• When most people think of acne, images of high school students and teenage angst come to mind. However, acne is also a problem for many adults. Adult Acne is a form of mild to moderate acne experienced by men and women in their 20s to 40s. Adult acne is not to be confused with clogged pores or congested skin. Congested skin is characterized by blackheads and whiteheads – with no signs of inflammation or infection. It does not become an acne lesion until the blocked pore becomes infected and inflamed.

    Although the causes of Adult Acne are unknown, there are a few possible triggers: overtreatment (from cosmetic procedures or skin care topicals), cosmetics, stress, hormones, a nutrient-deficient and overly processed diet, and an increase in resistant bacteria.

    Our recommendations for Adult Acne include treatments that not only help with breakouts, but also help combat some of the signs of aging as well. These include Alpha Hydroxy Acids, Retinols, Anti-inflammatories, and Salicylic Acid. To kill bacteria, we recommend the use of Sulfur or Mandelic acid over the use of Benzoyl Peroxide due to its pro-oxidative effect on the skin.

    When treating adult acne, special care must be taken to not overstrip or overtreat the skin as this can deplete the natural lipid barrier and leave the skin vulnerable to additional infection and further breakouts. One suggestion would be to use a cleansing oil at night. They are more thorough at removing makeup and sunscreen, without using harsh surfactants, and can actually help dissolve blackheads and clean out clogged pores. It may involve some trial and error before finding the right formula for you, as some may cause breakouts – but once you do, you will notice a big difference in the overall health of the skin.

    It’s possible that the acne is being caused by a product within your existing skin routine – by either the makeup, sunscreen, or other skin care products. It may be worth doing a trial run for a week or two with just a very basic routine consisting of a gentle, non drying cleanser at night – and no foundation or sunscreen during the day. If the breakouts subside or do not get worse, then something in your routine is causing or exacerbating the problem. Switching from traditional cosmetics to mineral makeup and using a zinc oxide sunscreen rather than one that relies on chemical filters (such as avobenzone and oxybenzone) may help.

    If the breakouts do not subside and/or get worse, start constructing your acne care routine by first adding an exfoliant – either an alpha hydroxy acid, salicylic acid, or retinoid (prescription-strength or over-the-counter). Do not add an entire routine of exfoliants, just choose one product to add – either a cleanser, toner, treatment, or moisturizer. You will have a greater chance of success if the product you choose also has either anti-inflammatory or antibacterial properties. Then, use this product for a minimum of six weeks before deciding to switch products or add additional treatment options. The one exception to this rule would be a spot treatment to treat new acne lesions once they appear.

    After six weeks, if additional therapy is needed, try adding an antibacterial agent to the routine – Sulfur, Mandelic Acid, or a botanically derived ingredient.

    Last, but not least – do not forget to moisturize – especially when you are on an exfoliating routine. Moisturizers help the skin to recover after an exfoliating treatment so it is better able to ward off additional infection.

    Antibacterial Agents for Adult Acne –

    Mild, but effective is the key to selecting an appropriate antibacterial treatment for adult acne.

    Sulfur – Sulfur is mildly exfoliating and as well as anti-inflammatory and antibacterial. Its mild, non-irritating nature make it an ideal therapy in the treatment of cystic acne, where irritation can only further inflame the breakouts. Sulfur is sometimes combined with sodium sulfacetamide – which enhances the antibacterial properties of sulfur and improves results. Despite its benefits, sulfur has not become popular as a mainstream acne treatment due to its unpleasant smell and difficulty to formulate into cosmetically elegant leave-on treatments. This is why it is usually relegated to cleansers, masks, and spot treatments.

    Mandelic Acid – Mandelic Acid is an alpha hydroxy acid with antibacterial and lipid-soluble properties. It can penetrate the pore and kill bacteria, while improving exfoliation in the skin. Used as an oral antibiotic in the medical industry for the treatment of urinary tract infections, mandelic acid is safe enough for ingestion and is safe for use during pregnancy.

    Botanical Extracts – There are a wide variety of antibacterial agents found in various plants from around the globe. Many of these extracts have other beneficial properties that help reduce redness, relieve pain, speed healing, and prevent free radical damage.

    Echinacea – A potent antibacterial and healing agent, Echinacea is useful for the treatment of burns, insect bites, psoriasis, eczema, and acne.

    Olive Leaf Extract – Olive leaf contains nearly 100 phytochemicals and essential nutrients for the skin. It is a potent anti-fungal, antiviral, and anti-bacterial agent that is growing in popularity as a natural anti-acne ingredient.

    Turmeric – Turmeric is a flowering plant from South Asia with antioxidant, anti-inflammatory, antiseptic, and anti-bacterial properties. Its healing properties and skin lightening properties make it useful for preventing and fading acne scars.

    Grapefruit Seed Extract – Extracted from the driend, ground seeds and pulp of the grapefruit, Grapefruit Seed Extracts is a natural preservative with antibacterial and anti-fungal benefits. Its astringent and acidic qualities make it particularly useful in the treatment of oily skin.

    Lavender – One of the most versatile of plants, lavender is both soothing and antibacterial and is useful in a wide range of treatment products ranging from eczema to acne. Lavender is also balancing – and helps to prevent the oversecretion of oil in the skin.

    Myrrh – A small tree native to Somalia, myrhh is both antifungal and antibacterial.

    Neem – Used extensively as a medicinal herb in ancient, Indian civilizations, Neem leaf is a potent antifungal and antibacterial agent that works on several prominent bacteria strains, including P. Acnes. It is also a pain reliever and anti-inflammatory.

    Oregano – Perhaps one of the most potent antibacterial herbs known, it is also extremely effective at reducing inflammation and redness.

    Witch Hazel – First used by the Native American Indians, Witch Hazel is soothing, anti-inflammatory, anti-fungal, and anti-bacterial. It is a free radical scavenger and its anti-oxidant properties make it a common ingredient in anti-aging treatments as well as acne treatments.

    St. John’s Wort – Both anti-inflammatory and antibacterial, St. John’s Wort soothes the skin while preventing breakouts and bacterial infection.

    Sea Buckthorn – Sea Buckthorn extract a natural anti-bacterial, antioxidant, and analgesic treatment that is rich in vitamins, antioxidants and skin emollients.

    Peppermint – Peppermint extract has an immediate cooling effect on the skin and is used in acne preparations to relieve inflammation and redness, as well as for its antiseptic and antibacterial properties.

    Tea Tree Oil – A popular acne remedy, Tea Tree Oil is naturally antiseptic and antibacterial and is effective against bacteria, fungi, and viruses. It also reduces redness and inflammation – speeding the healing process.

    Exfoliating agents for Adult Acne – Exfoliation is key when it comes to preventing and treating acne. The trick is finding the right exfoliant that works for you without causing excess irritation or dryness. Since retinoids and retinol are one of the most effective anti-aging ingredients on the market – and an effective acne care treatment as well, we first recommend starting off in search of the right retinoid for your skin. If your skin is too sensitive for any retinol or retinoid treatment, start off with an alpha hydroxy acid (preferably lactic acid or mandelic acid since they are less irritating).

    Retinoids and Retinols - Retinoids stimulate cell division and increasing cell turnover and exfoliation in the skin and within the follicle, preventing hyperkeratinization that contributes to clogged pores. They also help moderate sebum production, reduce the skin’s inflammation response, and kill bacteria. Retinoids – both prescription and over-the-counter – can cause irritation and sun sensitivity, so finding the right treatment can take a lot of experimentation and patience.

    Salicylic Acid – Salicylic acid is a beta hydroxy acid that works on the surface of the skin and directly within the pore to soften keratin and encourage dead skin cells to slough off and exfoliate. It is also anti-inflammatory, which helps reduce swelling and redness. It can be found in over-the-counter topicals in concentrations from 0.5-3%, though most treatments do not go above 2%.

    Alpha Hydroxy Acids – Alpha Hydroxy Acids create skin exfoliation originating in the dermis, whereas salicylic acid works on the surface layer of the skin. AHAs loosen the bonds that hold dead skin cells together – so they slough off more easily and readily once they reach the skin’s surface. Choosing a more gentle alpha hydroxy acid such as lactic acid or mandelic acid may help alleviate some of the irritation associated with AHA use.

    Enzymes – Enzymes, as used in skin care treatments, are protein-dissolving agents that digest dead skin. Their ability to immediately and effectively remove dead skin from the surface make them a useful adjunct therapy in the treatment of acne. A weekly enzyme treatment will help improve penetration of acne topicals and increase their effectiveness.

    Anti-inflammatory agents for Adult Acne – Inflammation is not only a central factor in acne breakouts, it is also one of the causes of aging. Adding an anti-inflammatory ingredient or product into your routine will not only help reduce the redness and size of your breakouts, it will also help prevent aging caused by inflammation.

    For more information on anti-inflammatories and a list of anti-inflammatory ingredients, click here to read the Anti-inflammatory article.