Your most pressing questions about adult hormonal acne answered by experts

I'm a 20-year-old who has been dealing with acne since my teenage years. I always hoped that my skin would eventually clear up, but unfortunately, it's still a problem for me. Dealing with acne can be confusing and frustrating, as I've tried numerous remedies, even resorting to some ineffective ones (I'm looking at you, toothpaste on pimples).

Hormonal acne, in particular, can be incredibly painful due to constantly fluctuating hormone levels. It's unclear why these hormonal changes lead to skin breakouts, but dermatologists have shed some light on the subject. Keep scrolling for more insights!

What are the main causes of adult acne?

“The causes for adult acne are similar to those in teenagers i.e. blocking the oil glands which leads to inflammation and acne. Adults can get acne in their 20s, 30s even 40s and 50s! Fluctuating hormone levels are a major cause of acne in adult women. This is seen around their period, menopause or even if they start or stop hormonal medications like birth control pills. Additionally, stress can also cause acne due to raised levels of androgens during stressful periods. If you have a relative who has adult acne, chances are that you could also get adult acne. Few skincare and haircare products can also cause acne known as acne cosmetica and pomade acne, respectively,” says Dr Manasi Shirolikar-Bansal, consultant dermatologist and founder of online skincare consulting brand www.drmanasiskin.com

What are the causes of body acne and how does one fix that?

“Our body also has the same oil glands as our face. Therefore it is also prone to getting acne in a similar fashion. Additionally, body acne can also be caused if you are exercising and not having a shower afterwards. Or wearing tight clothing leading to compression of the glands along with sweat and bacteria. Hormones can also aggravate body acne. Use body washes or soap with salicylic acid or benzoyl peroxide. Treat Dandruff, if any. Jump in the shower immediately post workout,” Dr Shirolikar-Bansal explains. 

What causes adult acne and is it typical?

“I wish there was a magical age when acne would stop. But acne is seen in babies (known as neonatal acne) to even 90 years old! Causes of acne are multi factorial—from stress to lifestyle to diet and ofcourse your skin type, genetics, skin care products, hormones, family history—all have a role to play! If your acne is not getting treated by over-the-counter products, do consider visiting a dermatologist,” Dr Shirolikar-Bansal points out. 

Would you say hormonal acne is often caused by excess testosterone? What kind of diet should one have to improve hormonal balance?

“Hormonal acne is due to androgen excess and testosterone is also one androgen, others being Dehydroepiandrosterone (DHEA), DHEA sulfate (DHEA-S) and Dihydrotestosterone (DHT). Diet devoid of milk will help in improving hormonal acne. Milk should be avoided and butter milk, curd, cheese, butter should only be consumed in moderation. Diet with low sugar will help in acne as well. Sugar increases IGF (Insulin like growth factor), which in turn increases oil secretion from sebaceous glands, causing more acne,” says dermatologist Dr Aanchal Panth. 

What should people know about acne scars?

“Scars form due to an exaggerated reaction or inflammation around an acne caused by frequent touching or popping the acne, delaying treatment, inappropriate methods of treatment or usage of harsh products. Seeking advice from a dermatologist and getting early treatments for acne help in preventing scar formation. Once formed, they are difficult to treat and may take six to eight months. While black, brown or red spots can be treated to a great extent with topical products, pits and skin and elevated scars need in-clinic treatments like lasers,” says Dr Saloni Vora-Gala, senior consultant dermatologist and cosmetologist at Dr. Rekha Sheth’s Skin and Hair Clinic, Mumbai.

What chemical treatments/skin care ingredients do you recommend for acne?

“Routine usage of skin care basics to help in skin repair is a must and this includes using a cleanser twice a day, moisturizer application twice a day and applying a broad-spectrum sunscreen with SPF 30 or more and PA++++ every 3 to 4 hours in large quantities. Besides this, products with ingredients like 2 to 6% salicylic acid, 2.5% benzoyl peroxide, azelaic acid, niacinamide, retinoids help in resolving acne. Instead of spot treatments, treating the entire area works better. I recommend seeking a dermatologist’s advice before starting any of these. In-clinic treatments like chemical peels, light therapies and carbon laser therapies work very well in treating acne,” Dr Vora-Gala adds. 

How to treat hormone related acne?

Dr Vora-Gala points out that hormonal acne is best treated with thorough skin examination and blood hormone investigations followed by appropriate oral as well as topical medication. In-clinic procedures are a great addition in such cases. “Along with this, required lifestyle modifications have to be done. It may take up-to a year to bring acne under control but patience and consistency does help,” she adds. 

Apart from seeing a dermatologist, how does one address the root cause?

“A well-balanced lifestyle is the best medicine to address the root cause of acne and for long term maintenance. One must sleep early and for seven to eight hours at the least. Exercise for 45 to 60 minutes daily to have a control over one’s imbalanced hormones. Keep a check on your weight; make sure is it under control. A well-balanced diet is a must, which includes eating fruits, green-leafy vegetables, adequate amounts of protein-rich foods daily, while avoiding excessive sugar and processed food intake. Avoid alcohol and smoking and hydrate well,” Dr Vora-Gala advises.