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Are you facing stubborn adult acne that is not going away despite of treatment? Be altered! You might be suffering from some underlying disease which could be the reason behind your acne.

Adult acne is a skin disease that you can face at any point of life. Many cosmetic concerns are attached to acne and, adult acne treatment is one of the most widely discussed skincare topics.

Almost 80 percent of all people face acne at some point during their lifetime [1]. Though acne can occur in both men and women regardless of age, women experience acne more frequently [2].

There was a time when people associated acne with puberty. Pubertal acne is a thing, but it doesn’t mean that you cannot suffer from acne after your teenage years. Adult acne is a frequent condition and people can experience it in their twenties, thirties, and even later.

Some people have acne-prone skin and they get used to dealing with one or two pimples every now and then. However, you can experience acne out of nowhere even if you have never dealt with it before. Many factors, including numerous medical conditions, are involved in causing acne.

A clear skin mirrors your good general health. When you suddenly start experiencing acne, you should always try to find the reason in order to rule out any underlying disease. [3]

Some physiological conditions are also associated with acne, with hormonal changes being the most common culprit. Certain drugs, pathological conditions, and physiological conditions may also be behind your sudden acne breakouts.

1. Polycystic Ovarian Syndrome (PCOS)

Polycystic Ovarian Syndrome (PCOS) is a very common disease characterized by irregular periods, excessive facial hair, weight gain, and acne. [4]

Acne is a very prominent and bothersome feature of PCOS and it cannot be treated unless the underlying disease is addressed. As the hormonal irregularity is the root cause of disease, treatment is focused on correcting that.

If you are facing two or three of these symptoms, consult a doctor as soon as possible. Topical and oral acne medications can also be given along with PCOS medications. 

2. Cushing Syndrome

Cushing Syndrome is caused by an excess of adrenal hormones. The symptoms of Cushing Syndrome include obesity, stretch marks, a moon-like (puffed up) face, excessive facial hair, and acne. [5]

Cushing Syndrome is a serious disease that has many dangerous consequences. Acne, alone, cannot be treated unless the underlying hormonal cause is corrected.

Contact your doctor as soon as you notice such symptoms because trying to treat acne and ignoring other symptoms is risky due to the potential complications of this disease.

3. Congenital Adrenal Hyperplasia (CAH)

This is a congenital condition and usually diagnosed at birth. However, in some atypical cases of Congenital Adrenal Hyperplasia (CAH), the symptoms are not as marked so the disease may remain undiagnosed. Later in life, these patients can present with refractory acne that doesn’t respond to any drug. [6]

If you have refractory acne that doesn’t respond to any drug, another possibility is that you are carrying a mutant gene which couldn’t cause full-blown CAH but is causing you acne.

Acne in CAH is due to excessive androgens in the blood. Optimizing hormonal levels with appropriate drugs is necessary to get rid of acne.

4. Androgen Secreting Tumors

Androgens are the hormones which activate the sebaceous glands. The increased sebum production causes acne. Testosterone is one of the androgens.

Your body might be hiding a benign or malignant androgen-secreting tumor that can be the source of acne. Whenever you are facing resistant acne with hormonal abnormalities, contact your doctor.

5. Acne Due To Certain Drugs

Certain drugs have the potential to cause acne breakouts. These drugs are mostly hormonal and that is why women using contraceptive pills often experience acne. Some vitamin supplements and other drugs are also the culprits at times. A few of these drugs are testosterone, progesterone, steroids, lithium, phenytoin, isoniazid, vitamins B2, B6, and B12. [3]

If you just started taking a drug and acne started showing up, double check what your medicine contains. The treatment of acne in such a scenario involves the discontinuation of the offending agent.

6. Premenstrual Acne

Many women with acne-prone skin experience a premenstrual flare of acne. This is a physiological phenomenon and doesn’t need any treatment. It occurs with your cycle each month. [7]

Hormonal changes that take place during the cycle are to blame for these acne flare-ups. When the level of progesterone rises, it causes adult acne that settles as your hormones return to normal.

7. Pregnancy Related Acne

Many pregnant women experience pregnancy associated adult acne. This occurs due to high levels of progesterone and other pregnancy hormones. Generally, no treatment is required but if you want to get it treated then using antibiotic topical medications is the best option. [8]

Make sure that you don’t utilize oral acne medications during pregnancy due to the teratogenic effects attached to them.

Note that isotretinoin is STRONGLY PROHIBITED during pregnancy and you should not use it in any form, topical or oral.

8. Menopausal And Post-Menopausal Acne

Menopausal and post-menopausal women can also face acne issues. This is mainly because the ovaries stop producing their hormones and there is an unopposed action of androgens, like testosterone. This hormone acts on the sebaceous glands and increases sebum production, leading to acne. [9]

This type of acne is usually mild to moderate and using topical isotretinoin is the treatment of choice.