Acne is a condition associated with the adolescent years- a not so welcome indication of puberty. But pimples can occur in your 20s, 30s, 40s and around menopause– even among those who never endured acne as a teen.
“Adult-onset acne is more prevalent in women and more likely to appear along the jawline than in the “T-zone” of the forehead, nose and chin,” said F. Clarissa Yang, MD, Chief of Dermatology at Tufts Medical Center. “Jawline acne in women can suggest a hormonal imbalance.”
The hormonal imbalance that results in jawline acne is thought to be caused by a relative increase in androgen levels, explained Dr. Yang. Androgens are male hormones which can result in increased oil gland production and clogging of pores.
Some women with jawline breakouts may find they have an underlying condition called Polycystic Ovary Syndrome (PCOS) with irregular periods, ovarian cysts, weight gain, facial hair, and/or thinning of the hair on their heads. Other women might have imbalances from going on or off of hormonal therapies such as birth control pills or other hormonal shifts such as pregnancy or menopause.
Stress, poor sleep habits, and diet can also contribute to hormonal imbalances and acne flare-ups.
Help for Breakouts
“While breakouts can be frustrating for many women, regardless of their age, we have a wide spectrum of treatments that work,” said Dr. Yang.
Those treatments include everything from over-the-counter acne washes and creams to topical and oral prescriptions medications that treat the causes of acne. Additionally for patients with hormonal acne, there are FDA approved oral contraceptives for acne that contain less acne causing progesterone components such as norgestimate, norethindrone acetate or drospinone. The Pill can help by regulating hormones and menstrual periods, clearing up skin within three to six months according to some research, but could also have side effects, including increasing the risk of heart disease, blood clots and stroke in women who smoke. Another option is a prescription diuretic called spironolactone, which can block the effects of androgen in women.
Retinoids, a drug derivative of Vitamin A, can also help, explained Dr. Yang. Retinoid creams can attack acne by decreasing oil gland production and regulating the way the skin sheds from the hair follicle, unclogging pores. In severe cases, retinoids can be taken in pill form, known as isotretinoin or Accutane. This medication should only be used when acne is severe and should never be used in women who are trying to become pregnant.
Chemical peels and light-based treatments can also be helpful, but often are not covered by insurance.
“Acne is mostly a problem in developed countries, so we need to be mindful of environmental factors that may play into breakouts,” said Dr. Yang.
Diet, sleep patterns, medications and pollution could all play a role, she explained. Cosmetics also can be a culprit. The American Academy of Dermatology reminds women to check the ingredients in their hair and skin products. Look for one of these terms on the label, to ensure it is less likely to cause acne:
- Won’t clog pores
“Any of these things could tip the balance enough to cause a problem,” said Dr. Yang. “Learn what causes your flare-ups and avoid them as much as possible.”
Posted February 2018. The above content is provided for educational purposes by Tufts Medical Center. It is free for educational use. For information about your own health, contact your physician.