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Skin Health Research Article

Yeva Ohanjanyan


Teenage and Adult Acne:
What Causes It and How to Treat It – Physically and Emotionally


Growing up is complicated, especially during puberty. Things change: our height, body shapes, voice, and even our worldview. Unfortunately, something that can remain constant during that awkward time of our lives - and beyond - is acne.

According to a 2020 study by the Cleveland Clinic, almost 80% of people between the ages of 11 and 30 will experience acne. For those who deal with this unpleasant condition, it can be a challenging and emotionally tolling experience. As someone who has personally gone through teenage acne, post-acne skin, and adult acne, I'm here to seek answers not only for myself but for everyone in the same position. The real question here is how we can understand and deal with all of this. Can the effects of acne be undone? To find out, I spoke to Dr. Vera David, a dermatologist based in Torrance, and several patients, discussing all aspects of their skin journeys and seeking the best ways to treat the physical and emotional effects in our beauty-obsessed society.

Let's start from the roots. Our skin is composed of three layers: the outermost layer, called the epidermis, followed by the dermis and the hypodermis. It is one of the largest and most sensitive organs in our bodies. These layers play a significant role in protecting us from the elements, UV rays, bacteria, and even help produce vitamin D through sunlight. However, our skin, being the superhero that it is, often faces the aftermath of battling against these external factors, resulting in acne. The Mayo Clinic describes acne as "a skin condition that occurs when your hair follicles become plugged with oil and dead skin cells, causing whiteheads, blackheads, or pimples."

Dr. David explains that genetics play a significant role in acne, so if one's biological parent had severe acne, there is a strong chance that the individual will as well. She also points out that changes in hormones and testosterone levels, particularly during puberty, can be another cause. Hormonal imbalances in our bodies can lead to acne, and the age at which acne appears may vary from person to person. For example, one patient I spoke to started experiencing acne at the age of 15, while another started in her 20s. Both instances could be attributed to hormone imbalances, as explained by Dr. David.

Ramya Chaturvedi, an international student at USC from India, mentioned that she started getting acne in her 20s during the COVID-19 pandemic due to stress, dietary factors, and irregular sleep patterns. Another patient, Anna Grigoryan, developed acne during her teenage years as a result of puberty. Anna describes acne as a bumpy road, with breakouts occurring during her menstrual cycle. Hormone levels can change due to various reasons, including metabolism, blood pressure, stress levels, and the process of growing up, as highlighted in an article by Medical News Today.

Acne is now an unfortunate but normal part of our bodily changes. However, due to the sensitivity of our skin from its constant battles, it often leaves physical scars. According to patients and Dr. David, the physical scars commonly include hyperpigmentation, large pores, and scars themselves. Dr. David states, "Pores are tough; there's never a satisfying answer with pores." As if the aftereffects of teenage acne weren't enough, Dr. David further explains that some individuals may have never experienced acne or have had it during their teenage years, only to find it resurfacing in their late twenties or thirties. This resurgence of acne in adulthood adds an additional challenge to healing the scars and recovering from an already awkward stage in life.

Adult acne differs from teenage acne. Dr. David describes it as a different type of acne, often presenting as deeper, painful bumps on the lower cheeks and chin, with a different distribution pattern. Hormonal factors usually cause this type of acne, making it harder to treat permanently compared to teenage acne. The common factors contributing to acne all come down to genetics and hormones.

As much as we try to accept it and move on, putting on a brave face every day presents its challenges. Growing up, especially in our beauty-obsessed society, we often encounter comments and questions from people regarding our acne. The American Academy of Dermatology (AAD) states that people with acne tend to develop depression, anxiety, and low self-esteem. Ramya shared her experience, saying, "I didn't feel like going out. I couldn't put makeup to cover my face. It put mental health stress on me, to be honest. I didn't want to show people, and even when I had a housewarming party after the pandemic, I still had acne. People would ask what happened and if I was doing something wrong. It affected me mentally." Hearing her story resonated with me, as I too experienced the emotional toll that acne can have on a person. It constantly leaves us worrying about what others will say, which is unfortunate but true.

Having the right resources and support is crucial when searching for a cure or managing our skin's condition. Personally, I had my mother by my side when I first started experiencing acne, and she continues to support me as I work on repairing my skin. However, it's important to note that our parents grew up in a different generation, and their knowledge on how to deal with acne may be limited. Anna recalls, "I don't think our parents were as educated in how to deal with it, how to handle it, like taking us to an aesthetician or dermatologist. So, it just kept getting worse." On the other hand, Ramya had the advantage of her mother's knowledge and was directed to a dermatologist who could help fix her skin.

When we develop acne, we often turn to our parents for answers and support, but as much as they want to help us, they may not have all the answers. They grew up in a different time. I remember my mom telling me that when she wanted to cover a pimple during her school days in Armenia, she would apply chalk to it to reduce the redness. Each of us comes from different backgrounds and cultures, and we have learned various remedies, some effective and some not so much. However, there are treatments that may potentially work for everyone if we immerse ourselves in research.

I discussed my concerns about pores with Dr. David, and she confirmed that there is no definitive cure for them. She mentioned that retinoids, microneedling, and Botox treatments can help improve the appearance of pores, although the results may not be completely satisfying. Personally, I have tried a treatment called "Matrix," which involves a heat laser that almost burns the first layer of my skin to address pore issues. Did it make my pores disappear? No, but it did make them smaller. Dealing with pores requires patience and regular maintenance. It's like how we need to touch up our hair color every few months. Similarly, visiting a dermatologist regularly can help with our skin upkeep.

Ramya shared that she started using Accutane, a potent drug taken orally, also known as Isotretinoin. Dr. David clarifies that while Accutane has potential side effects, it can be safely administered under proper supervision. This drug requires a prescription from a doctor, and Ramya's doctor in India prescribed it to her. Despite the side effects such as dry skin, joint pain, and the potential for depression, Accutane has shown significant success in clearing acne almost completely, and acne rarely returns after the treatment. However, it's important to emphasize that this medication should be administered by a professional.

From my personal experience, the most effective treatments for managing acne and post-acne skin have been microneedling, extraction facials performed by trained experts, and laser treatments. Dr. David also mentioned prescribing Spironolactone to her patients dealing with acne. Spironolactone is an androgen blocker that helps balance hormone levels and reduce acne.

Acne is undoubtedly tough, but it can be managed. Many people are affected by it and face its challenges daily, resulting in not only physical scars but also mental scars. While researching this topic, I didn't find a one-size-fits-all cure, but I discovered stories from others and potential treatments to manage acne and post-acne skin. The cure for acne is not an overnight success, but we can strive to improve it through various treatments and, most importantly, by taking care of our mental health.




Accutane - American Osteopathic College of Dermatology (AOCD). (n.d.). 

Acne can affect more than your skin. American Academy of Dermatology. (n.d.). 

Acne scars: Causes, diagnosis, types & treatment. Cleveland Clinic. (n.d.). 

Consuelo Veronica David MD MSC. Good Dermatology. (n.d.). 

MediLexicon International. (n.d.-a). Hormonal imbalance: Symptoms, causes, and treatment. Medical News Today. 

MediLexicon International. (n.d.-b). Hyperpigmentation acne: Causes and treatment. Medical News Today. 

Spironolactone for hormonal acne. Midland Skin. (n.d.).,is%20only%20available%20on%20prescription. 

Yale Medicine. (2022, September 24). Microneedling. Yale Medicine.•A%20procedure%20that%20uses,•Involves%20dermatologic%20surgery 

Chaturvedi, Ramya. Interview. Conducted by Yeva Ohanjanyan. 11 April 2023.

Grigoryan, Anna. Interview. Conducted by Yeva Ohanjanyan. 11 April 2023.

Consuelo Veronica David MD. Interview. Conducted by Yeva Ohanjanyan. 17 April 2023.

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