The unfortunate truth is that if there’s one skin issue that will plague you from adolescence into adulthood, it’s acne. Just when you thought that a smattering of zits would become as dated as your high school yearbook, it erupts again and again, in your twenties, thirties, forties, and beyond. Yes, the struggle is real — so real, in fact, that many dermatologists report that more than half of their adult patients have acne.
“About 30 percent of adult [women] will have acne or carry acne into adulthood,” adds Jenny Liu, MD, a board-certified dermatologist in Minneapolis, Minnesota. “There is definitely an increase [in adult acne], especially among women and female hormonal acne, which is cyclic, deeper, and appears on lower cheeks and jawline,” she explains.
While hormones are still at play for some adult acne patients, this skin concern may also be tied to environment, genetics, and your lifestyle. “Adult acne can be caused by environmental stressors, like work, diet, even not drinking enough water, which helps keep skin hydrated,” says Kim Nichols, MD, board-certified dermatologist and cosmetic surgeon in Greenwich, Connecticut. “When your skin gets dried out, oil glands compensate for it and go into overdrive.” Touching your face — be it your hands or your phone screen — can also be to blame, as this will aggravate the bacteria that thrives in your oil glands. (Basically, even if you have relatively clear skin, you’re always at risk for the occasional pimple.)
The causes of your breakouts aren’t the only things that make treating adult acne a challenge: the treatment options themselves have changed. Benzoyl peroxide (BP) was probably your go-to back in the day, but now, as your skin starts maturing, it might be too harsh. Though BP is still the gold-standard for clearing moderate to severe acne, it can be overdrying, and using a high concentration (or too much!) can cause irritation, notes Dr. Liu.
Instead, you have another option: acids. This formidable skincare category can not only treat, but also help prevent future flare-ups. “Acids can dramatically improve acne with regular use,” explains Dr. Nichols. “They also help to even out skin tone and texture, which may be more beneficial for aging skin, especially among sensitive types.” While all acids will offer an exfoliating and skin-clarifying effect, the most effective for acne are the “big three:” lactic, salicylic, and glycolic. Remember, as with any exfoliating product, your skin will be sun-sensitive after using formulas with these acids, so make sure you avoid direct sun and use SPF after application. Read on to get the right fit for your skin and routine — and finally break the acne cycle for good.
[Editor’s note: As always, talk to your doctor before starting or stopping any new treatment.]
The acid: Glycolic Acid
What it is: Glycolic acid comes from a family of exfoliating alpha-hydroxy acids (AHAs), which are water-soluble ingredients and suitable for all skin types. Glycolic in particular is derived from sugar cane and fruit, and is a very small molecule, meaning it can penetrate the skin more deeply than other AHAs.
How it works: Pimples mean your skin has an excess amount of oil and clogged pores, so glycolic can be key in keeping breakouts at bay. It goes beneath the skin to dissolve the cellular glue that holds onto pore-clogging cells, while also exfoliating the surface to remove the buildup, says Dr. Nichols. The bonus is that with regular use, it lessens the look of acne scarring and post-inflammatory hyperpigmentation, too.
Who should try it: You can reach for glycolic acid if you have normal to dry skin — because it doesn’t strip skin of its natural oils, it won’t leave you feeling parched. Get the occasional spot? Regular use of a glycolic can lessen your chances of getting it again, while higher concentrations can help treat existing bumps.
Where you can find it: One of the best characteristics of glycolic acid is that it’s used in a wide range of different formulas — so if your preference is a mask, an overnight cream, or a targeted serum, you can find it. What’s more important than the delivery system, however, is checking out the percentage. Most dermatologists recommend starting with a concentration of 10 percent glycolic for acne treatment, because it’s strong enough to make a difference, yet won’t be irritating (though sensitive types should start with the lowest amount possible, then work up to build tolerance).
Both Drs. Liu and Nichols recommend Skinceuticals® Glycolic 10 Renew Overnight ($80), which can be used nightly and promotes cell turnover, so that pores stay clear to prevent future flare-ups. You can also try PeterThomasRoth® 10% Glycolic Solutions Moisturizer ($45), which works similarly to the Skinceuticals formula, but also contains glycerin, aloe, and squalane to help soothe and soften skin.
The acid: Lactic Acid
What it is: Lactic acid is another type of AHA. It also exfoliates the surface of the skin, but doesn’t go quite as deeply as glycolic acid. It naturally occurs in milk, and helps promote skin’s hydration levels.
How it works: If used regularly, lactic acid will help decrease the frequency of acne breakouts by sloughing off the dead skin cells and speeding up cell turnover. Since cells are getting more moisture, they’re less likely to go into oil production overdrive and clog pores, leading to fewer eruptions. Regular use also improves skin texture, making it look more even overall.
Who should try it: For those who have mild acne or if your skin is super sensitive to acids, lactic is a good choice as it is one of the least irritating AHAs. It’s also ideal for very dry skin, since it helps to improve hydration and stimulates collagen renewal.
Where you can find it: Lactic acid is found in serums, peels, and moisturizers, many of which can be applied daily to the entire face. Lower strength treatments are great for newbies and those with sensitive skin; once you work it into your routine and your skin gets acclimated, you can try more concentrated solutions. We’re particularly fond of treating breakouts by washing up with lactic acid-based cleanser, which can clear away oils and impurities before they clog pores. Try Dermalogica® Skin Resurfacing Cleanser ($45) — along with lactic acid, it contains vitamin E and rose oil to leave skin soft and nourished.
The acid: Salicylic Acid
What it is: Salicylic acid — which is a byproduct of aspirin — differs from the other acids on this list because it’s a beta-hydroxy acid (BHA). This means that it dissolves in oil, rather than water. Because of this, it’s primarily found in acne treatments, where it gets to work tackling excess sebum and related concerns.
How it works: Being oil-soluble means salicylic can get through the sebum in your pores easily. Once there, it exfoliates the dead skin cells that build up inside them, helping to unclog blackheads and whiteheads. Since it gets to the root of the pimple more quickly than other acids, it will usually make a noticeable difference after a few uses. “It’s very good for normal to oily skin that’s prone to bumps, clogs, and blemishes, because it can exfoliate the top layer of the skin and dry out cysts or pustules,” agrees Dr. Nichols. Even if you’re not oily, consider it a must for clearing up visible spots. The caveat? It can dry out skin too much, causing irritation. If that’s the case, ease up on the amount, or use every other day, until the pimple clears.
Where you can find it: Salicylic acid is typically formulated into products specifically for acne treatment, including gels, creams, and ointments, as well as masks for acne-prone skin. Because it’s stronger than other acids, look for percentages that range from 0.5-5 percent; typically, you don’t need to use much. Ren® ClearCalm® Non-Drying Acne Treatment Gel ($20) targets spots with .5 percent salicylic acid, and contains soothing ingredients like willow bark extract to help calm redness.
Dr. Kim Nichols is a paid Allergan® consultant.