Skin cleanse: how to treat adult acne

How to treat adult acne

Sarah MorganBeauty, How to 44 Comments

ACNE, spots, pimples, zits, black heads,

These terms usually bring to mind spotty, greasy teenagers who have a voice breaking or just trying on their first training bra … you don’t usually think of a 20-something (somewhat) professional , or dare I say it corporate (why not, you don’t know my CV) woman.

Well you should! Shame on you.

Adult acne is a serious condition, which is seriously taking over the world.

Well maybe not the world but I would call it an epidemic … well I can because this is my blog post.

While at school I was one of the lucky ones who would occasionally get a spot here and there but nothing major. I had friends who really suffered from pizza face syndrome as we called it.

But as we all went on to finish school and head off in our directions; the amount of Clearasil seemed to drop off the shopping lists.

Skin cleanse: how to treat adult acne

Photo: credit

That was until I hit 23. Now most people don’t think of 23 as a substantial year. I mean it’s not 21 or 30, or even 40.

It’s a really nothing year when it comes to milestone years. But for me it was the year of hell. I started to get really bad acne and my skin started to look I was a star in one of those movies which has horrible flash back scenes complete with horrible metal braces, puffy shirts and scrunchies.

And it’s got worse from there as I’ve started to approach my 30s. Over the past seven years I’ve spent hundreds (and then more hundreds) on ointments, lotions, treatments, appointments with skin specialists, facials (and not those soothing types with the background Enya music playing), microdermabrasions, chemical peels, tablets – you name it, I have tried it.

I even waited for three months for a meeting with a dermatologist who spent the 20 minute appointment , where he walked around the chair studying my face and speaking into his Dictaphone about the “client” rather than actual talk to me. And then when I dared to ask him questions he said “ok take these ointments and come back in six months now that’s $250”. Did I mention the said ointments than cost me $80 per piece and of course I must have three of them – as part of a three part step.

And then on the other side of the coin, I have also spent a ridiculous amount of money on make-up, which let the skin breathe (I mean really how much breathing do they do to do – have you ever seen skin die of lack of oxygen?) but didn’t cope too much with my natural oil (touchy little things those oil ducts) or even cover everything like I’m a drag queen going out for a night in the Valley.

Our bathroom cabinet is covered in all the failed attempts. I could have seriously bought a new face if I combined all the money spent on every new ointment and treatment that hits the market.

Once when travelling around the Philippines for a work trip, I was so desperate that I listened to an old woman who told me to rub the skins of paw paw on my face.

Wasn’t a pretty sight as I sat in the worst humidity on a bustling street of regional Philippines with a woman who couldn’t speak a word of English and me with paw paw caked on to my skin.

Needless to say, apart from attracting a lot of flies and dogs for the next two days, it didn’t fix the problem.

Then the world changed (insert a lightning bolt here, a light bulb being turned on, a cloud moving and showing God’s face – any cliché you can think of) and I found a paramedical skin therapist Melissa Ling (at Cozimedics), who knew what she was talking about, mainly because she was my age and had been through the same thing. She didn’t have the nerve to look at me and say “it’s just hormonal spots, they will clear up, or maybe lets change your contraception pill for the million time”.

She actually looked at me and said, “this sucks – let’s do a combination of things”.

The first thing that came out was that adult acne is not so much pimples, they are often cystic, which means they form lumps under the skin. These cystic pimples can scar badly and the worst thing (I found out for me) was to reach for the soap as it only removes surface oil. And that I shouldn’t use a moisturiser as my skin is oily.

After discussing this with Mel (or my Skin God a I now call her), it came out that there are many contributing factors to the development of adult acne, including build-up of dead skin cells on surface of the skin, hormones, bacteria, skin care, makeup, environment, genetic predisposition as well as various prescription medications and medical conditions. And it turns out I was about 99% of these.

Typical, if I’m going to do anything I’ve got to do it 99%.

But that’s ok because Mel made me feel better because she said adult acne can affect 25% of all adult men and 50% of all adult women at some time in their adult life.

“Regardless of when someone’s struggles with acne it can be difficult to cope and can cause depression and social anxiety in an adult the same way it can in a teen,” she said.

So what did we do to make said pizza-face more normal?

Following a medical assessment, it turned out that I had acne but I also had very infected pores, which needed to be fixed straight away or the acne would never be fixed due to damaged pores.

To fix the infection and damaged pores I was giving a dose of antibiotics and a topical cream to zap that area. For long term care, I then embarked on a skin care regimen for home.

This was supported by a series of laser/light based treatments, micro/skin peels and enzyme therapy.

LASER/LIGHT BASED TREATMENT/PDT: Light based therapies using medical grade technology which targets redness, bacteria, pore size and can also assist with scarring. The laser genesis combined with enzyme therapy was used on me. This is a new development in the treatment of acne is also the use of PDT to reduce infection and breakouts. Think long term!

MICRO/SKIN PEELS: helps to reduce dead skin build up, clogging pores and brighten up the skin tone and texture.

ENZYME THERAPY: One of the most advanced skin care treatments available and is great at restoring the skin to function optimally. Enzymes are nature’s biological catalyst to work with the skin rather than merely acting on it. Enzymes promote a plasmatic effect in the skin, offering oxygen therapy, pulling away toxins and impurities, stimulating an immediate response to the dermal level, enabling optimal skin functioning, the key to youthful, healthy skin. I have been getting these treatments monthly are fantastic. I have found they also encourage the skin to heal quicker if you still get cystic bumps.

After three months of these combined treatments, my skin is really starting to show a difference. I am wearing less coverage and also feeling more confident that the bumps under my face aren’t showing up under the make-up.

I can’t say it’s completely gone but it has made a vast change to my skin and I can see the scarring start (slowly) to heal.

While this worked for me (enter disclaimer here), these types of treatments are individually customised and really needs to be determined on individual cases.

If like me you are starting to get pizza face syndrome and scarring in your 20s, 30s or 40s, then don’t stop trying. There are answers. You just need to ask the right questions which suit your situation.

My tips from a half-way reformed pizza face sufferer:

  • See a skin specialist that works for you.
  • See a good GP and try and combine that with your skin treatment.
  • Once you find a treatment that works, don’t stop it.
  • Fix the deeper problem, if you keep getting acne in one area then it could be infected area that needs stronger healing.
  • Use the right make up.
  • Have a proper home care treatment – which suits your treatments.
  • Don’t put paw paw flesh on your face on a street in Philippine. It will cake and smell horrible.
  • Don’t buy every new item on the shelf that has anti-acne on it, save the money and see a good specialist.
  • Remember adult acne is not something to be ashamed of. It’s not your fault.
Have you ever suffered from adult acne? What treatment worked for you? Do you think it’s a bit unfair that we should have to deal with wrinkles AND pimples?

Sarah MorganSarah Morgan always wanted to be a writer. Before finishing high school, she was already working as a journalist for the local newspaper as a junior correspondent. After graduating from uni, she gained work on a number of regional newspapers and magazines. In 2002 she launched Core Communications Group to provide professionally written copy, which is sharp, effective, interesting and more importantly gets to the core of the issue.  


Comments 44

  1. I’ve been stressed out lately & I think that’s caused a painful cyst-like bump to form under my skin. Ouch. I know not to try popping it, so I’m going to try an at-home remedy using sea salt & baking soda to try to decrease swelling.

  2. I still have adult acne at almost 40? I’ve been looking for a way to dry up the deep cysts and dermalmd blemish serum does the trick. I leave it overnight and have bought the invisible for daytime too. After one week of dermalmd regime it is gone!!

  3. Oh gosh! I always think i’m the only one that suffers through this. My skin was pretty good throughout my teens, a few spots here and there. Over the last few years its just gone nuts (I’ll turn 24 this year) and although my skin has improved over the last year, the scarring and my frustration continues. I’ve tried peels, different products, no makeup, makeup, different pills (which gave me migraines so i had to give up), i’ve seen millions of different people about my skin. I too had a run in with a less then helpful specialist… who dismissed my skin as not that bad (i was having a pretty good week skin wise) and recommended a bunch of products that added quickly to over $1000 and expensive treatments. His assistants were more helpful and ask more questions then he did! As much as I wanted my skin to be better, I wasn’t comfortable to spend that money on what seemed like another money grab. I’ve moved jobs (and state for that matter), made slight changes to my alread healthy diet and I still get acne.I’m on the hunt for a new skin specialists up here, hoping to make some sort of improvement.

  4. Correct washing of the skin will eliminate oils and bacteria that can cause acne. However, when you already have serious acne breakouts, washing alone likely will not make it go away. Frequent and harsh washing can even make it worse.

    There special anti-bacteria soaps designed for people suffering from acne. These soaps can help target the bacteria which may be causing the acne breakout. source:

  5. I have suffered AA since my early 20’s – now mid 40’s. My adolescent friends used to hate me for my peaches and cream complexion – then the tides turned and i had serious acne. In my 30’s, after Clinique, JUvena, Jurlique, Avene – man thousands I think – i found Paula’s Choice stuff. Her BHA 2% Liquid has made my life. I use it twice a day, and combined with her other stuff according to the season makes such a difference. I can’t use anything with perfumes – I get itchy and red. This stuff is unperfumed and supermarket priced (like Loreal Etc). It just works. Can’t rave highly enough.

  6. I had terrible skin, it kicked in when I was about 16 and hung around until I was about 22. I now know that I did every wrong to try and fix it and would have been making it worse. If my girls are unlucky enough to go through it, I’ll be taking them straight off to the professionals to deal with the right way.

  7. I had a shocking case of adult acne after I went off the pill at 24. My skin had been temperamental in the past, but nothing like this. I saw a paramedical skin therapist for a facial and she used skinstitut products. I saw such a difference in the days following the facial that I started to introduce the products into my skin care routine. I use the gentle cleanser, the glycolic cleanser, serum, moisturiser, glycolic scrub and vitamin c powder. At $40-$45 a product, they were cheaper than the organic line I was using, and were active products. I also used MooGoo oil cleanser to ensure my makeup was completely removed at night. This, combined with my GP prescribing a new kind of pill, cleared my skin in 6 months. My therapist followed up with a course of glycolic peels, which saw 80% of the scarring disappear. 2 years later, I’ve gone off the pill again and my skin has remained clear and well behaved…I still get the odd hormonal pimple, but it appears to be generally healthy and balanced.

  8. So well written Nikki, I’m glad you found the right solution for you and I have to agree “don’t stop trying”. A combination of actions is really what works, each person is different and from my experience the client has to be willing to stick to it for at least 3-6 months to get the results. I love your list of tips for pizza face couldn’t have said it better!

  9. Pizza face is one of my fave expressions LOL. I have had adult acne too and being a beauty therapist it makes life that little bit harder. The lactic acid complex in Priori advanced AHA worked for me. I also had Priori peels. In ten years as a salon owner that was the thing that worked for me and I only really found it two years ago. There are lots of answers but you need to find what works for you.

  10. I began suffering from acne as a teenager and it was particularly bad on my back. I still get pimples and I’ve got acne scarring on my upper back. I’ve been having microdermabrasion once a month this year, which has really helped together with using some great Ultraceuticals products and tea tree body wash and body lotion. But I have to agree with a lot of comments on here – hormones can be a real bitch!

  11. I had acne until my early thirties, regardless of being on birth control since I was 18. Taking dairy out of your diet does not work, mineral make-up helps but doesn’t stop it, low carb diets don’t help either. It all comes down to hormones. Those little buggers cause the pimple, and then stress and oily skin/make-up just aggravate what is there.

    I changed my pill about 5 years ago and within a month I was pimple free, so clearly correcting hormones is the starting point. Following up with good cleaning products and make-up is second and third in the daily struggle.

    I still get them, but instead of getting them all in one week, I get one here and there. In all reality, you cannot stop what’s going to come up, all you can do is treat it properly to make it leave faster.

    I find toner really helps to keep the oil away, and in summer, for oily/combination skin, a daily avocado and oatmeal face mask helps keep oil at bay.

  12. It’s the most depressing awful thing in the world. There’s nothing quite like the silvery regrowth/lengthening laugh lines and general saggy bits developing … then having to deal with acne as well. I can’t even say the word. And as for people who say ‘what’s wrong with your face’ …. I’ve seen a couple of different dermatologists but it’s so freakin’ expensive in New Zealand. I am hoping it’ll be more successful here, cos quite frankly it didn’t make much difference. Roaccutane was alright, but the side effects really hit me. I am generally happy with myself – flaws and all – but the bad skin is one thing I really can’t cope with. So mortifying, depressing and embarrassing. 🙁 Now I’m off to put some more napalm on the cyst I’m currently fighting on my cheek – mirror image on the other side of the one that took over a year to heal on the other cheek. I’m going now, I feel like bloody crying 🙁

  13. Adult acne is the reason I have to be plucked rather than waxed at the Benefit Brow Bar.

    Whatever the cause, acne comes from the inside, the creams, lotions and potions make you feel a little better for about 3 minutes, but the painful acne is still there making you feel horrible.

    Diet and Brenda (the magical pill that prevents acne) are my weapons of choice.

  14. I think its time for I have acne and exactly like you mentioned. They are hard, wont go, itchy at times and an ugly sight. Plus, I have used gallons of cetaphil and have had n number of Allegra 180 but of no use.

  15. Roaccutane.

    I don’t know why some people think it’s the devil; it works.

    I had terrible acne aged 18/19. Pioderma faciale. You could barely see my features there were so many spots. So much redness. Awful, awful.

    After creams, antibiotics, the pill – eventually I went to a dermatologist. I had concerns about Roaccutane, and the ongoing talk that it caused depression. He asked me how I was feeling living with the acne. I answered, “Well, actually – pretty depressed.”

    A six month course fixed me up. Brilliant stuff. Yes, I suffered some minor side effects – dryness of eyes, cracked lips – but I would do it again to clear my face up. My mood improved markedly when I stopped seeing people’s eyes stare at my spots, and actually start seeing me.

    I NEVER mention acne to anyone in person; having been on the receiving end of lines like “What’s wrong with your skin?” and “You probably eat too much chocolate”, believe me – an acne sufferer is AWARE of their face.

    But if anyone is reading this and has acne currently – do follow Sarah’s advice and see a dermatologist who works for you. That’s the place to spend your money.

    1. Thanks for sharing Natalie … I think the caution around Roaccutane is a good thing. I took my teenage son to the GP about his acne (not super serious but wasn’t improving) last week and he said that a dermatologist will not put you on it now until you’ve tried antibiotics and cream from GP first for 6 months. I think that’s a good think. Already in 10 days great improvement from this in my son.

    2. I also agree about Roaccutane – I have been on it twice, it lasts about five years for me. It gets the best outcome. Diane (the pill) works for me long term but the acne came back (in full spirit) when I went off it to have a baby – antibiotics cleared it up during that time, thank fully.

      I think I have tried all the topical creams – none of them work – wont waste time and money on them. The only one that got some minimal results was the celebrity one – i cant recall the name but it’s on TV a lot and in shopping malls. Those reading it will know it.

      Adult Acne is a curse and very tricky to manage.

  16. Good on you Sarah for sharing your story, it will provide a short cut for many who are suffering the same. I am now in my late 40’s and going through it “again”!! It was through incorrect advice in my teens that started me on the learning path and a career in the “beauty” industry. Treatment is usually via several methods and great results can be achieved. Professional skin care is often comparable in price to high end cosmetic lines and is worth finding the correct products. Couple that with professional advice/treatment and the benefits are visible.

    1. thanks Tracey. It was a long over due story I just had to write. It’s such a horrible problem. On my way to a new face, minus pizza look

  17. I had cystic acne on my decolettage and neck in my 30s after I had my two children, Painful, and embarrassing. I used to wear clothes with high necks to hide it, but was told by the Dr that this probably made it worse.
    I ended up on antibiotics for years. Finally went off them last year and so far my skin is not too bad. Not perfect, but not cystic and painful!

  18. I am so glad you finally got someone to listen to you and got it treated,I have never suffered from acne ,so I am lucky,just very bad sensitivity issues that I find very frustrating<all skin issues are annoying and expensive I am finding ,Hoping it clears up and you have no scars.

      1. Yes I was on the right track and then tried a sample of an organic product and it made my skin back to what it was ,have found Lancome Ultracalm and Dermalogica and Trilogy to be the best thus far.I apologize for the post above my computer does that sometimes and I don’t know why??.

  19. Great post.
    At around 30 I had similar skin problems. It’s thoroughly depressing.
    I finally landed on the Danne Montague-King range and not only did it clear my skin, now, some 7 years on, I get comments about how radiant my skin is. I still use DMK products even though I am in ‘maintenance mode’ and swear by them. The salon treatments, while expensive, are fantastic with almost immediate improvements – it also teaches you to use their products properly. Artisan in Robertson St, Fortitude Valley is where I go for treatments and my products and I could not recommend the DMK system more highly. It is not cheap but it is worth every penny and works.

  20. I totally agree, a majority of the over the counter treatments are just a waste of money unless you particularly like the smell. I put up with acne for years just trying different creams etc until I finally went to a dermatologist who told me ‘you look like shit so let’s fix it’ I very much appreciated his honesty and followed what he said. Which was: 6 month course of antibiotics, a high oestrogen pill and washing my face only in cetaphil. I personally believe that diet also has a huge impact on acne (I know they say it doesn’t but I just cannot accept that) so have improved my diet and exercise for overall health. Now I use home remedies for exfoliation such a bicarb soda a couple of tea a week and a light moisturiser and the problem seems to have disappeared. I’m not badly scarred but would love to try one of the treatments that you mentioned.

    So glad you have found something that works for you and I totally agree, early medical treatment is much better than trying a million different anti acne washes.

  21. Arghh!! though I’m not a sufferer of cystic acne, I fully understand the adult pimple dilemma. Hormones were my cause, which was fairly easy to quickly break the cycle on with a male androgen pill- only used short term, funny ’cause male androgens are what are now causing my hair to thin and I am doing the opposite at 44- I hope my zits don’t return!!
    These are very good tips/advice for anyone at any age! Can I also say that I found washing my hair each and every day seemed to make a big difference to me.
    I am really lucky, my Gp is also a cosmetic physician and has big interests in beauty so has ‘prescribed’ me a series of physician strength VitC and Glycolic serums and creams too, these will work on both the pimples and the wrinkles, win win!

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