It is reasonable to say that acne should only grow during puberty. But why is it still there when you are in your 40s? The actual fact is that it is as a result of the movie “back to 20 years old”? In fact, acne is not a patented product of adolescence. Acne at this age is what we usually call “late-onset acne”. Late onset acne is more common in female patients and is more likely to worsen during menstruation, with acne mainly around the mouth and chin. This “return to youth” only acne, but not youth, why is this? The body’s androgen ratio is relatively elevated As we age, the body’s hormone levels gradually imbalance, mainly due to the relative increase in androgen levels. 1, gynecological diseases Late onset acne in women is sometimes not only a skin problem, but may also be combined with gynecological problems, at which time special attention should be paid to the exclusion of polycystic ovary syndrome. In addition to acne, these patients may also have hairiness, obesity, and irregular menstruation, so they need to go to a gynecologist for further examination. 2, glucocorticoids caused by long-term use of glucocorticoids can occur drug acne. 3, bad composition cosmetics caused by some people long-term use of some poor quality or thick skin care cosmetics, can lead to symptoms of acne. 4, caused by chemical products Those engaged in certain organic chemical industries, or those exposed to asphalt may experience occupational acne, also known as oil rash, which is related to the action of organic compounds on the sebaceous glands of skin follicles. It is recommended that certain protective measures be taken at work, such as wearing a mask and long-sleeved gloves, and paying attention to carefully cleaning the face, hands, and other parts exposed to the work environment after work. Management and treatment of late-onset acne 1. Reasonable emotional regulation In recent years, the number of people with late-onset acne has increased. In addition to the reasons listed above, it is actually related to the accelerated pace of life in modern society, the increase in work and life pressure, and changes in life style and diet. 2, the appropriate choice of skin care products Late onset acne, due to the patient’s age of onset, the skin is often in addition to acne problems, but also accompanied by a variety of problems such as skin aging, dryness, skin tone dullness. Therefore, we recommend skin care products containing certain fruit acids and salicylic acid, which can eliminate acne as well as anti-aging. 3. Individualization of treatment The treatment of late-onset acne is also more difficult than acne in young people. It is necessary to decide the treatment medication according to the severity of the lesions and how much, in order to prevent the medication from being overkill, but also to achieve effective treatment, which requires a professional doctor to evaluate the medication. The lighter ones can use topical fruit acid peels, vitamin A acid, etc. to regulate the skin keratinization process; the heavier ones can consider laser + photodynamic therapy, along with herbal conditioning. Laser or photodynamic, can directly improve the skin quality, anti-inflammatory and antibacterial. Chinese medicine will generally regulate several aspects of the lung meridian wind-heat, spleen and stomach damp-heat or liver depression and qi stagnation, which will improve the skin acne while benefiting the overall improvement of the body. If the patient has elevated testosterone in the serum, then the treatment needs to be balanced with some targeted anti-androgen drugs. The selection of anti-androgen drugs should be used with caution on the basis of a confirmed diagnosis, paying attention to the possible adverse reactions brought about by the treatment such as the problem of male feminization, etc. When used by women, a consultation with an obstetrician and gynecologist should be invited to avoid the side effects of sex hormone treatment, especially the occurrence of tumors, etc.