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Adult Acne? 6 Things Everyone Needs to Know

Because you think you know everything there is to know about acne and blackheads ... but you don't
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Like braces and heartbreak, acne is something most of us endured as teens. Eventually, you outgrow those epic awkward years, but in a cruel twist of fate, acne can rear its red, inflamed head well into adulthood -- especially in winter. Cold winter weather means there is less moisture in the air, which leads to drier skin. To compensate for lost moisture, the skin overproduces sebum, which combines with dead skin cells to block hair follicles. Then, boom: You break out.

Treating adult acne takes finesse -- you can't just go back to using Stridex pads and Noxema. We hit up a few dermatologists to find out everything you need to know about adult acne -- from why it's stalking you well beyond puberty to the best ways to prevent and treat breakouts.

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Hairline Acne Can Spread to Your Face
You know all of those products that keep your hair perfectly smooth and glossy? They cause the blackheads and breakouts around your hairline -- a.k.a. pomade acne, says New York dermatologist Macrene Alexiades-Armenakas, M.D. And those bumps can spread onto your cheeks, especially if you sleep with product in your hair (it gets all over the pillow and thus, your face). Prevention is the only real treatment -- go cold turkey on those leave-in products and don't revert back to using them even when you're free and clear, says Alexiades-Armenakas.

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Your Acne Could Be Caused By a Serious Medical Condition
"If you've tried a lot of medicines, pills and prescriptions, think about your hormones," says Miami-based dermatologist Betty Bellman, M.D. She sees a lot of patients who come in with symptoms of persistent acne, those stray, wiry facial hairs, and trouble losing weight. Sound like you? It could be PCOS (polycystic ovary syndrome). According to the Office on Women's Health, as many as five million women in the U.S. may be affected. Dr. Bellman refers these patients to an endocrinologist, who can help figure out the best way to regulate the hormonal imbalance.

All acne is hormone-related, but flare-ups caused by Aunt Flo and breakouts induced by a visit from your in-laws respond differently based on the treatment. Most hormonal acne (the kind related to your period) will pop up about a week before your period and it appears along your chin and jaw line, says Joshua Zeichner, M.D., director of cosmetic and clinical research for the department of dermatology at Mount Sinai Medical Center. If this is when and where you notice your breakouts occurring, look into hormonal fixes, like birth control, with your doctor.

Spironolactone is also prescribed for treating hormonal acne flare-ups, according to Dr. Zeichner. Originally designed to treat high blood pressure, the medication has been used off-label for decades to treat acne. "It works by competing with testosterone," says Dr. Zeichner. It races the testosterone to your oil glands and binds to the receptor before the testosterone -- decreasing oil production and starving the acne-causing bacteria on your face.

Acne caused by stress hormones can't be helped by contraceptives. Your skin freaks when you're stressed because it causes your adrenal glands to pump out more cortisol, increasing oil production and "feeding" the acne-causing bacteria on your face. The solution? Manage your stress (yeah, easier said than done) and get into a good cleansing regimen.

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There's a Blackhead Cure Hiding in Your Refrigerator
You know why blackheads seem to hang around a lot longer than your average pimple? Because they sit inside of the pore and dead skin builds up on top of it, sealing in the blackhead, says Dr. Bellman. The majority of blackheads are caused by external factors, like makeup, because they plug up your pores. "Once the pores get clogged, there's really only one way for the contents to get out," says Dr. Zeichner. No picking! Little by little, your body actually pushes the gunk out of your pore.

Dr. Bellman says you can help loosen your blackheads with a simple egg white mask. Whisk one egg white until its frothy, or toss it in a blender. Pat the egg white onto any areas with blackheads and let it dry completely before rinsing off. Do this 1-2 times per month and you'll see improvement.

You can also use a beta hydroxy acid (BHA) exfoliant like salicylic acid, which sinks into the oil gland and loosen blackheads; it also kills bacteria, which prevents the blackhead from turning into a pimple. Or, your dermatologist can prescribe a retinoid that will zap blackheads, like Tretinion, Azaphalene and Tazarozene. Here's a little blackhead fact that'll blow your mind: The average lifespan of a blackhead is about a month, but they can hang around for months -- even years! (Editor's note: Please don't Google "25-year-old blackhead." No, really. Don't. We're still squirming.)

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You Should Quit Using Your Clarisonic
Because dead skin is the only thing standing between you and popping out that blackhead, it makes sense to exfoliate every day, right? Wrong. Resist the siren song of those "invigorating granules" and Clarisonic-type scrubbing devices -- Dr. Bellman says she's seen far too many patients do more harm than good by over-exfoliating and irritating their skin more -- which only leads to more pore blockage.

Picking also counts as irritating your blackheads. It's not as bad as popping a pimple ("[A picked pimple] will stay red for two to three weeks instead of two to three days," warns Dr. Alexiades-Armenakas) it can still lead to infection and scarring.

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