The most common age to develop the first signs of acne – often greasy skin and blackheads – is early puberty. This is because the sebum glands up until this stage are immature and too small to produce a lot of sebum. Think about a child’s smooth skin and how soft a baby’s cheeks are – the last thing you would find with younger children is greasiness. So for most acne first appears around 11 years of age or older. Girls are more likely to get spots a younger age because their puberty usually starts younger than boys. However, boys get more of the male hormones (testosterone) commonly responsible for the sebum output of the body, so they maybe more likely to get worse acne than girls.
Acne can affect almost anyone, at any age. Luckily, for many teenagers the skin improves over time. Medical textbooks describe many varieties of acne, and some of these seem to affect certain age groups more than others.
As the name suggest this type of acne affects newborns and infants up to the age of two years. This is usually caused by a surge in maternal hormones as the baby is developing, and the outbreak typically clears in a matter of weeks, often without the need for any treatment. Many midwives and health visitors will describe these small spots as ‘normal milk spots’. So if these spots are fairly normal, when should a parent ask for help?
If the spots have not cleared up on their own after 4-6 weeks then seek advice from a doctor. There are a few treatments more commonly used on adult acne that can be recommended or prescribed and will often need to be used for a relatively short time. These will usually be products applied topically (on top of the skin). However, it is wise to start any such topical treatments by gradually introducing them to the tender skin of a baby. Using a damp cotton pad, apply the lotion or cream to the affected area, followed by a few minutes later with a moisturiser such as baby lotion. This will help to reduce any dryness and keep the skin hydrated. If there is no improvement after 1-2 months then return to your doctor. Getting acne at this stage of life may require some further medical investigation if it does not clear after the usual treatments. Similarly, if acne first appears at around three to six months without any previous signs, consult a doctor for further advice.A referral to a paediatric dermatologist may be necessary.
Childhood acne (ages two to six years)
It is very rare for children of this age to develop acne, especially as the main cause of acne in newborns - the surge of maternal hormones passed on in the womb – will have disappeared. While the spots can be treated with the usual acne treatments, the child will probably require a referral to a paediatric dermatologist if there is no response to treatment. Any possible underlying causes, such as problems with the endocrine (hormone producing) system or a tumour, could then be investigated.
There are theories that getting acne at this age may be an indication of future acne that may be more severe in nature and harder to treat. Having the acne investigated and treated with strong medications at an earlier stage might help to prevent or minimize future problems.
This is by far the most common age to start developing acne. As it is so common, it should be considered more normal to have acne than not. As with acne at any age, if it appears to be getting worse or failing to respond to any self-medication, seek help from a doctor, nurse or pharmacist.
There is undoubtedly a group of people whose skin fails to improve following the more typical adolescent phase. Others may find that their skin was relatively spot-free as a teenager, but becomes progressively worse in their twenties or thirties. For some people the first signs of acne do not appear until this age. This can often be more distressing than for those who have experienced on-going teenage acne. Some people report that having acne for the first time in their late twenties was one of the hardest things they had to face, thinking they had somehow escaped the scourge of most teenagers.
Up to 51% of women have acne well into their twenties, but men are only just behind this figure. Some dermatologists estimate that 1% of men and 5% of women are still affected by acne in their forties. The fact that there are more women may be a sign of an underlying condition known as polycystic ovarian syndrome (PCOS). This is fairly common affecting up to 5% of women. Some doctors believe that any woman in her thirties who presents with acne should be investigated for this condition.
Although it may not be fair to consider anyone over 65 years as ‘senile’, there is a type of acne that may appear in older people, taking the form of large blackheads. This will usually be painless and unlikely to cause any further problems, although doctors can treat these comedones with the usual medication. This may also be a time when rosacea first appears, which may be confused with acne. Rosacea differs from acne in that it comedones are not a feature of acne rosacea.
Where on the body does acne appear?
Acne only occurs where there are sebum producing glands (sebaceous glands). These are located on various parts of the body. The most commonly affected areas are: Face, neck, chest, back and shoulders. Some types of acne flare up on or around one area only, such as the scalp or buttocks.
Other conditions linked to acne, but with different causes, can affect specific areas of the body where the skin folds, such as the groin, the armpits or under the breasts. Although it is possible to get spots in other areas of the body, acne spots do not occur on the soles of the feet or the palms of the hands, because there are no sebaceous glands in these places.