Thinking the pimply teen years were in the rearview mirror, many adults are often unpleasantly surprised to see acne appearing in their 20s, 30s, 40s and even 50s.
Dermatologists have noticed that adult-onset acne is increasingly common for men and women after adolescence, with recent studies finding that acne affects more than 50 percent of women between the ages of 20-29 and more than 25 percent between ages 40-49.
As blemish sufferers wonder “Why me?” and search for solutions, dermatologists point to a variety factors, from genetics to habits to environment, that could be causing adults to develop more acne.
The mechanics of acne are simple. Acne results from the interplay of three factors: hormone-stimulated increases in oil secretion; obstruction of the hair follicles; colonization of the follicle resulting in infection and inflammation. How these factors interact isn’t completely understood by dermatologists, but many studies indicate genetics is a good place to start.
Just like blue eyes and curly hair, acne has a hereditary component. Familial and twin studies demonstrate that genes are significant in determining factors that can lead to adult acne, such as oil secretion. One study found the risk of adult acne was significantly greater in people who had parents and siblings with acne. The researchers concluded that genetic factors help determine the inability of acne-prone follicles to evolve and resist acne in later life.
Genes also control the hormones that can affect the development of adult acne. For example, hormones called androgens can over-stimulate oil glands and lead to blemishes around menstruation while the hormone progesterone can do the same during pregnancy. While annoying, the blemishes usually do not continue beyond menstruation or pregnancy.
Blemishes caused by genetic factors may just be part of living. However, researchers have a growing concern that environmental elements, including endocrine-disrupting chemicals. From soda bottles to cash register receipt paper, both both man-made and natural substances are mimicking the hormonal signals that guide basic bodily functions and might one day be labeled a factor in increased instance of adult acne.
Scientists point to growing evidence linking endocrine disruptors to human health problems. These include infertility, low sperm counts, breast cancer, genital deformities, early menstruation and even obesity and diabetes. (Some of the chemicals of concern include ingredients in plastics that touch our food (including bisphenol A (BPA)), polychlorinated biphenyls (PCBs), DDT and other pesticides, dioxin and dioxin-like compounds.)
Of course, we can’t remove ourselves from the modern world and industry groups like the American Chemistry Council cite several of their own reports, including their testimony before the U.S. Congress, which dispute that substances such as BPA pose a risk to humans.
Long discounted by dermatologists, the link between diet and adult acne is receiving new attention. One recent metastudy of 27 other studies found that eating a diet rich in high-glycemic index foods, those that are highly processed and are high in white flour, might be tied to acne breakouts. After the subjects in some of the studies followed a low-glycemic-load diet rich in whole grains, fruits and vegetables, researchers documented decreases in blemishes.
Another study of two isolated, non-Westernized populations that ate a diet rich in low-glycemic-load foods found little if any presence of acne. Researchers assert that the hyperinsulemia, or excessive levels on insulin in the blood, related to a diet of high-glycemic index foods can affect the development of acne by influencing changes in follicle cells and androgen- mediated oil secretion.
Jennifer Burris, a nutrition researcher at New York University and one of the author’s of the more recent metastudy, likened eating the link between high-glycemic foods and acne to a “domino effect”—foods that spike blood sugar increase hormones, hormones stimulate oil production and excess oil production can trigger acne.
It’s not a coincidence that people suffer breakouts before big events such as weddings and job interviews. The stress caused by these events raises levels of cortisol, nicknamed the “stress hormone,” which can cause oil glands to work overtime and increases inflammation.
One study of university students found a direct relationship between stress around tests and exams and worsening of acne. Furthermore, the severity of the acne outbreak correlated highly with increased stress. In addition, some experts point to the increase in women working outside of the home and experiencing stress at work and home as a factor in increased levels of adult acne.
Acne can even worsen overnight. Experts know lack of sleep due to travel or a busy schedule can raise levels of cortisol and lead to breakouts.
Skin experts also note other lifestyle factors as causes for increased adult acne.
Most men and women who suffer with adult acne can see their lives reflected in the aforementioned causes. While the ability to change one’s genetic makeup isn’t possible yet, many of the other factors that could be causing adults to develop more acne can be managed.