BLOG

“Even though it’s the same type of acne, I feel like the causes differ depending on age and skin type”—that intuition is correct. For people in their teens and 20s, the main causes are excessive sebum production and clogged pores, while for those in their 30s and 40s, hormonal changes are often compounded by the effects of lifestyle habits and cosmetics. A cosmetic dermatology clinic will carefully assess these factors and work with you to create a manageable treatment plan that combines topical and oral medications, procedures, skincare, and lifestyle adjustments. It’s natural to feel nervous about your first visit, but our role is to ease your anxiety and present options that are easy to stick with. In this article, we’ll provide a clear, age-specific guide to acne treatment at a cosmetic dermatology clinic.

 

[Doctor’s Point] Acne is a chronic inflammatory skin condition. The underlying factors often differ between adolescent acne and adult acne, so the same treatment is not necessarily suitable for everyone. During a consultation, it is important to comprehensively evaluate sebum production, the condition of the pores, hormonal influences, and lifestyle habits to determine the appropriate treatment plan.

 

An Approach to Acne Treatment in Cosmetic Dermatology

Acne progresses through various stages, including “whiteheads and blackheads (clogged pores),” “red, inflamed lesions,” “lesions with pus,” and “nodules and scars.” At our cosmetic dermatology clinic, we evaluate your current stage, the areas most prone to breakouts, and the combined effects of lifestyle, hormones, and cosmetics to determine the appropriate intensity and sequence of treatment. Since effectiveness, pain, downtime, and duration of results vary from person to person, we discuss the treatment schedule and review milestones with you in advance.

 

The Evaluation Process and Key Points for Interviews

We’ll review how often you wash your face, the skincare products you’re using, your menstrual cycle, sleep patterns, dietary habits, friction from items like masks or helmets, and your stress levels. If necessary, we may also consider blood tests or consult with a gynecologist. We will also review your plans for pregnancy, current contraceptive methods, medical history, and any medications you are taking to determine the suitability of oral medication. In cosmetic dermatology, we take a three-pronged approach: “first, unclog the pores,” “then, reduce inflammation,” and “finally, minimize recurrence.”

 

Acne Caused by Sebum in People in Their 10s and 20s and Treatments at Cosmetic Dermatology Clinics

Adolescence through the early 20s is a time when sebum production is high, making it a period when comedones are likely to form. At cosmetic dermatology clinics, we recommend treatment regimens designed to balance sebum and dead skin cells and quickly reduce inflammation.

 

The Role of Basic Treatment (Topical and Oral)

・Topical treatment: Use topical retinoids or benzoyl peroxide (as a single agent or in combination) to smooth the skin’s surface and reduce clogs, and gradually introduce medications with anti-inflammatory and antibacterial properties as needed. If you experience irritation, adjust the frequency or amount applied accordingly.
・Oral medication: Antibiotics may be prescribed for short-term use—ranging from a few weeks to a maximum of about 3 months—only during periods of severe inflammation. Vitamins and traditional Chinese medicine may also be used as adjunctive therapy. In cases of refractory disease or a high risk of scarring, a course of isotretinoin (typically lasting several months) may be considered. Due to its strong teratogenicity, strict contraception and regular pregnancy tests and blood tests (liver function and lipid profile) are required for women of childbearing potential. In Japan, this medication is prescribed off-label, and the conditions for its use vary by medical institution. For women with a type of acne suspected to be hormone-related, spironolactone may be an option (especially for those in their late 20s and older). Be mindful of side effects such as diuretic effects, menstrual irregularities, breast tenderness, and, rarely, hyperkalemia; monitor blood tests and ensure contraception as necessary. The need for oral medication should be discussed in consultation with the patient, taking into account its impact on daily life and academic performance.

 

Treatment Options and Guidelines

We select chemical peels, comedone extraction, and light- or laser-based treatments based on your skin type. Mild stinging or redness may last from a few hours to a few days; however, since individual responses vary greatly, we explain this in advance and determine a treatment frequency that is comfortable for you. We view these treatments as “accelerators” and aim to achieve a synergistic effect with topical treatments.

 

Skincare and Lifestyle Tips

・As a general rule, wash your face twice a day—once in the morning and once at night—using lukewarm water and avoiding scrubbing.
・When choosing moisturizers, look for products labeled "non-comedogenic" or designed to minimize clogging.
・Choose foundation that is labeled "non-comedogenic" or is a powder formula.
・Since high-carbohydrate foods and dairy products can affect some people, start by observing your own reactions for 2 to 4 weeks.
・Sleep and stress management are the foundation of inflammation control.

 

Adult Acne in Your 30s and 40s and the Cosmetic Dermatology Approach

Adult acne is often caused by a combination of factors, such as hormonal imbalances, an imbalance between dryness and oiliness, compatibility issues with skincare products, and lifestyle changes due to work or childcare. At our cosmetic dermatology clinic, we create a long-term treatment plan designed to avoid repeated skin irritation.

 

Background Checks and Review

We check the strength of the cleanser, the quality of moisturization, whether hair care products are getting on the face, the cleanliness of pillowcases, and whether there is a regular cycle. If necessary, we recommend a gynecological evaluation and adjust daily routines within a reasonable scope.

 

Treatment Planning

・For topical use, start with a mild formulation and adjust as needed based on the patient’s response.
・Limit oral medication to the inflammatory phase and avoid indiscriminate long-term use. Consider spironolactone for women with strong effects of male hormones (blood tests and contraception are required). For refractory cases or those at high risk of scarring, consider a course of isotretinoin (strict contraception and regular blood tests are mandatory).
・Treatments are tailored to the risk of hyperpigmentation and work schedules (such as meetings or photo shoots), with methods and frequencies chosen to minimize visible redness.
・Treatment for acne scars (discoloration and uneven skin texture) should be considered in stages once the inflammation has subsided.

 

Balancing Makeup and Anti-Aging Care

On days when you prioritize coverage, apply a thin layer of primer and focus on concealing specific areas. Since anti-aging products that are too oily can contribute to clogged pores, fine-tune the texture and amount you use. A cosmetic dermatologist will work with you to reassess the balance between “adding” and “subtracting.”

 

Which Treatment Is Right for You? Key Factors to Consider

We don’t focus on which treatment is better or worse; instead, we consider whether it “suits” your lifestyle and skin.

• Symptom Type: Is the primary issue blockage, severe inflammation, or preventing scarring?

• Daily Routine: Can you maintain a consistent schedule for medical appointments? Are your event and photo shoot schedules, as well as blood tests and medication management (including birth control), manageable?

• Acceptable Downtime: How much redness and peeling are you willing to tolerate?

• Skincare Routine: Can you effectively use different products and apply them correctly?

• Priority of Recurrence Prevention: To what extent can topical treatments and procedures be continued during the maintenance phase?

•  

Frequently Asked Questions (FAQ)

How long does it take to notice a change?

If the focus is on blockages, gradual changes are often seen within a few weeks; if inflammation is severe, changes are typically observed over a period of several weeks to several months. Results vary from person to person, and making minor adjustments along the way is key.

 

I'm worried about pain and redness.

You may experience a mild stinging sensation when applying the product topically, and temporary redness may occur during the treatment. We’ll adjust the intensity and frequency of the treatment and plan your downtime to fit your lifestyle.

 

When should I see a doctor?

If you experience recurring pain in the same area every month, if the condition seems likely to leave scars, or if you feel you’ve reached your limit with self-treatment, we recommend consulting a cosmetic dermatologist.

 

Is it safe to use while pregnant or breastfeeding?

The range of available topical treatments, oral medications, and procedures may be limited. Isotretinoin and spironolactone cannot be used during pregnancy or while breastfeeding. If you are of childbearing age and considering these options, strict contraception and regular monitoring (pregnancy tests and blood tests) are required. Prioritizing safety above all else, we will proceed by focusing on skin care and lifestyle adjustments to the extent possible.

 

Can acne scars be treated at the same time?

The first priority is to reduce the inflammation. Once it has subsided, we will gradually consider how to address the color and texture.

 

Summary

Acne varies depending on age, skin type, and lifestyle. A cosmetic dermatology clinic is a place where professionals identify the root causes of your acne and help you find a balanced combination of topical treatments, oral medications, procedures, skincare routines, and lifestyle adjustments—all tailored to your needs. Since pain levels, downtime, and the timing of results vary from person to person, making minor adjustments along the way and sharing your progress are the keys to successful treatment. If you’d like to find the approach that’s right for you, feel free to consult with a cosmetic dermatologist.

The causes and aggravating factors of acne often differ between adolescents and adults, so it’s important to choose a treatment tailored to each individual. Starting the right treatment early on not only helps reduce inflammation but also helps prevent hyperpigmentation and acne scars. If you’re struggling with acne that doesn’t seem to clear up or with recurring breakouts, don’t suffer in silence—please consult a cosmetic dermatologist.

 

▷ Counseling Appointment Page