How to treat adult acne in men in your 20s
Acne isn’t strictly isolated to teenagers. Adults can get it too and women tend to have adult acne more than men, according to the American Academy of Dermatology.
Why do adult males get acne?
Acne occur in male adults due to hormonal changes from treatments (such as testosterone therapy), steroid use, stress and diet.
For acne to occur in males, there is either one or a combination of the following events occurring at the same time:
- An over production of testosterone and dihydrotestosterone, causing an increase in oil production. This can lead to clogged pores, giving rise to acne.
- Abnormal increase in skin shedding in the pilosebaceous gland leading to clogged pores.
- An increase in a special type of bacteria that lives inside the hair follicles and sebaceous glands known as Cutibacterium acnes. The population of C. acnes is known to higher in people prone to acne.
What foods causes pimples in males?
Foods high in sugar affect insulin levels, causing the testes to produce more androgens. Increase in androgens causes the sebaceous glands to produce more sebum and therefore the likelihood of acne. Foods with a high glycemic index such as bread, rice and pasta can also cause sugar spikes, causing the body to produce more insulin.
Diary stimulates insulin growth factor (IGF-1) release from the liver. IGF-1 stimulates insulin. Insulin causes the testes to produce more androgens and the cycle continues.
This is a simplified summary but there are plenty of research to support this.
For example, in 2022 Meixiong published a systematic review analysing 34 clinical studies on acne and diet. The study concluded diets with a high glycemic index, increased glycemic load, and carbohydrate intake have a significant proacnegenic effect. Increased dairy consumption may have been proacnegenic in select populations, such as those in which a Western diet is prevalent.
What is the best acne treatment for males?
The best treatment is always identify the underlying cause and a implementing consistent skincare routine.
If you're on testosterone therapy for a medical treatment, it is worth adjusting the dose with your doctor.
Daily cleansing to remove sunscreen, debris and oil is important to keep the pores unclogged. Avoid ingredients such as benzyl peroxide and witch hazel which can really dry the skin. Choose a gentle cleanser with antibacterial ingredients such as Salicylic acid is vital.
A topical retinoid such as adapalene, tretinoin or retinaldehyde to unclog pores and exfoliate the skin. Retinoids increase the rate at which our skin cells divide to help reduce brown acne marks. Retinoids also have anti-ageing benefits when used consistently.
In severe cases, oral retinoids such as isotretinoin is also prescribed, alongside seven days of oral corticosteroids to reduce swelling, inflammation and red acne marks.
Reducing your intake of dairy and sugary foods can also improve acne.
References
1. Benzyl Peroxide (2019). NHS UK. Accessed: https://www.nhs.uk/medicines/benzoyl-peroxide/ Assessing Salicylic Acid for Acne (2021). Journal of US Pharmacist.
2. Australian Medicines Handbook 2021
3. Layton, A (2009). The use of Isotretinoin in Acne. Journal of Dematoendocronology. May-Jun; 1(3): 162–169.
4. Del Rosso, J (2012). Face to Face with Isotretinoin. Journal of Aesthetic Dermatology. Nov; 5(11): 17–24
5. Meixiong, J et al. (2022). Diet and Acne: A Systematic Review. Journal of American Academy of Dermatology. June, volume 7, p95-112
