, whether that it’s caused by menstrual cycles, discontinuation of birth control pills, during pregnancy, peri-menopause, or even menopause," says Dr. Levin. "Other causes can include lifestyle or environmental factors such as diet, stress, congestion from skincare products, genetics, over-cleansing or over scrubbing the skin, side effects from medication, or an undiagnosed medical condition." Ouch, so basically anything from your 12-step skincare routine to a taxing morning commute can affect your skin's clarity. Great news.
As for where this kind of inflammation pops up, it tends to be in a very specific region. "In most adult acne cases, it tends to be present with cysts distributed along the chin and jawline," says Dr. Levin. So at least you're (probably) not getting it allover your face?
How Are They Treated Differently?
Since there are different types of acne and various causes, treating them as such is the key to curing your specific iteration.
According to Dr. Levin, it's all about determining the stage and strength of your skin. "Teenage skin is more resilient and has faster skin cell turnover than adult skin, so it responds more effectively to typical over-the-counter acne medications, such as salicylic acid and benzoyl peroxide." Think about those super-strong astringents and potent pimple creams you wielded as a teen — when your skin was able to tolerate the ensuing dryness. "Adult acne can have different causes and is usually more difficult to treat, as it can overlap with other skin conditions such as rosacea, eczema, and other issues." So basically, your skin becomes increasingly drier and sensitive to the products with age, and the harsh pimple creams you once turned to may prove frustratingly ineffective as an adult.
If you're not experiencing the typical adolescent acne, keep in mind that "adult skin is often less resilient." Dr. Levin tells me that adult acne is almost never successfully treated with the same over-the-counter antibiotics that could've been found in your shower back in your high-school days. "Instead, hormonal treatments including birth control pills and spironolactone are commonly used to treat adult female acne," says Dr. Levin.
What if you don't know what TF is happening on your face?
If you're not sure what's popping up north of your neck, consult Dr. Levin's handy explanations.
Acne Mechanica — "Lingering sweat and dirt can clog pores and cause breakouts. In my patients who work out regularly, often times I do see a worsening or new-onset acne, particularly on the chest, back, forehead, or chin, especially if they're wearing a hat, non-breathable clothing, or sports equipment."
Acne Rosacea — "Rosacea is a chronic inflammatory disorder of the face that results redness, inflamed blood vessels, flushed cheeks, thickening of the skin, and sometimes pimples."
Acne cosmetica — "Breakouts caused by congestion from cosmetics such as foundation and powders."
Wow, there's an acne cosmetica? It actually sounds pretty...
The Dos And Don'ts Of At-Home Treatment
"Often times, people overly treat a pimple in order to try to get rid of it, but end up causing irritation to the area," explains Dr Levin. While there is no magic cure for bringing pimples down overnight, there are things you can definitely do to minimize the inflammation. But regardless of how you decide to pummel your pimple, she suggests prepping skin by cleansing and moisturizing first, in order to prevent too much irritation.
Sometimes you can treat acne without spending a dime — all you need is to break out ice cubes or a cold pack. "Ice-cold temperatures can help tighten blood vessels, reduce redness, and relieve swelling. While this is not a permanent fix, I recommend washing your face, wrapping an ice cube or cold pack in a paper towel, and gently icing the pimple three times in an hour for 10 minutes each time." How's that for an actually free fix?
In addition, a topical retinoid such as Differin Gel can help to both quickly shrink a zit and prevent it from occurring at all. The formerly prescription-only treatment functions as a daily pimple check, by encouraging cell turnover so nothing icky gets trapped underneath your skin. Even better: it helps soften fine lines and wrinkles, so if you're tackling acne as well as the early signs of aging, you're one and done. Peek over the Differin website to snag a coupon for the stuff, which is already moderately priced.
If you have a bad habit of picking at your skin à la Dr. Pimple Popper, know that popping comes with its own set of issues. "That can often worsen the breakout, increase inflammation, and even cause scarring!" warns Dr. Levin. If you really can't control yourself, at least be sure to tread with caution. "If the pimple has a yellow head, you can use two clean Q-tips and gently apply pressure on the sides. If the pimple is released easily, you can continue, but if nothing comes out, stop and put those Q-tips down." Step away from the Q-tips, friend.
The moral of the Great Acne Story is, you first need to pay attention to what exactly your skin is trying to tell you — and then be prepared to adapt your plan of attack.