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Q: I've had acne for years. Aren't zits supposed to disappear after puberty?

A: Not necessarily. Acne is most common among teenagers, but even people in their 40s and 50s may suffer from skin blemishes. Whereas adolescent acne is typically characterized by oily skin and whiteheads or blackheads on more visible places, such as the forehead, the nose and the cheeks, adult acne often results in inflamed lesions on a person's lower cheeks, jawline, chin and neck, according to Diane Berson, M.D., assistant professor of dermatology at Cornell University's Weil Medical College.
While nobody knows the exact cause of adult acne, genetics and changes in hormone levels are two key factors. "If you're genetically predisposed to adult acne, then any hormonal change, including your menstrual cycle, pregnancy or going off birth-control pills, may trigger it," explains Dr. Berson. Plus, women are more prone to adult acne than are men, since they tend to experience more hormonal fluctuations. Several other factors can contribute to acne. Stress causes your body to release hormones called androgens, which may increase the likelihood of pimples and cysts. In addition, air pollution, friction caused by rubbing on the skin and certain certain cosmetic products can lead to flare-ups. Try to reduce your stress levels, avoid touching your face during the day, and choose creams that are labeled oil-free and non-comedogenic.

Contrary to popular belief, dirty skin and a bad diet do not cause acne. Excessive cleaning or scrubbing actually irritates skin and makes the problem worse. And while a recent study suggests that high-carbohydrate diets may cause acne, most dermatologists still believe that greasy or high-carb foods don't cause breakouts. (However, if you truly believe that certain foods cause you to break out, avoid them, advises Berson.)

Fortunately, there is a wide variety of treatment options for adult acne. Mild cases can often be cleared up with over-the-counter gels, lotions, creams, soaps or pads containing benzoyl peroxide, a chemical that reduces oil production and kills bacteria associated with acne. Products that contain salicylic acid, resorcinol and/or sulfur may also unclog pores. In moderate to severe cases, a dermatologist may recommend prescription medicine such as topical or oral antibiotics, which curb bacterial growth and reduce inflammation, or retinoids, drugs that contain a form of vitamin A that decreases the development of blemishes. A doctor may also prescribe hormone-regulating medications — such as corticosteroid pills or low-dose estrogen birth-control pills — or perform an extraction or a chemical peel. It may take approximately four to eight weeks before your skin visibly improves, so be
patient.