SHREVEPORT, La. (KTAL/KMSS) – A Shreveport physician explains why some adults experience acne and provides tips for keeping sensitive skin free of flare-ups.

Dr. Cara Permenter, a Family Medicine physician at Ochsner LSU Health Bossier’s multi-specialty center in Shreveport, shared some tips on controlling acne.

Acne is for grown-ups, too

Acne is not just for teens.

More than a quarter of women and 12 percent of men still report having acne into their 40s. And even if you avoided mid-life acne, you likely know someone who has it.

Adult acne is a normal part of life, Fermenter said adult women can develop hormonal shifts at different points in their lives such as postpartum and during menopause.

“It’s more hormone-related than age-related,” Permenter said.

Permenter says people of all ages suffer from acne and it can have any number of causes.

But acne can affect adult men, too.

Hormonal acne can begin in a person’s teens and last well into their 30s, and being sensitive to androgens like testosterone can be the cause of hormonal acne.

In women, Polycystic Ovarian Syndrome can cause higher levels of androgens and be the source of adult-onset acne.

Multiple studies show that many women who suffer from hormonal acne have high levels of DHEA, it is the hormone that creates androgens and estrogens – the male and female sex hormones respectively.

Correcting acne issues are often about learning how to manage your skin’s secretions. Whiteheads and blackheads are open and closed comedones, which are usually clogged with skin materials that allow bacteria to grow. That’s what often causes the infection we call acne.

When women suddenly develop acne after having a baby or while going through menopause, the culprit may not be comedones. It is more likely an imbalance of estrogen and testosterone. And women who develop post-birth acne may find the way they treated acne in their teens does not work for their adult acne issues.

“We need to address androgen levels in women, and we do that in different ways,” Permenter said. “(Women) may not have blocked pores. Acne is not a cleansing issue for them. It can be age, diet, stress level.”

Permenter says that if you have acne, it’s important to ask questions of yourself and pay attention to your surroundings

When did your acne start? What’s going on around you?

Where on the face is your acne occurring?

Is being in the sunshine good for acne?

One popular home treatment for acne is to bask in the sunshine, but medical professionals don’t necessarily agree with this old wives’ tale.

“While we know there are sun rays and frequencies of UV lights that help skin conditions, the big thing we have to weigh is that we’re increasing the risk of skin cancer to treat acne,” Permenter said. “Is that a balance we want to have to walk?”

She also said sun exposure is a possible treatment for other skin conditions, though.

“Psoriasis and some of the plaque rashes, you’re at increased risk of cancer because of the inflammation,” Permenter said. “And so you look at those situations and you say okay, a little bit of UV exposure in graded amounts with certain doses may be a cost benefit you’re willing to look at. But with acne, there’s so many ways we can treat it that we wouldn’t want to expose you to things that can cause damage to healthy tissue.”

Can you wash your face too much?

“You can wash your face too much,” she insists. “One of the things I learned early in residency is everywhere in the marketplace you find products for exfoliating. But the act of scrubbing your skin too hard can be irritating, and irritated skin is more likely to develop bacterial infections.”

“Healthy tissue” is a phrase that Permenter repeats when she’s talking about acne.

She said over-the-counter spot treatments are great because you can address the problem without irritating healthy skin tissue surrounding acne.

“We start someone on a benzoyl peroxide wash or treatment and tell them not to overwash. If that’s not doing what we want, we look at dyes and perfumes and using unscented products.”

Permenter said Cetaphil makes some great unscented products for sensitive skin.

According to Permenter, we need to think about water temperature and the harshness of the detergents that we use to wash our faces. Water for facial cleansing should be warm or lukewarm, not cold or hot.

“Steroid creams that people use for rashes on the face can also increase the risk for acne,” she said. “If I see someone, whether it’s a teenager or an adult, I tell them to get rid of all perfumes and dyes. Water’s harsh enough. You have to look at the type of skin someone has and really try to figure out what they’re doing that may be the reason for acne.”

Top tips for dealing with acne

Permenter said weight issues or hormone issues can propagate your risk of acne, too, but acne is not a direct result of eating oily foods like pizza or chips. The old wives’ tale about eating grease is simply not true, though cutting grease out is part of a healthy lifestyle and should not be ignored.

“It’s all about absorption of the gut. You have to absorb quite a bit for it to come out on the skin,” Permenter said.

That doesn’t mean what you eat cannot make your face break out, though.

“A lot of acne is people touching their face,” Permenter said.

Finding sunscreen for your sensitive skin is important, too.

And smoking can make acne worse.

Acne and emotions

Acne can cause anxiety and depression. Getting treatment for these issues is important, as stress can cause acne, too.

“If someone has acne and they have depression and anxiety, then they may also have other complaints that need to be addressed,” says Permenter.

“We (medical professionals) do have decent facials that help with scarring,” says Permenter. “I’ve had plenty of grownups who say ‘I’ve been struggling with this since I was a teenager. I’m supposed to be done with this by this point.’”

She understands their desperation and recommends treating acne instead of taking the “Don’t let it bother you” mentality, no matter what your age. Get help to overcome acne, and don’t let it overcome you.

“We’ve got a couple of oral treatments that we do. But some of those meds have side effects.”

Your acne may be the result of a bacterial barrier issue, or an allergic reaction to something. And there is always the possibility that a biopsy may give unexpected results.

Non-traditional treatments

Data shows that acupuncture can be used to treat acne. And with fewer side effects this may be a treatment option for those who do not find other therapies effective.  

Toners can keep the skin clean without stripping it of its natural moisturization.

Some essential oils, such as tea tree, eucalyptus, myrtle, lavender, oregano, and thyme oils, have been proven to be effective in the treatment of acne.

Some sunscreens can cause acne. Search to find the one that is right for you, and protect your skin from harsh rays.

Increasing the natural bacteria on your face is an option, too. Flora-repairing face masks are formulated for people with oily and combination skin, and they replenish the very nature of your face. Think of your skin as a bacterial ecosystem and repair it as you would an endangered forest. We are a part of the environment, after all.

Bill McKibben once said that there is a tendency at every important but difficult crossroad to pretend that it’s not really there. The same is true of acne.

Permenter says there are many different ways to treat acne, and these examples are but a few. You must find what works for you.

“Talk to you PCP and see if they can help you. And try to stay as natural as possible,” Dr. Permenter says. “And a good antiseptic helps.”