Facing Acne As an Adult Man

The good news for most adult men is that acne that first appears
after age 20 is an unusual occurrence. I suppose the bad news is
that if you’re reading this, you’re having just such an “unusual
occurrence.” In men with adult acne, lesions are more often seen
on the chest and back. When it arises on the back, it’s sometimes
playfully called “backne.” If you’re a guy, and you’re facing acne,
odds are that one of several things is occurring:
 The teen version has stuck around: Though most acne
vulgaris (teenage acne) clears up by the time you approach
the 20 mark, it can stick around. Check out Chapter 4 for an
explanation of acne vulgaris.
 You’re an athlete: In recent years, acne is being seen increas-
ingly on the chests and backs of men who participate in
vigorous athletic activities. Some observers speculate that
sweating and friction causes the acne because the primary
sites are most often under clothing.
 You’ve used performance-enhancing drugs: Another, more
likely, source of chest and back acne may result from the use
of performance-enhancing preparations that contain such
ingredients such as creatine, colostrum, and, of course, ana-
bolic steroids such as testosterone and andro. I talk more
about steroids in Chapter 6.
 You don’t really have acne: If you have any doubt about your
diagnosis, see a dermatologist because she may tell you that
you don’t have acne at all but may have rosacea, an adult
acne look-alike, or folliculitis (an inflammation of hair follicles)
due to shaving your face and maybe even from shaving your
chest and back. (See Chapters 18 and 19 to learn more about
these acne impostors.)
Significant scarring from acne is more common in men than in
women. In men, lesions that leave scars may be the dominant type
present, especially in men who had severe acne in their teens. In
Chapter 16, I explain the types of scars and tell you what can be
done about them.