What Causes Sudden Acne Breakouts in Adults?

1. Fluctuating hormone levels around the time of a woman’s period
2. Things that are used to cover the head such as hats and sports helmets
3. Environmental factors such as:
   • Air pollution
   • High humidity
   • Heat
   • Exposure to the sun
4. Using oily skincare products (heavy lotions and creams)
5. Haircare or hairstyling products (dripping of oil from the products on the facial skin causes acne breakouts)
6. Frequent contact with oil such as in restaurants
7. Stress
8. Diet heavy in carbs and processed foods
9. Using too many products on the skin simultaneously
10. Removal of facial hair
11. Use of comedogenic makeup remover products (use a gel-based cleanser instead)
12. Not removing makeup at night with a good cleanser
13. Some medications
14. Genetics (acne may run in families)
15. Certain foods such as:
    • Skim milk
    • Whey protein
    • Diets high in processed food and sugar
16. Smartphones (bacteria on smartphones can be passed to your skin when you continuously take your phone to your ears for talking)
17. Dry skin (excessive dryness of the skin triggers oil production)

You may be prone to developing a certain type of acne. Seven types of acne that are based on their appearance (and sometimes on their cause) include:

1. Blackheads: Open bumps on the skin filled with excess oil and dead skin that look like dark spots as if filled with dirt
2. Whiteheads: Closed bumps filled with oil and dead skin
3. Papules: Small red or pink bumps
4. Pustules: Small pimples containing pus that look like whiteheads surrounded by red rings, which are most likely to scar if picked at
5. Cysts: Pus-filled large pimples that are most likely to scar
6. Nodules: Large and painful solid pimples that are formed deep in your skin
7. Fungal acne: Also known as pityrosporum folliculitis; this type of acne can be itchy and is caused by the accumulation of fungus (yeast) in the hair follicles

If over-the-counter prescription medications have not worked for your acne, your doctor may put you on prescription drugs. These acne medications work on either the oil glands or infection-causing bacteria on the skin.

• Do not expect the acne treatment to start working immediately.
• You may need to wait for four to eight weeks with most prescription drugs to show their effects.
• Sometimes, the waiting period can extend to even months or years for the acne to disappear completely.

Your doctor will decide the best treatment for your depending on your age, the type and severity of your acne, and your willingness to commit to the treatment. The treatment most often involves a combination of topical medications and oral prescription drugs.

Sometimes, procedures such as laser and chemical peeling may be recommended for severe acne not responding to other treatments. Inform your doctor if you are pregnant or planning to conceive because certain medications must be avoided in pregnancy.

Topical medications

The most common topical prescription medications for acne include:

• Retinoids and retinoid-like drugs:
  • These are available as creams, gels, and lotions and may include:
    • Tretinoin
    • Adapalene
    • Tazarotene
  • You first apply the topical retinoid medication on alternate days (three times a week). As your skin adapts to it, you can apply it daily. It works on acne by preventing the plugging of hair follicles. Your skin becomes sensitive to the sun, so you need to apply sunscreen diligently when venturing out during the day. Additional side effects include skin dryness and redness, which can be reduced by applying moisturizer.
• Antibiotics:
  • These work by killing excess skin bacteria. The most commonly used antibiotics include clindamycin and erythromycin.
  • Antibiotics need to be used in combination with other topical medications such as benzoyl peroxide to prevent resistance to antibiotics. Examples include:
    • Clindamycin with benzoyl peroxide
    • Erythromycin with benzoyl peroxide
• Azelaic acid:
  • It has antibacterial properties and is available in the form of cream, gel, and even soaps. It is safe during pregnancy and breastfeeding and can be used to control discoloration that occurs with some types of acne.
• Salicylic acid:
  • Salicylic acid may help prevent plugged hair follicles and is available as both wash-off and leave-on products.
• Dapsone:
  • Dapsone five percent gel two times daily works best for inflammatory acne, especially in women with acne.

Oral medications

• Antibiotics:
  • Your doctor may put you on antibiotics if you have moderate to severe acne, which most commonly includes:
    • Minocycline
    • Doxycycline
    • Erythromycin
    • Azithromycin 
• Combined oral contraceptives:
  • The U.S. Food and Drug Administration has approved four types of birth control pills to treat acne in women. These contain a combination of female hormones—estrogen and progesterone.
• Anti-androgen agents:
  • Your doctor may put on the drug spironolactone if oral antibiotics fail to work on your acne. It blocks the effect of androgen hormones on the oil-producing glands to reduce acne breakouts.
• Isotretinoin:
  • A derivative of vitamin, isotretinoin may be prescribed for you as a last resort if you have moderate or severe acne that has not responded to other treatments. These medications are avoided in women who are pregnant or planning to be pregnant due to the risk of harm to the unborn baby.

Other therapies/procedures

Depending on your skin condition, your doctor might suggest one of these specialized therapies or procedures:

• Steroids (injected into large nodules to reduce inflammation)
• Chemical peels (use of special chemicals to remove the top layer of old skin)
• Lasers (use of targeted heat to stimulate the production of collagen and decrease the severity of acne scars)