Managing Adult Acne


By Amy Wechsler, MD

Though acne is often thought of as an affliction of adolescents, it seems that an increasing number of adults are contending with the problem. Can you describe some of the factors that lead to adult acne?
Yes, more than half of women over the age of 25 have acne. Stress is often the main culprit. It turns on inflammatory pathways, which result in breakouts. Genetics, menstruation, hormonal changes, a new medication, the occasional irritating cosmetic, and other factors can also contribute to acne—but stress is by far the most influential.

Are there preventive strategies that women can employ to keep their skin clear of acne?
No matter how tempting it might be, do not pick, pop, or squeeze pimples. It can cause more inflammation, not to mention scarring and marks. Apply a warm compress on blemishes to loosen the thick oily plug of sebum and then apply gentle, even inward pressure using two clean cotton swabs. If something comes out, pat the spot dry and put on a treatment. If not, leave it alone.

Eliminate stress by getting enough exercise and sleep, eating cleanly, having sex, and using relaxation techniques such as breathing exercises. Keep skin clean, but don’t over-cleanse skin, as this strips it of natural oils. Benzoyl peroxide and salicylic acid can work together to treat and prevent acne at home, but be advised that it’s best to start off using low-strength options. Use oil-free, noncomedogenic lotions and sunscreens.

If prevention strategies fail, what are the most effective treatments available?

Topical retinoids, salicylic acid peels, and Isolaz acne therapy, which combines a vacuum and painless broadband light to deep-cleanse and purify your pores from the inside out—all are helpful. In some cases oral antibiotics, Accutane® (isotretinoin), and oral contraceptives might also be considered.

Are there any other general skin care tips that you would offer women as a complement to acne prevention and treatment?

Never smoke and always wear sunscreen—the sun makes acne worse!

Amy Wechsler, MD, is one of only two physicians in the country board-certified in both dermatology and psychiatry and is well known for her unique approach to all dermatological procedures—administering traditional practices only after spending significant time with patients and thoroughly understanding their emotional state of mind and the impact it is having on the outer surface. She treats men and women of all ages. Dr. Wechsler graduated magna cum laude, Phi Beta Kappa with a Bachelor of Science degree in Psychology from Duke University. She earned an MD with honors from Cornell University Medical College. After completing her residency in psychiatry at Payne Whitney Clinic – The New York Presbyterian Hospital, she stayed to do her fellowship in child and adolescent psychiatry. Fascinated by the fundamental connection between the mind and body, Dr. Wechsler completed her residency in dermatology at SUNY Downstate Medical Center. Her hospital appointments include Assistant Clinical Professor in Dermatology, SUNY Downstate Medical Center, and Adjunct Assistant Clinical Professor in Psychiatry at Weill Cornell Medical College. Dr. Wechsler is a member of the American Academy of Dermatology, the American Society for Dermatologic Surgery, the Women’s Dermatologic Society, the American Psychiatric Association, the Independent Doctors of New York, the Physician Scientific Society, and the Skin Cancer Foundation. Dr. Wechsler is the author of The Mind-Beauty Connection (Free Press, 2008), and is frequently called upon by the media to explain and demystify complicated dermatological topics.