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Hi, My Name is Brett and I suffer with adult onset acne! There, I said it. It is truly one of the most frustrating things I have ever had to deal with. I do not write this blog, because I have conquered it. I write this blog, because I have tried numerous products — and have found one combination that has worked for me… finally!

Turning 30 was a very difficult thing not only mentally, but physically. I developed, among other things, acne around this time. Being a Nurse Practitioner clinician and speaker, I am in front of a lot of people every day. I struggled with the idea that patients and audiences would not take my recommendations seriously, when they discovered that I could not even treat my own acne. While this thinking may be a bit overboard, it has always been on my mind. I have been to numerous dermatologists, with little to no help. So, I began extensive research — and have developed a treatment plan that is working.

What Is Adult Onset Acne?

Adult onset acne is a skin condition that occurs in adulthood when your hair follicles become plugged with oil and dead skin cells. Acne most commonly appears on your face, neck, chest, back and shoulders. Acne can be distressing and annoyingly persistent. Acne lesions heal slowly, and when one begins to resolve, others seem to crop up.

Depending on its severity, acne can cause emotional distress and lead to scarring of the skin. The good news is that effective treatments are available — and the earlier treatment is started, the lower your risk of lasting physical and emotional damage.

Even as an adult, fluctuating hormones can cause acne flare ups. Androgens are hormones released from the adrenal glands, the ovaries, and the testes. These hormones stimulate the sebaceous glands, increasing oil production and creating a skin that is more prone to comedones, or breakouts.

Adult onset acne most commonly affects women. Sharp hormonal fluctuations often occur during ovulation and menstruation, pregnancy, perimenopause, and menopause, and can also be caused by using certain birth control medications. Women may see their acne suddenly develop, or worsen, during these periods of life.

While acne strikes adult women at a greater rate than men, they are not immune to acne. Acne in adult men usually starts in the teen years and stays with them into adulthood. Men tend to have more severe and longer lasting acne than women, because of the higher levels of testosterone within the body. It is not uncommon for acne in men to last 10 years or more, if left untreated.

My acne was cystic is nature. I would have large firm, painful, red, swollen and warm areas appear. You are always told not pick…. well WHATEVER!!! I quickly found that if I did not extract the large core from the cyst, it simply got worse. Now, I will tell you – DON’T PICK YOUR FACE. It is the single worst thing you can do, and it makes everything worse. I have a health care degree and knew what I was doing. I don’t recommend this at all!!

What I Tried That Didn’t Work:

1) Birth Control Pill: I have taken these over the years for their intended purpose, but I was also on the pills that were supposed to help with acne. THEY DIDN’T FOR ME!

2) Doxycycline (Oral Antibiotics): The first dermatologist put me on antibiotics. They didn’t work either. I took them for many months with no improvement. You should be careful when taking long-term antibiotics for acne – as the ‘cycline antibiotics can cause discoloration of teeth after long-term use.

3) Clindamycin Ointment: Helped some initially, but never got rid of acne.

4) Retin-A: I used this for at least 5-6 mos., and I really think my acne actually worsened on this product.

5) Proactive: This probably worked best for me, but it was VERY drying. I was also concerned with the harsh chemicals, and my aging skin. This works better in younger people. I believe aging skin in adults, needs special attention.

6) Obaji Skin Care Line: I was sure this line would work for me. It cost an arm and a leg, and again my face actually worsened on this product.

7) Erno Laslo Skin Care Line: This is the skin care line used by Marilyn Monroe – it cost a kidney and liver. But, I was desperate (at this point – my husband would have paid just about anything, as he was seeing the devastating effects from acne). It helped some – but still had acne.

8) Benzoyl Peroxide (In Many forms) and Salicylic Acid: Of any of the treatments, these worked best – still couldn’t get the right combination. I later discovered I was sabotaging my face and skin, by some simple techniques I was doing.

9) Aesthetics: Chemical Peels and Microdermabrasion – These felt great. The microdermabrasion was basically useless for acne. The chemical peels helped, but you experienced extreme peeling after you had the treatments. It still did not really help the acne. I am definitely considering adding peels back into my regimen now, that I have my acne more controlled. It definitely has it’s place, in healthy aging skin.

Each of the above therapies was tried on average of at least 6 mos. at a time. You must get your skin through a couple of “turnovers” to see if a product is actually beneficial. So, I am writing from the point of view – I am not only a health care provider, but a sufferer

The Products I Use:

Here is what I love: most of my ingredients can be bought over-the-counter. After investing a large amount of money in all of the above therapies, these are so much cheaper. Only one product is by prescription, but can be bought over-the-counter.

I cannot take credit for this regimen, really. I had an idea of what could work, but found this AWESOME website: www.acne.org. You can read in-depth information here.

1) The Facial Cleanser:


  • Soap. Soap will dry and irritate the skin. A tell-tale sign of whether something is soap is a lack of an ingredient list. Soap manufacturers are not required to list ingredients on the package.
  • Sodium Lauryl Sulfate (SLS). SLS strips the skin, damaging its protective barrier and introduces irritation. Avoid it altogether.
  • Sodium Laureth Sulfate. Not as big of an offender as Sodium Lauryl Sulfate, Sodium Laureth Sulfate should still be avoided if it is one of the first 3 or 4 ingredients in a cleanser. If it is far down in the list of ingredients, it should be okay.
  • Scrubbers. Scrubbing beads, seeds, shells, sugars, or anything else that is made to “scrub” the skin is the last thing inflammatory acne needs. Scrubbing irritates the skin and should be avoided at all cost. Unless you have only non-inflammatory acne, the kind that never gets red and is way under the surface of your skin, or unless you only get blackheads, avoid scrubbers entirely.
  • Scents. Some fragrances tend to irritate some people, and some do not. I recommend avoiding scents when possible.
  • Isopropyl Palmitate, Isopropyl Myristate, Myristal Myristate

Look for:

  • The words “gentle“, “non-over drying“, “for dry, sensitive skin“, and similar words alluding to the gentle nature of the cleanser.
  • Glycerin, a moisturizing ingredient, is often included in non-over drying cleansers, and is a welcome addition to an ingredient list.


  • Clean & Clear Foaming Facial Cleanser
  • Purpose Gentle Cleansing Wash
  • Basis Sensitive Skin Bar
  • Cetaphil Gentle Cleansing Bar
  • Cetaphil Gentle Cleansing Bar, Antibacterial
  • Purpose Gentle Cleansing Bar
  • Netrogena Extra Gentle Cleanser
  • Cetaphil Gentle Skin Cleanser Wash – *** This is my favorite***

The Treatment:

Benzoyl peroxide must be 2.5% strength, initially. I now use 5%, because I can get a 90gm tube which will last 2-3 mos. and costs much less. You definitely want to start with 2.5% – because it is drying. Neutrogena on the spot is basically the only 2.5% strength on the market. It comes in tiny containers. This is why it is a good idea to see your healthcare provider and get a prescription for a larger container.


  • Alcohols. Alcohol can tend to dry and strip the skin.
  • High levels of moisturizing ingredients. You want benzoyl peroxide to be in a neutral base. Part of why benzoyl peroxide works so well is because it is a mild drying and peeling agent. Too much moisturizer in the formula can prevent some of this drying and peeling from taking place. It’s best to give benzoyl peroxide the environment it needs to do its job.
  • Other active ingredients. When you start adding in other active ingredients that means you’re adding in an external variable. We want to get you completely cleared up on The Regimen before adding in any external variables. Once you’re completely clear, you can feel free to add in 1 variable at a time. If you stay clear, you’re good to go. If you break out from the new variable, you’ll know it’s the culprit.
  • Fragrance. Some fragrances tend to irritate some people, and some do not. Avoid if possible.
  • Isopropyl Palmitate, Isopropyl Myristate, Myristal Myristate
  • 10% benzoyl peroxide, 5% benzoyl peroxide

Look for:

  • Gel based benzoyl peroxide. Cream based benzoyl peroxide tends to turn white when you perspire. This can cause embarrassment at times. Also, cream based benzoyl peroxide can be harder to apply since it dries so quickly. Gel based benzoyl peroxide gives you more time to apply and also does not turn white when you perspire.

The Moisturizer:

Be diligent when checking labels.

Without SPF:


  • Most oils with the exception of jojoba oil (which is actually an extremely welcome ingredient), macadamia nut oil, and mineral oil. Some other oils may be safe as well, but generally it’s a good idea to avoid oils.
  • Thick and greasy moisturizers. Moisturizers that are too thick and greasy can sometimes tend to clog pores. Plus, when a moisturizer is thick, it can be harder to apply gently to avoid irritation.
  • Isopropyl Palmitate, Isopropyl Myristate, Myristal Myristate

Look for:

  • Moisturizers made specifically for the face.
  • The words “non-comedogenic” on the label.
  • Jojoba oil as an ingredient.

If buying on store shelves:

Some people find that these options work well for them, however:

  • Cetaphil Moisturizing Lotion. Takes care of flakiness well. I’m slightly concerned with the combination of Cetearyl Alcohol and Ceteareth-20 as the 3rd and 4th ingredient, however, due to high comedogenicity scores in rabbit ear assays when this combination is used.
  • Complex 15. Contains Mysristyl Myristate, a highly comedogenic ingredient, but as the 12th ingredient. Requires jojoba oil with each use for full moisturization.
  • Lac-Hydrin Five. Contains AHA, so not for use at the onset of The Regimen. Wait 4 weeks before use.

With SPF:


  • Most sunscreens. In my experience, most SPF moisturizers I have tried have broken me out. I am uncertain if this is due to a particular active ingredient or the stabilizing ingredients. I am researching this and will report back when I find out more.
  • Isopropyl Palmitate, Isopropyl Myristate, Myristal Myristate
  • I have not found any good SPFs other than Oil of Olay Classic Gentle Formula (see below).

I use nothing except Jojoba Oil on my face. I LOVE Jojoba Oil. It is natural. I buy 100% Jojoba Oil at GNC. I love it even more, because it is also good for your hair. So, I use it as my moisturizer twice daily and in my hair periodically. (Be on the lookout for my blog about Jojoba Oil).

Alright, now you know what products to buy. I recommend checking out www.acne.org. Next, I will blogging about my skin care regimen and the Do’s and Don’ts of skin care.

I would love to hear from you regarding what skin care products you use!