The real reasons we get adult acne and how to treat it

In recent years, trends seem to be recycling from earlier decades, when some of us were in our teenage years. Fashion trends and entertainment from that time of your life are welcome, but probably not the acne you experienced as a teen.

But acne is not just for teenagers. It affects 40 million to 50 million Americans a year, many of whom are adults. It is the most common skin condition and can occur on the face, chest, and back. Women are affected more by acne, making up 80 percent of all adult cases.

Below are the answers to some common questions I get from adult patients about their acne:

Does food cause acne?
It depends. A popular rumor is that chocolate causes acne, but it is not always true. We do know that high glycemic diets, those that are high in sugar, cause acne. It is important to monitor your sugar intake and try to cut out unnecessary sources of sugar in your diet if you suspect that could be the cause of your pimples.

What about hormones in milk?
Milk is an excellent source of calcium and good for a balanced diet, but drinking an increased amount of dairy can cause acne due to the artificial hormones cows are treated with. This can throw your own hormones off balance.

Does my menstrual cycle cause acne?
The fluctuation in hormones during menstruation can cause acne. Birth-control pills can help to regulate hormones. Another secret weapon: Spironolactone is generally used to treat high blood pressure, but dermatologists have adopted it to use as a treatment for adult female hormonal acne. It is an androgen blocker and women with hormonal acne either have too much androgens or are too sensitive to them.

My friend found a great cream that works for her. Can I use that?
It is best to tailor treatments based on the specific cause for your acne, and even then, different agents are used to treat different forms of acne. So while your friend may have found a miracle cure for her, it may not elicit the same results for you.

How do I know if I need a topical cream or an oral medication?
For mild acne, we typically prescribe topical retinoids, topical antibiotic creams, and benzoyl peroxide washes. For more moderate acne, we prescribe oral medications, such as antibiotics.

For severe, cystic acne, we use an oral retinoid, isotretinoin (Accutane). Accutane has many risks that should be discussed at length with your physician, but it can be very effective.

Are there other types of treatment?
There are also lasers we use to help treat active acne. They work by destroying the bacteria, calming inflammation and helping shrink the oil glands. Treatments are quick and often painless and allow you to go back to regular activity the same day.

Acne is incredibly common, yet can be difficult to target your direct cause and best course of treatment. Talk with a dermatologist about how you can best fight acne to reveal smooth, healthy skin.

Nazanin Saedi, M.D., is a board-certified dermatologist at Thomas Jefferson University Hospital, and an associate professor of dermatology at Thomas Jefferson University. She is the director of the Jefferson Laser Surgery and Cosmetic Dermatology Center.