Dr. Kavita Mariwalla: So, adult acne is actually, in terms of location, very different. When we are younger, our acne tends to be on the central face, and as we get older, it migrates out to the jawline. And interestingly, it tends to be more painful. So, women will complain that they get these cysts, or these painful bumps, that they never really experienced when they were teenagers. A lot of times, women also get something called Perioral dermatitis, which looks like acne, but is a slightly different entity altogether. And that tends to focus around the mouth, the nose, and it’s like little tiny breakouts all around here.

So, we will do different things. We always take a careful history, “What medications have you tried? What is your daily regimen? Are you doing things that are as simple as washing your face before you go to bed?” A lot of times, we are at work, you put on makeup, maybe you don’t wear a lot of makeup, but you put a little concealer on, a little mascara, you run around. “Are you washing your face after you get out of the gym? That’s an easy one to solve. Are you actually washing your face before you go to bed?” And a lot of times, busy people are tired and they do not even take a minute just to wash your makeup off.

So, we go through their lifestyle habits, and then, we also take a look at, “What are the things that you are eating? What are your hours like?” And then finally, “What are the remedies we can do for you?” A lot of times, a low dose antibiotic works really well. Other times, there are things that are not antibiotic options. There are things like Spironolactone, which is a medication normally used for high blood pressure, but actually works on the kidneys, and can alter your hormones a bit to calm that hormonal acne down.

And then, there are things like the redness associated with conditions like Rosacea, which is not acne, and I think a lot of times is a lot of sun damage. There is some new topicals out that help with that redness. And then, of course, there are those sort of standard arsenal we have of topical medications, chemical peels, and then for scarring, things like laser.

The Top Causes of Adult Acne

Doctor Kavita Mariwalla discusses adult acne causes and treatments.