If your skin is erupting with blemishes that you thought could only afflict a teenager, you may have adult acne. Acne is the term for oil-clogged pores (tiny openings on the skin) that become inflamed and form blemishes. Adult acne blemishes appear mainly on the face. In women, blemishes tend to form around the chin, mouth, jawline, and neck. In men, acne often affects the entire face. But the trunk and upper arms can also be involved.
Acne starts inside the hair follicles under your skin’s surface. Oil glands that open into the hair follicles release excess oil (sebum). Sebum and skin cells clog your pores. Bacteria can then get trapped in the follicles, leading to swelling and acne blemishes. Why adults get acne is not well understood. The good news is that acne is treatable.
Acne results from a disease process of certain skin follicles. One of 4 things happens, and in most cases, multiple mechanisms are involved. The skin follicle has an abnormal shedding or plugging of the skin, oil or sebum production increases, abnormal growth of a bacterium called Propionibacterium acnes (P. acnes) occurs within the follicle, and the follicle becomes inflamed.
The 4 main types of acne blemishes are described below:
Whiteheads are round, white blemishes that form when hair follicles become clogged.
Blackheads are round, dark blemishes that form when whiteheads reach the skin’s surface and touch air.
Pimples are red, swollen bumps that form when plugged follicle walls break near the skin’s surface.
Deep cysts are pus-filled pimples. They form when plugged follicle walls break deep within the skin. Acne cysts are often large and painful. In some cases, they also cause scars.
The goals of treatment are to keep new acne blemishes from forming and to prevent scarring. You and your health care provider can discuss the best way to control your acne. In most cases, acne treatment includes medications applied to the skin (topical) for mild acne, and medications taken by mouth (orally) for moderate acne. Frequently, combinations of several medications are initially needed. Your health care provider may also remove blemishes or give you injections. If you have acne scars, surgery or medications can help improve the way your skin looks. Be sure you understand your treatment plan. You will play an important role in the success of your treatment.