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Acne in Older Women

Many women suffer from acne into their 50s

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Updated July 07, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

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Adult acne is more common in women

Garry Wade / Getty Images

If you're frustrated by blemishes you thought you'd left behind in your teenage years, you're not alone.  A 2012 study by Harvard Medical School scientists builds on previous research which found that many women suffer acne into their 30s, 40s and 50s.  Here's a look at how common adult acne is among older women, its causes, and what you can do to treat the problem.

How common is adult acne in women vs men?  Various studies have investigated the prevalence of acne among older adults, and have found adult acne is more common in women than in men, and that it often continues past menopause.  For example, a 2008 study published in the Journal of the American Academy of Dermatology discovered that a quarter (26%) of women in their 40s reported having acne, compared with only 12% of men.  Among those subjects over the age of 50, 15% of women said they still had acne, but only 7% of men did.

Harvard researchers published their study of 2,895 women between the ages of 10 and 70 in the Journal of Women's Health.  Analyzing high-resolution photographs of women from the United States, United Kingdom, Japan, and Italy revealed results similar to those gathered in 2008, with the following percentages of female subjects found to have clinical or well-established acne:

  • 45% of women aged 21-30
  • 26% of women aged 31-40
  • 12% of women aged 41-50

The authors report that mild acne - which they describe as more minor blemishes (involving a small number of comedones or papules - is even more common, persisting throughout adulthood in about a quarter of women and decreasing minimally with age.

What causes acne in older adults?  The primary causes of acne are the same for young and old:

  • Over-production of oil or sebum by the skin
  • Abnormally sticky or abundant skin cells produced within the follicle, forming a plug
  • Proliferation of a normal skin bacteria called p.acnes within the plugged follicle
  • Inflammation of the skin

Additional triggers in older women:  According to the American Academy of Dermatology (AAD), factors that may cause acne in women in their 20s, 30s and beyond include:

  • Hormone fluctuations
  • Family history
  • Stress
  • Cosmetics

What's believed to be a major contributing factor in adult acne in women are the hormonal fluctuations that occur during menstruation, pregnancy, ovarian cysts, stopping or starting birth control pills, and menopause. Hormone imbalances can affect oil production by the skin as well as how effectively skin cells are shed.

Other things can cause adult acne or make it worse include family history: if you have brothers or sisters with acne, you may be more likely to develop it as an adult, according to the AAD.  Stress can boost the production of male hormones called androgens. These hormones - which naturally occur in both men and women - stimulate oil production and can worsen acne. 

In addition, cosmetics like anti-aging creams, sunscreens, or hair pomades and sprays containing heavy oils or perfumes may clog pores and cause acne, typically along your hairline, scalp, or face.  This type of acne can occur later in life and has been dubbed acne cosmetica by dermatologists.

Same old problem, or a new one?  Acne that develops later in life among adults who didn't suffer as adolescents is called "adult-onset", or "late-onset" acne.

Hirsutism, or an excess of facial hair was found to be more common among adult women with acne in the 2012 study. Since hirsutism can be caused by hyperandrogenism, the authors suggest an excess of androgen may be a significant cause of late-onset acne.

Diet plays little or no role in the development of adult acne, according to the AAD.  No food has been identified that can cause, prevent or treat acne.

What you can do about it:  There are simple things you can do on your own to help prevent adult acne and keep it from getting worse.  First, wash your skin once or twice a day with a non-drying, non-comedogenic (non pore-clogging) cleanser, and look for cosmetic products labeled oil-free, non-comedogenic, and non-acnegenic (unlikely to cause acne breakouts).  Avoid heavy skin creams or hair products which may aggravate your skin condition.

When to see a dermatologist:  Whether your acne has persisted since your teenage years, or has appeared as a new skin problem in later life, consider seeing a dermatologist (physician specializing in skin disorders).  A specialist can help you determine the factors which may be triggering your acne, and can help you with prescription medications to help regulate hormones or treat your breakouts without drying or otherwise irritating your aging skin.

Sources:

Acne.  A.D.A.M. Medical Encyclopedia.  Accessed October 30, 2013.
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001876/

Adult Acne.  American Academy of Dermatology Public Information Sheet.  Accessed October 30, 2013.  http://www.aad.org/dermatology-a-to-z/health-and-beauty/every-stage-of-life/adult-skin/adult-acne

Collier CN, Harper JC, Cafardi JA et al. "The Prevalence of Acne in Adults 20 Years and Older." J Am Acad Dermatol 2008;58:56-59.

Perkins AC, Maglione J, Hillebrand GG, Miyamoto K, Kimball AB. "Acne vulgaris in women: prevalence across the life span." J Womens Health (Larchmt). 2012 Feb;21(2):223-30.
http://piel-l.org/blog/wp-content/uploads/2012/05/JOURNAL_OF_WOMENS_HEALTH212223.pdf

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