You have never had acne. You have never had pimples, at most the occasional one that appeared before menstruation. But now, in your thirties or forties, you have more pimples than when you were a teenager. Some of them are quite large and even painful.
It’s a fairly common story in dermatology offices, and while it may surprise you , it’s not that uncommon; there are plenty of other girls just like you.
Acne is more common in boys during adolescence, but from their 20s onwards, women suffer from it more frequently, even without having gone through it in their teens.
Why do pimples appear at 30 or 40?
·Androgens:
We know that male hormones play a very important role in their appearance. Yes, women also have these hormones (androgens) naturally, produced by the ovaries and adrenal glands.
These hormones stimulate the production of sebum in our skin, which is a major factor in the appearance of acne. The production of sebum favors the growth of a bacterium called cutibacterium acnes in the pore of the oilier areas of the skin, which can induce some inflammation and hence the pimples.
However, the appearance of these symptoms does not necessarily imply that there is a hormonal alteration. In fact, in most women the hormone levels are perfect. One interpretation for this is that the androgen receptors are more easily activated in affected women. Much remains to be understood…
·Menstrual cycle:
The influence of the cycle on the appearance of pimples is known to almost all women. It is not uncommon for pimples to appear in the premenstrual phase. The exact cause of this is also not very clear.
·Tobacco:
This relationship is not fully established, but smoking is seen as another possible influencing factor in the appearance of adult female acne. So if this is your case, you already have another potential reason to quit smoking;)
·Cosmetics:
In some cases, in a few cases, certain types of cosmetics, more or less greasy or occlusive, could “clog” the pore in such a way as to favor the appearance of comedones, which are the initial lesion of acne.
·Others:
Stress, as in almost all skin diseases, can cause worsening phases and a greater number of lesions. It is not the cause, but a precipitating factor for those women who already suffer from pimples.
Diets rich in sweets and refined flours have been shown to be associated with worsening acne. This is true in adolescents and may apply to adult women as well. Thus, a healthy diet, rich in fruits and vegetables, minimizing pastries, sweets and refined flours, will help control breakouts.
What to do about pimples in your 30s or 40s?
In general, the measures to be taken to control acne in adult women are very similar to those used for adolescent acne. However, it is important to highlight some particularities:
-It is chronic: although we know that in time it will heal, it is possible that it has a tendency to prolong itself over time.
-The approach will depend on whether you want to have children or not. Some of the treatments should not be used in pregnancy or during pregnancy, so the therapeutic strategy will be conditioned by this. Here you can read more about acne treatment in pregnancy.
Skincare routine for pimples in your 30s or 40s
The daily cosmetic routine can help a lot in the maintenance of acne. We know that it will not be the solution, and in many cases we will have to resort to medical treatment, but the measures I will outline below will help to keep the skin cared for and the pores clean, thus minimizing the likelihood of pimples appearing from the surface.
- Morning and evening cleansing with a specific product for acne.
- Moisturizing with non-comedogenic products.
- Cosmetics (toner, cream, gel, serum) with salicylic acid and other hydroxy acids: they have an exfoliating effect. In addition, salicylic acid, by penetrating the pore, can to some extent dissolve the follicle clogging that gives rise to the first blackheads.
- Photoprotection with an oil-free product to avoid the appearance of hyperpigmented acne marks.
Medical treatment for pimples in your 30s or 40s
·Topycal treatment:
In general we will resort to retinoids (retinoic acid, adapalene, trifarotene) associated or not with benzoyl peroxide (there are creams that contain both active ingredients and are convenient to use). Both treatments are scientifically proven to be in the first line of treatment in all international acne management guidelines.
The adaptation process is usually slow and they should be used progressively (every other night) and increase their frequency little by little, always reinforcing the treatment with specific moisturizing creams. This is because in the early stages retinoids can cause redness, dryness and flaking. Tolerance to retinoids comes with time and the skin gets “used to them”.
For this reason also, the effect is slow and it is often necessary to wait about 2 months to see if they work or not. If they work, they are great treatments, because they have no negative effects and can control acne in the long term. In addition, retinoids have an anti-aging effect :)
It is important to know that retinoid creams should not be used during pregnancy. However, benzoyl peroxide can be continued.
·Oral treatment:
In many cases, especially when the pimples are more red, painful or inflamed, it is necessary to resort to oral treatment, which is usually based on:
-ISOTRETINOIN: the most effective oral treatment, which despite its bad press is very safe and about which you can read in this article. Isotretinoin is absolutely contraindicated in pregnancy as it can cause malformations in the fetus.
-ANTI-CONCEPTIVE AND/OR ANTI-ANDROGEN: these drugs act against androgens and moderate their effects, managing to control acne. They cannot be used in pregnancy.
-ANTIBIOTICS: they are quick treatments, but their effect does not usually last in the long term. All guidelines advise against their use beyond 3 months due to the risk of developing bacterial resistance, for the prevention of which it is useful to combine them with topical benzoyl peroxide. Except in specific cases, we do not usually use them as a first option.
In conclusion…
There are different treatments for pimples in adult women. Many times it is necessary to use a medical treatment, beyond mere cosmetics, so I advise you to consult with a dermatologist online or in person to find the best option in your case. Do not give up;).
