Dr. Adam Wallach, Board-Certified Dermatologist with Skin Cancer & Dermatology Institute, Shares His Insights and Tips on Managing Adult Acne

Dr. Wallach, shares his top tips for managing one of the most pervasive skin conditions in America.
Dr. Wallach, shares his top tips for managing one of the most pervasive skin conditions in America.

Growing up and experiencing puberty is a challenging time for most of us. Once we grow out of that stage, we often believe we are beyond acne breakouts, and then in adulthood, we notice something a little too familiar to us, a pimple on our face. According to the American Academy of Dermatology, “adult-onset acne” can affect many adults in their 30s, 40s, and 50s. Skin Cancer & Dermatology Institute’s, Dr. Wallach, shares his top tips for managing one of the most pervasive skin conditions in America.

Q: Is adult acne the same as teen acne?

A: In some sense, acne is acne, regardless of age. Teenagers develop acne as a result of both genetics and surging hormones that stimulate the sebaceous glands, leading to a higher production of sebum, an oily substance produced by the sebaceous glands. In adults, there can also be hormonal underpinnings, especially in women. Genetics often play a role as well, especially when a person’s acne has been ongoing beyond the teenage years.

Q: Why do we get acne as adults?

A: Hormonal fluctuations relating to the normal menstrual cycle and the use of estrogen supplementation or birth control, make the incidence of acne in adult women more common than for men. Men can have acne into the third to fifth decades when they are genetically predisposed. For some, adult acne can be caused by an underlying medical condition such as polycystic ovarian syndrome or an endocrine disorder.

Q: I wash my face twice a day, why do I still get blackheads? 

A: Blackheads or comedones are the most basic form of acne arising from the plugging of the follicular sebaceous unit with oil, dirt, and skin cells. Washing with certain cleansers that contain salicylic acid and benzoyl peroxide can help prevent blackheads as can retinoids like Retin-A or tretinoin.

Q: Can my makeup cause breakouts and what should I look for in makeup products?

A: Oil-based makeup can certainly contribute to breakouts. If you are looking to avoid oil in makeup, there is a simple test you can perform: place a drop of your makeup on a Kleenex tissue overnight; in the morning see if there is any oil residue on the tissue. If there is no residue, there is no oil.

Q: Do certain medications cause breakouts?

A: Most common medications do not cause acne. In some cases, medications can be acnegenic and cause a breakout. The most common of these are Lithium, used to treat manic depression, as well as testosterone and anabolic steroids.

Q: Is stress a factor in adult acne?

A: Stress can certainly make acne worse. On its own, it is unlikely to be the sole cause.

Q: When it comes to food, do certain items trigger breakouts?

A: Western medicine does not traditionally support a food-triggered notion of acne. Oily foods do not generally make acne worse, although having a poor diet composed of fast foods does put additional stress on the body and deprives the body of nutritional support. On rare occasions, some people report a clear connection between the ingestion of certain food and the resulting acne breakout. The American Academy of Dermatology shows numbers from different studies that might suggest that a low glycemic diet and not drinking cow’s milk may help with fewer outbreaks, though they emphasize more research needs to be done.

Q: What is the best way to treat adult acne? Which products do you recommend everyone include in their daily skin care routine?

A: Adults are treated much the same way as teenagers in that the degree of breakout and the type of skin determines which medication and medication strength should be used. A simple acne-fighting skin care regimen for adults might be a gentle salicylic acid (SA) based cleanser (willow bark is a natural source of SA) along with 1% adapalene cream, now found over the counter, mixed with your favorite light night cream. If this simple program does not help, then come see us. Some people will benefit from peels or light treatment, such as Sciton® BroadBand Light (BBL)™, while others require systemic treatments like oral antibiotics, Spironolactone or Isotretinoin.

Q: If we pick at our face a little too much, resulting in acne scars, what treatment options are available to help minimize them?

A: There are various options offered at medical clinics, including ours, to help with acne scarring. These include microneedling and laser treatments such as Cartessa’s Quanta EVO Light™ Elluminate, Fraxel®, and Sciton.

About Our Dermatology Provider

In private practice since 1997, Dr. Wallach treats patients at Skin Cancer & Dermatology Institute’s Truckee location. He diagnoses a full range of dermatologic problems for both adults and children, specializing in medical and cosmetic dermatology, including the use of various lasers over the last 25 years. He is a strong proponent of patient education in his practice and is the contributing author to the chapter on the skin in the new highly reviewed book, The 21st Century Man. Dr. Wallach and his family live in the North Tahoe area. Get to know Dr. Wallach and book an appointment online here.

Bringing you patient-centered, world-class dermatological care with ten locations in the Reno-Tahoe area. Skin Cancer & Dermatology Institute specializes in Medical Dermatology, Mohs Skin Cancer Surgery, and Cosmetic Dermatology.

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