Acne, acne scarring, beauty, mens treatments, scars, Treatments, Your hormone doctor

Adult acne: An update

Acne is widely perceived to be a teenage issue, but late-onset or adult-acne is becoming increasingly common in women in their 20s, 30s, 40s and even 50s.  I’ve had patients of all ages come to me suffering from acne. Not only can it be painful, but it can cause confidence issues and lead to scarring.

Whenever your body experiences a spike in ‘male’ hormones such as testosterone, oil production increases—and that can cause a clogged pore where propionibacterium acnes (slow growing) bacteria develops, leading to inflammation and pimples. This may occur more frequently during perimenopause, but it also happens just before your period.

The first part of a woman’s cycle is mainly under the control of estrogens, whereas the second part (after ovulation) is mainly under the control of progesterone. Excess of, or lack of both will lead to irregular periods, pre-menstrual syndrome, acne, and as you get older perimenopause and then menopause. It’s those hormones stirring it all up; so finding the right balance that works for the individual to control them is essential. This also applies to men.

Whatever your age it’s worth speaking to a doctor about hormone testing if your symptoms are bothering you. Bio-identical hormones, creams and certain supplements can then be prescribed for your individual needs. Some woman benefit from being on the birth control pill, but every woman is an individual and no one prescription fits all.

It’s worth mentioning that there can be other causes of adult acne. Poor hygiene is one, and skin needs to be thoroughly cleansed twice daily to be sure that this is not the issue. Cosmetics and skin creams can also be a problem. If cosmetics are not totally removed at night they will clog pores causing spots, if skincare creams are too thick they will also sit in pores causing blockages.

Food intolerance and/or allergy can also cause acne. Mobile phones can also be an issue, and anyone finding their acne is mainly on one side of the face and near the chin should ensure they clean their phone regularly.

There are four main ways in which I would treat acne, but with each patient I’d start with a set of blood tests, take a full history and discuss diet and lifestyle, in order to help determine the underlying cause.

1) VI Peel – The VI Peel is one of a new generation of chemical peels; it gives dramatic results with a far shorter downtime that conventional peels and I have a specific protocol for using the VI Peel to combat acne. The process will need to be repeated twice, but the results on my patients have been incredible. Plus, unlike many other peels, it can also be used on darker skin types.

2) Hormone balancing – The results of your blood tests will give us an indication as to whether hormones are to blame for your acne. There are a number of possibilities, including high levels of testosterone, low levels of progesterone and polycystic ovarian syndrome (PCOS). If I believe that hormones are the cause of your acne, we’ll look to rebalance your hormone levels with medication, supplements and nutritional advice.

3) Spironolactone treatment – The drug Spironolactone is an agonist of androgen receptor that can be used to treat hormonal acne. It’s similar to Roaccutane, but I find it to be without most of the side-affects. Again, the results of your blood tests will determine your suitability for this course of treatment.

4) Dietary advice – Changes to our diet can radically affect the way our skin behaves. At your consultation we’ll discuss your current diet and I’ll offer advice on any changes you can make that will have a positive effect in your skin.

If you want to know if I can help you tackle adult acne, or if you have questions about any of my other treatments, please get in touch. You can comment on this blog post, email me at, tweet me @DrDanielSister, or find me on Facebook. I look forward to hearing from you.

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