That's probably related to the more varied and volatile hormone changes that accompany the adult physiology and lifestyle. Also, subtle early pre-menopausal changes in estrogen and testosterone may contribute.

Women are subject to more stress than perhaps at any other time in history. There are more concrete demands and more mixed messages demanding personal and professional perfection. The price is often physical and emotional exhaustion and emotional stress. How is it possible for the skin to not respond badly as well?

The final basic “cause” of adult acne is the same, abnormal response of the follicle lining cells to androgens. However, there are many more potential and identifiable causes in women, i.e. hormone medications, menses, pregnancy, personal care, etc.

The following regimen is one which is typically recommended to varying degrees of adult acne:

- Non-comedogenic soaps, cosmetics, etc. Many skin cleansers, make-up, etc. actually leave residues which block pores, and can make acne worse. The products which are used should state that they do not exacerbate acne. Some have recommended a very inexpensive, "natural" topical antibiotic. Placing 1 tsp. of essence of lemon oil (found at supermarkets) in to 4 ounces (120 cc) of liquid soap. This is used for cleansing the skin - essence of lemon has antibacterial properties.

- Topical antibiotics: several antibiotics (esp. tetracycline types, erythromycin, clindamycin, etc..) are prescribed for adult acne twice daily. They usually come in a "roll-on" type bottle.

- Topical Vitamin-A acid (e.g.. Retin-A): cause peeling of the superficial layer of the skin to lessen new comedone formation. Quite effective. Face gets "raw" if use to much. Must use a sunscreen. Takes 4-6 weeks of consistent use to attain benefit.

- Facial cleansing: people with adult acne usually have very clean skin because attention they give to this area.

- UV light therapy: should be done with great care and under the supervision of a dermatologist.

- Oral antibiotics: tetracylines or erythromycin are most commonly given by mouth for moderate to severe acne in adult. More expensive antibiotics are not necessarily any better than plain tetracycline. Tetracyclines work very well, however because they can discolor new bone formation, they are contra-indicated in youth who have not completed their permanent teeth, as well as pregnant and nursing females.

- Isotretinoin (Accutane) is indicated in only the severest adult acne cases. It is highly effective at reducing sebum production, comedone formation, inflammation, etc. However, it can cause severe birth defects if taken while pregnant and runs the risk of toxicity, requiring certain laboratory monitoring prior to and during therapy. It usually needs to be taken for at least 20 weeks. All other adult acne therapy is stopped while on isotretinoin.

In general, it's not how you wash, what you eat, what you drink, or impure thoughts. The over-the-counter, television, and internet “miracle cures” are too good to be true. REALLY. You need real therapy that can clear your skin.