New York's Top Dermatologists Offer Answers for Adult Acne

If you’re an adult in New York City struggling with your complexion, (construction on every corner, muggy subway platforms, and city pollution don’t bode well for breakouts) you’re not alone. New York’s top dermatologists confirm that women in their 20s and 30s are experiencing adult onset acne in record numbers. You might wonder, what’s the big deal about a couple of blemishes? I’ll say it: zits have the power to destroy your self-image.

If that sounds dramatic, you must be one of those people who never breaks out. Acne, even with the best concealer, can make you feel like a teenager (in all the wrong ways), infantilizing you while you’re trying to do this adult thing.

Acne can take your beauty game down a notch—in your mind’s eye, at least. It’s true, a pimple can make even the most beautiful woman feel ugly, marred, dirty, and like she doesn’t care about her hygiene. None of these things are true, but that doesn’t mediate your feelings around breaking out as an adult. So, here’s a guide to help you navigate what it’s like to live with and manage adult acne, with advice from New York’s most prominent dermatologists.

New York Dermatologic surgeon, RealSelf Contributor Dr. Sejal Shahexplains why so many adults these days are breaking out. Unfortunately, adults who suffer from acne break out for the same reasons as teenagers. “The four main causes of acne, in both adolescents and adults, are oil production, dead skin cells, bacteria, and inflammation.” However, as Shah says, adults might have to contend with other challenges to clear skin. She adds, “There are a number of other factors that may be influencing acne in adults, such as hormones, diet, stress, environment, medications, friction/pressure (e.g. from clothing, athletic equipment), certain supplements, and skin and hair care products.”

According to Shah, here are the four different types of adult acne that don’t differ from the types of acne adolescents get.

1. Comedones: includes both blackheads (comedones that are open at the surface of the skin) and whiteheads (comedones that are closed at the surface of the skin)
2. Papules: inflamed pink or red bumps
3. Pustules: another type of inflamed acne lesion, it basically looks like a papule that has come to head or a papule with a whitehead on top and is filled with pus
4. Nodules and cysts: painful, large, inflamed bumps that are deep in the skin; cysts are typically pus-filled whereas nodules are not.

OK, we’re talking pimples, not a life-threatening disease. However, acne can wreck havoc on your self-esteem, leading you to wonder the futile and self-pitying question: “Why me?” RealSelf Contributor Dr. Michele Green,another prominent New York dermatologist, explains why certain people wrestle with achieving a clear complexion while, for others, flawless skin is a given. “There are both genetic and hormonal reasons why people tend to break out with acne,” says Green. “Acne tends to run in families.”

The good news is that, as an adult, you’re likely to have resources to help you deal with your breakouts. Green advises you seek a doctor’s care so you don’t waste money on the myriad products out there without scientific proof to back up their efficacy. She says: “Products can help manage adult acne by drying out current breakouts and cleansers and toners and gels like Differin gel to prevent acne breakouts. Products with salicylic acid and benzoyl peroxide gels can also help to manage current acne as well as oral and topical antibiotics and topical Retinoids and Accutane.”

And, over the past decade, lasers have come a long way in reducing both live acne and acne scars, leaving patients with more options. Says Green, “laser procedures such as the V-beam Laser helps to treat acne and the redness that is caused by acne. Lasers such as Fraxel and eMatrix help treat patients with acne scars. The Blu light helps treat acne patients and destroy acne after a few sessions.”

Yen Reis is founder of Skin Laundry, a skin and lifestyle company that offers laser care with a series of non-invasive light treatments to help adults control skin flare-ups. Skin Laundry also makes pillowcases made with silver ion technology to fight bacteria while you sleep, keeping bacteria off your face for up to 10 days.

Plus, as a Hong Kong native, Reis designed a laser that works for all shades of skin. This is a big deal because not all tones of melanin require similar treatments. “Laser treatments can drastically improve active acne and can also help manage, control, and prevent future breakouts,” says Reis. “LASER, which stands for Light Amplification by Stimulation Emission of Radiation, is a way to delivery energy to the epidermis and dermis. The application of energy not only vaporizes dirt and impurities from the skin, but also aids in healing and rejuvenating skin. Intense Pulsed Light, or IPL, targets redness, pigment and inflammation, which improves the appearance of acne as it heals.”

So, you’ve broken out. Now what? The impulse might be to hide out at home but, as an adult, you have to face the world. Makeup is out there to help conceal acne. Here’s what Green recommends: “Oil free, non-comedogenic makeup is what is best to conceal acne. Some even contain some blemish or spot control ingredients like benzoyl peroxide and salicylic acid.”

There are times in a woman’s life when she starts to panic. One of these times happens to be when she feels a monster pimple “sprouting” under her skin. You want to pick it, but know that is the worst thing to do for a burgeoning blemish. Here’s what Green advises: “The best thing to do if you have a pimple coming is to use a drying lotion and cleanser and apply a topical antibiotic ointment. If it is a large cyst you should consult your dermatologist for a cortisone injection to prevent scarring.”