Adult Acne

Source: Adapted from Know Your Options: The Definitive Guide to Choosing The Best Medical Treatments, Reader

What is adult acne?

Acne occurs when the oil (or sebaceous) glands under hair follicles’often on your face, neck, chest, or back’get plugged up, inflamed, or infected. Frequently the glands simply secrete too much of a thick, waxy lubricant called sebum that keeps your skin healthy. Sebum can block the pores and create a perfect breeding ground for bacteria. Follicles then get red and inflamed. In mild cases of acne (referred to as acne vulgaris), whiteheads and blackheads as well as some raised red blemishes appear. In more severe cases (cystic acne), pus-filled cysts and deep nodules form around the inflamed follicles, causing unsightly bumps and tenderness, which are often painful.

Who is at risk for adult acne?

Hormonal imbalances can also play a role in Adult Acne: Sebum increases with women’s hormonal fluctuations, such as those associated with the menstrual cycle, pregnancy, and menopause.

Treatment for adult acne

Acne doesn’t really last forever (it just seems like it does). It can, however, take time to clear up: anywhere from several days for a crop of pimples to months or years for some types of cystic acne. For occasional blemishes, applying over-the-counter anti-acne preparations and keeping your skin clean can make a real difference. For an extended outbreak, you’ll need to see a dermatologist for prescription medications. Certain office procedures’cyst removal, skin peels, steroid injections’can also be very effective in treating severe cases.

Acne isn’t life-threatening, but its ravages can be long term. The best way to prevent disfiguring scars is to treat any lesions promptly. And take heart: If you already have facial scars, cosmetic laser treatments have shown great success in reducing pitting.

Medications for adult acne

If you have mild to moderate Adult Acne, home treatment should begin with OTC antibacterial drugs‘gels, creams, lotions, and pads. Look for remedies with benzoyl peroxide (Oxy10, Neutrogena, Clearasil products), which fights the P. acnes bacteria. Other products (pads by Clearasil, Noxzema 2) feature salicylic acid, a derivative of aspirin. Salicylic acid products are a good choice for whiteheads or blackheads (medically known as comedones), because they gently dry up and peel away the skin’s top layer, unclogging pores.

If you think your Adult Acne flare-ups are related to your period, ask your doctor about oral contraceptives. Birth control pills can help because they systematically regulate the release of monthly hormones, preventing the natural imbalances that contribute to acne.

If your acne doesn’t improve, you may need to move on to prescription antibiotics (topical or oral), which reduce skin bacteria and have an anti-inflammatory effect. You may actually get the best results by combining topical OTC antibacterials with topical antibiotics, such as clindamycin or erythromycin. Oral antibiotics (tetracycline, minocycline, doxycycline) can be very effective at controlling Adult Acne when used long term. However, this practice is problematic because bacteria are becoming resistant to the drugs.

For this reason, consider trying a synthetic form of vitamin A known as tretinoin (Retin-A, Retinoic Acid). This topical prescription drug unclogs pores by regulating the growth of skin cells; it’s often used in combination with benzoyl peroxide. A word of warning: If you use tretinoin, your acne may actually look worse before it gets better. Because your skin will be extra sensitive, you’ll also need to stay out of the sun, and be sure to keep the gel or liquid away from your eyes.

Even more effective is the oral vitamin A derivative isotretinoin (Accutane), which shrinks the sebum-producing glands attached to hair follicles. Often dubbed a ‘miracle cure’ for severe cystic acne, Accutane requires careful medical supervision because it can have serious side effects.

Lifestyle Changes

In addition to medical treatments, good home care is essential for dealing with Adult Acne successfully. Try the following:

Wash your face gently (no more than twice a day) with a mild soap to remove oil, dead skin cells, and bacteria.

Pay attention to your hair. Style it away from your face so scalp oils don’t irritate your complexion, and avoid greasy styling products. Always pull your hair back when you sleep.

Wear clean, loose-fitting exercise gear. Working up a sweat in tight, nonabsorbent clothes or a constricting sweatband alters oil production, contributing to acne formation.

Don’t squeeze lesions. Picking at pimples will make the inflammation worse and increase the risk of scars and pitting.

Avoid prolonged exposure to the sun and ultraviolet lamps. These light sources dry up acne, but they also result in long-term skin damage and can even cause cancer.

Related Procedures for Adult Acne

Dermatologists have an arsenal of techniques to help control problem lesions and prevent scarring; however, many of these office procedures must be performed frequently. For comedone removal, doctors use a comedo (or loop) extractor to pull bacterial matter out of whiteheads and blackheads, reducing the risk they will develop into troublesome blemishes. (Some patients can learn to do this themselves.) For severe acne, doctors may inject steroids (corticosteroid drugs) into cysts and nodules to lessen inflammation and shrink the lesions. Superficial chemical skin peels often fail to minimize acne scars, which reflect damage to deeper layers of skin.

If you’re among the few Adult Acne sufferers who scars’and this depends on various factors, from your skin type to how extensive your inflammation is’new surgical procedures can have dramatic results. For one or two scars, consider collagen injections, which insert this natural protein under the skin to ‘fill out’ depressions. For a more extensive problem, dermabrasion is an effective surgical treatment that minimizes even deep scars. Under local anesthesia, a high-speed brush removes surface skin and alters the contour of scars. Laser treatments are an encouraging new development. They employ various wavelengths and intensities of light to recontour scar tissue, and are now being explored for the treatment of acne. Although your skin may be red for months, your scars will be changed for good.

Alternative Therapies for Adult Acne

Some herbal products are useful for drying up acne. Topically applied, tea tree oil is a natural alternative to benzoyl peroxide. Wipe on a 10% to 15% strength solution twice a day. The herb chamomile has long been used for calming skin inflammations. Make a strong chamomile tea, and wipe the cooled liquid over your face each morning. This effective daily rinse tones and cleanses.

Questions for your doctor

‘ What is the risk that my mild acne will turn into severe, cystic acne?
‘ Does it make sense to treat my scars now, as they occur, or should I wait?
‘ Could a hormonal imbalance be the cause of my premenopausal acne?
‘ Is it possible that at some point the antibiotic I’m taking won’t work anymore? What will I do then?

Living with adult acne

If you’re living with Adult Acne, here are some quick tips help you take control.

Go to a dermatologist, not a general practitioner, especially if you need to have a procedure done. Skin doctors are specially trained to perform such treatments.

Choose acne products with care. Expensive medicated cleansers often work no better than mild soap and are not worth the extra cost.

Try a blackhead extractor. This drugstore device may save you costly trips to the dermatologist. Before using this tool, soften the area with hot, wet compresses for about 10 minutes.

Use water-based makeup. Look for products labeled ‘noncomedogenic’ or ‘nonacnegenic.’ Also, don’t overdo on moisturizing. Skip cosmetics completely if your acne is severe.