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November 10, 2018 • 20 mins

Somewhere along the line, we bought into the myth that acne is merely a rite of passage for teens, rather than something that grown-ups with jobs and bank accounts should have to worry about. Cristen and Molly look into why so many women and trans men struggle with acne, how birth control affects and additional treatment options.

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Episode Transcript

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Speaker 1 (00:06):
Hey, this is Annie, and you're listening to stuff I've
never told you. A couple of you listeners have written
in about acne, and particularly adult acne, especially in response

(00:27):
to her episode around cosmetic surgery. You talked about how
it negatively impacted your self confidence, how it made you
uncomfortable in your own skin, and I can relate. I
had acne well into college and I still get stressed acne,
particularly around my mouth, and it's that painful, throbbing kind
to that that reminds me of Postulio from Invader Zim.

(00:48):
If anyone anyone has seen that, that really scared me
as a kid. But anyway, I felt like it was
all anyone could see. And in the interest of total transparency,
mine wasn't that bad of a case either. It certainly
felt that way to me, but um, it was pretty manageable.
My brother, on the other hand, he had a really

(01:09):
severe case of acne, and he took medicines, he got injections,
all kinds of things that were uncomfortable or painful or
messed with his hormones so that kids would stop making
fun of him. And it makes me really sad and
really angry. We hardly ever see acne and our media too.
It was so surprising to me to see it in
that movie Boyhood. If anyone remembers that, um, but it

(01:31):
impacts so many of us. And I remember reading too
that in movies like Harry Potter they used enhancement technology
to get rid of their pimple so that their skin
would appear clear, which on the one hand I totally get,
But on the other hand, it would have been kind
of a nice thing to know. Hey, this can happen
to anyone, and it does happen to a lot of us.
It's a myth that acne goes away once you enter adulthood,

(01:54):
and this classic episode is going to look into all
of that, So please enjoy. Welcome to Stuff Mom Never
told you from House Stuff Works dot com. Hold, and
welcome to the podcast. I'm Molly and I'm Kristin Kristen.

(02:16):
Whenever you're having a bad day, and I'm sorry to
the teenagers that are about to hear this. Whenever I'm
having a bad day, sometimes I go, well, at least
puberty is over. Oh man, you're right about that. Puberty
is a rough time. We're thinking of you, teenagers. It
is not fun. Your hormones are going crazy. And one

(02:37):
thing that I definitely remember from my my puberty years
acne acne. It was it was not good news for me,
and it's not good news for a lot of teenagers.
But we're going to talk about today is how this
is going to be the saddest podcast ever. I think,
I know, Molly, you really start this off on a
down note. Acne may not end after puberty. That's what

(03:00):
people tell you. If you can just get through puberty,
you'll sail through college with your clean skin and then
it might just come back. Or you go through puberty
with pretty good skin and you're like, WHOA touch that bullet.
Wait a minute, no adult acne strikes. We call that karma.
No we don't. I don't. I don't mean to say

(03:21):
that people who who had clear skin and puberty are
bad people, but I think we can all agree we
dislike them just a little bit. Well, anyway, thoughts thoughts
on clear skinned people aside, Let's talk about some adult
acne because here's the thing it might sound, you know,
adult acne is just one of those unfortunate sounding terms,

(03:44):
you know, like I know, yeah, adult acne, Like there's
something wrong, like it's a complete mismatch because, like you said,
we usually associate acne with adolescence. But take heart, all
of you people out of high school who are having
some some pimpular attacks. Yes I just made that word up.
It happens to a lot of people. First of all,

(04:06):
acne is the most common skin condition period, all right,
and it happens to get this of people between eleven
and thirty. Yeah, that wasn't eleven and fifteen or eleven eighteen,
that's eleven and thirty. So adult acne is kind of
this new, I don't want to say buzz word, but
a new phenomenon of sorts in the skin industry because

(04:27):
you know, people did think that, uh, pimples were something
that happened to teenagers, and when an adult woman came
in saying look at my skin, dermatologist kind of would
throw their hands up in the air and say, that's weird.
And for anyone who's ever seen you know, close ups
of P Diddy on proactive commercials, we all know it.
It doesn't just happen to kids. But you know what,

(04:47):
P Diddy is kind of a rarity, Kristen, because let's
break this down a little bit by gender, because good news, ladies,
it affects us more. Hey guess what what did you know?
And I'm sure you can just see the reason for
this coming mile way. And we'll get into hormones and
stress and all that good stuff later, but first, let's
just talk about this breakdown between men and women, because
I thought this was pretty fascinating. It's a two thousand

(05:09):
seven study that was done at the University of Alabama
at Birmingham School of Medicine, and this researcher went around.
She had a thousand thirteen men and women aged twenty
and older who were at the school, and you know,
very similar to that eight percent number you throughout Kristen,
seventy three point three percent of these participants at one
time or another had dealt with acne. Most of them

(05:30):
had had it when they were teenagers. But she was
finding a pretty pretty studying percentages of people who were
affected as adults, right, because as teenagers, the breakdown between
men and women affected by ACNE was pretty much the same.
We had sixty eight point five percent of males, sixty
six point eight percent of females. But then but then

(05:54):
we enter our twenties and then fifty point nine percent
of women and forty two point five percent of men
reported experiencing acne. So there we've got about, you know,
seven point five percent difference. During the thirties, thirty five
point two percent of women and twenty point one percent
of men reported experiencing acne. So now we're up to
fiftent And yes, both percentages are dropping, both genders as

(06:18):
as the times goes on. But that gulf between men
and women is getting wider because during their forties we've
got twenty six point three percent of women twelve percent
of men, and during fifties fift three percent of women
and seven point three percent of men. So it can
affect you as long as as your fifties. Yeah, and
as if your head isn't swimming with enough percentages right now,
I'm just going to throw one more out that kind

(06:38):
of sums up this whole thing, all right from this study, Uh,
three point five percent of men reported that their acne
worsened post adolescents, just three point six percent thirteen point
three percent of women reported post post adolescents acne worsening.

(07:00):
Oh so just it's just not fair. Yeah, what are
all those numbers saying? Yeah, we we got it worse ladies,
all right, And guess what. A majority of those women

(07:20):
who have trouble with adult acne report that they get
their flare ups around menstruation. So here we go. So
that leads us well into the big H word. We
haven't thrown around in a while. I don't think how we, Kristen,
I don't know, maybe like a couple of a couple
episodes or something. Well, that's a long time for us.
And so we're gonna we're gonna turn back to old

(07:41):
hormones because just just as in the teenage years, that's
a major cause of adult acne. But I would say
that the causes of adult acne are a bit trickier
to unwind than they are for teenagers. For teenagers, it
seems that treatment is pretty straightforward and the causes are
pretty straight forward. But it gets a little trickier, a

(08:02):
little trickier once you're out of school. Because the interesting
thing is with the hormones as it relates to women
an adult acne. A lot of times you guys are
probably guessing right now, let me guess, Chris Samali, You're
gonna talk about estrogen for another twenty minutes. Psych testosterone
and it's uh, androgen's which we've talked about before, especially

(08:24):
if you remember our peak host podcast. That's UM an
androgen imbalance and some and acne is one of the
main symptoms of PEAKS polycystic ovary syndrome and UM. So
sometimes women will go in and people might just immediately
jump to that and that causes the acne people to
you know, get get kind of thrown off. Because they've
done a few studies about whether androgen's can be the

(08:47):
cause of this persistent acne in later years and women,
and the studies are really inconclusive, UM in terms of
you know, an extreme abnormality indicating this presence of acne
and women. You know, they've done studies on all sorts
of hormone levels and there's really no clear pattern of um,
you know, one big hormone that's out of whack leading

(09:08):
to adult acne. It's very very in conclusive, so you
can't just say it's this hormone or another one. But
they do think it has something to do with androgen's, right,
because androgen's is would be a logical conclusion because androgen's
if you have a spike, and androgen's you're gonna have
a spike in sebum production. And see bum is the

(09:28):
oil that your face, oil that gets into those hair follicles,
clogs it up, mixes with some soloft off skin sales, siles,
some like a southern ga I'll talk in, yes, I am,
and then mixes with some you know, maybe some some
dirt that's gotten in there, and you got yourself a pimple,

(09:53):
and it's it's as christ And said, it's sort of
all below the skin. So you can't look at a
teenager or a woman who's really really zity for lack
of a better word, and just think, oh, she has
hygiene problems. She doesn't. You know, you can't wash away
pimples that happens under the skin. So that's not the
thing that's going on. So if it's not the androgens,
if that's still controversial, what else could it be. Doctors

(10:13):
are also throwing out things like genetic predisposition. Sure, if
you've got a family row that's got it, bad news
for you. Smoking is a huge one for women, yes,
because smoking also amps up your sebum production as well,
which makes sense because you know, if you're if you're smoking,
all of that smoke around your face is going to
dry things out, and as soon as your face gets

(10:35):
really dry, it's gonna kick that oil production into overdrive. Cosmetics,
if you use cosmetics, you want to make sure that
they are non kometogenic. Well, this goes for cosmetics and
for face lotions. All the stuff on screens too, and sunscreens. Yes,
that you're putting all over your face, make sure that

(10:55):
they are non kometogenic, meaning that they don't clog pores.
Looking for oil free formulas is also a good idea
because there is a dermatologist in one of our sources
that mentioned that the average American uses up to seven
products on the face and all of that stuff really
is not it's not really helping you out very much.
Kick one and just dedicate your life to it, right,

(11:17):
don't don't switch back and forth. All right, let's talk
about stress, Kristen, because this is another controversial one. There
are some sources when we were reading about adult acne
that we're like, oh, stress is not a quantifiable factor
in adult acne. You can't. We don't see a cause
and effect. But then people who have acne tend to

(11:38):
be really stressed, and uh, you know, they thought it
was more, you know, one happened and then the other.
But I think it's more a vicious circle, is what.
More people are realizing that stress can kick that oil
into overdrive cause acne, and then once you've got the acne,
you are stressed because you have acne, and it just
it's a vicious circle. And there's some evidence, according to
one paper we read from England, that the stress of

(12:00):
thing adult acne can be much greater than the stress
of having teenage acne. Um we don't think stress can
get worse than being a teenager. But because so a
few people recognize that adult acne is a condition, then
having a few pimples can really affect you know, you
as an adult, particularly because there are studies that show

(12:22):
that people who have pimples who have acne have a
lesser chance of landing a job than someone who has
clear skin. But you know what, one thing that can
ease our minds about this whole stress acne vicious circle
that you are that you're talking about, Molly, it's the
fact that, let's say you're really stressed and sometimes and
this is highly stereotypical, but you know what, for me,

(12:44):
sometimes it's true when I am pulling my hair out
with stress. I might want to eat a piece of chocolate. Okay,
I like dark chocolate, alright, So but if I eat
that piece of chocolate, is that going to mean I'm
going to break out and my going to aggravate this
whole cycle even more. No. So there's one thing that's

(13:05):
one silver lining with all of this. There is no
scientific evidence linking chocolate or even greasy foods too breakouts. Now.
At the same time, obviously, if you're just living off
of high sugar or high fat diets, you're not going
to feel very great and that might again aggravate that

(13:25):
stress level because your body is just not going to
handle it quite as well. But every now and then,
if you like to have that piece of dark chocolate, no,
no worries face. You're not endangering your face. Let's talk

(13:48):
about one big difference between teenage actinge and adult acne Kristen,
where it happens. Yes, because when you're a teenager, you
tend to break out in your oily tea zone, forehead, yeah,
the nose. I'm just seeing pictures of myself flashing up
as soon as I name a body part. But adults
have it more around their chin, their neck um, cheeks

(14:11):
lower more at the lower face. And why this gets
harder to treat is because you're not just treating an
oily area. Adults don't have that oily skin that a
teenager might have. They might have more combination skin. And
as if things can't get worse, they might also be
trying to treat wrinkles right there. Yeah, so sometimes the
things that will treat the acne will cause the wrinkle.

(14:32):
It's it's another vicious or the wrinkle streams might be
too harsh on the skin. That's why you do want
if you if you have noticed that you all of
a sudden are having some some flare ups, talk to
a dermatologist to make sure that you aren't doing your
skin more harm than good by whatever your daily facial
regimen is right, And if it if the acne does

(14:53):
bother you, then um, like christ And said, talk to
a dermatologists. You might need a slightly different tweak than
what a tea andrews. You don't need to go by.
You may not need to go by like the nutrol
gena clear soil that we all use when we were teenagers.
And the thing is, with all of this a lot
of people are talking to their dermatologists. In fact, so
many people and by people I mean adults are talking

(15:15):
to their dermatologists about this. That there has been a
huge industry boom related to adult acne. And the final question,
while we've been almost like fearmongering I think about adult acne,
I guess the final question is are these statistics growing up?
Are the incidents rates of adult acne actually going up

(15:37):
as as these studies would suggest, or have we just
become hyper aware of our own face condition by watching
too many Proactive commercials? You know what I mean. Yeah,
there's this really interesting article in The New York Times
by Natasha Singer called why should Kids Have All the Acne?
And it was about sort of how Proactive had a

(15:58):
really genius marketing camp hame because it targeted women of
our age Kristen, women who thought they were past worrying
about pimples, and said, you need to take this aggressive
care of your face because you do get breakouts. The
question is is whether these breakouts are worth treating. So
it's almost like half the things we read and researching

(16:19):
this podcast, where like people should know adult acne is real,
and the other half of things we read were people
should know that breakouts happen, and it's not worth investing,
you know, hundreds of dollars in a continuing, proactive or
any other acne treatment regiment. So um, you know. They
did raise the point in that article that it may

(16:39):
not be that these numbers are rising so much as
adults have health insurance so it's easier for them to
go to a doctor and get something they can use
on their face, and that they are just more anxious
about it because they think their acne days are behind them.
So to me, the main takeaway of all of this
adult acne research is to take at least small comfort

(17:01):
and knowing that if you are out of high school,
even out of college, and you're having some out of
nowhere some acne flare ups, you're not alone. You're not alone.
I'm willing to tell you that I've got a giant
ZiT on my cheek right as we record this podcast.
She does people, So you know, if you're walking around

(17:21):
there having a bad skin day, just know I'm right
there with you today. So that's what we've got. We
want to know what you think adult acne. Have you
experienced it? Do you have a great way to prevent it.
Do you think that you know it is just something
that's being uh voisted on us by the skin industry,
and uh let us know what you think. And the
email addresses mom stuff at how stuff works dot com.

(17:44):
And let's read a few emails that we've gotten to
that very email address. I have one here from Vaughn
and it's about our Tribute to Doll podcast. Kristen Vaughn writes,
while I'm a guy, I did have a bunny rab
a doll as a small child. It was more of
a stuffed animal. But I couldn't function with thought the thing.
I brought it everywhere and did everything with it. Apparently,

(18:06):
the day I got it, it belonged to my mother's
a child, I had the task of naming it. So
of course Sesame Street was on and the word of
the day was exit. Apparently I was so moved by
this word of the day that it became the name
of my rabbit doll. To this day, I can't see
an exit sign without thinking about bunnies. Also, I once
lost exit before bed one night. My parents frantically searched
for the dolls. I cried. They couldn't find it, but

(18:27):
they remembered they had another rabbit doll in the attic.
They gave the job to me and suggested I name it.
I didn't want to name it, so they naturally suggested
the name of Entrance. So as a child, I had
no idea why other kids thought my stuffed animal dolls
have funny names. Totally made sense to me. Nice All right, Well,
I've got an email here from James, and this is
in response to our episode on chivalry. He said, I

(18:51):
can understand from the female perspective how constantly being on
the receiving end of these courtesies would seem like an
unbalanced equation, but rest to share that we don't give
these acts because we view women the lesser. Every time
I hold the door for a woman or give up
my seat on the bus, I'm making a reaffirmation to
myself that I am a gentleman, not hinting that I

(19:12):
view her inferior in any respect. I also tend to
believe that whereas women can vocalize their intent and feelings
towards others with greater ease, most of us men are
left primarily with our actions to speak for us. Treat
us like a magic act be entertained by what we're saying,
but watch our actions for a proper glimpse at our
intent and motivations. Interesting. That's an interesting perspective, James. Thank you, so.

(19:37):
If you've got something to say, email us again Mom
Stuff but how stuff works dot com. You can also
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where our name is mom Stuff Podcast. And last but
not least, you can see what we're doing during the
week on our blog. It's called stuff Mom Never Told You,
and it's at how stuff works dot com. For more

(20:01):
on this and thousands of other topics, visit how stuff
works dot com. Want more how stuff works, check out
our blogs on the how stuff works dot com home page.
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