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My adult acne won't subside. What can I do?

Welcome to The Globe and Mail's Ask a Health Expert centre, where our psychologist, family doctor, dietitian, trainer and pediatrician answer your personal health questions. Look for a new Q&A each weekday here.

The question

I'm a woman in my mid-30s and have recently experienced acne breakouts. I've tried Clearasil and other over-the-counter remedies. Nothing is helping! What's going on?

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The answer

It's frustrating to deal with acne as an adult, especially if you already fought the battle as a teenager. But acne is very common beyond the teen years. In fact, more than 50 per cent of women older than 25 experience outbreaks at some point in their lives.

It's not entirely clear what triggers acne breakouts, but research has identified several factors that may be involved. At the skin level, acne can occur due a blockage of hair follicles or pores by dirt, bacteria and sebum - oil produced in sebaceous glands that protects and softens skin.

Specifically in adult acne, the main factors that seem to lead to increased sebum production and blocked pores are hormonal fluctuations and chronic stress. This is why individuals are more prone to breakouts during times of hormonal change such as menstrual cycles, pregnancy and menopause, and also during periods of stress, which can increase stress-related hormones.

Fatty foods and chocolate have not been found to trigger acne but the use of heavy makeup, sunscreens and creams can block pores. To avoid this, choose products that are water-based and wash your face after use with a gentle cleanser and exfoliant.

Here are some treatment options that may help:

Benzoyl peroxide is a mild antiseptic that is often used in over-the-counter acne treatments, such as Clearasil and Proactiv. It can help treat acne, but can cause drying of the skin and can increase sensitivity to the sun.

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Salicylic acid is another popular ingredient in over-the-counter treatments. It can also irritate and dry the skin, so use it only on areas that have broken out.

For acne that does not respond to these options, a visit to your doctor may be in order. Prescription medications including topical or oral antibiotics, topical retinoids, hormonal therapy such as the birth control pill, or for more serious cases, retinoic acid - better known as Accutane - are effective options but can carry their own risks, benefits and side effects.

On average, acne treatments take six to eight weeks to take effect.

Combining the right treatment with a healthy lifestyle and limiting stress can help you keep control over your skin. Everybody is unique, so work with your doctor or dermatologist to personalize a treatment plan that will work best for you.

Send family doctor Sheila Wijayasinghe your questions at She will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.

Read more Q&As from Dr. Wijayasinghe.

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Click here to see Q&As from all of our health experts.

The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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