Acne is one of the most common problems that send people to the dermatologist, and it's not always young people coming through the door, according to Dr. Angela Peterman, Anne Arundel Medical Center dermatologist. Adult acne isn't uncommon, and there is help at the drugstore and from doctors.
How common is adult acne?
Adult acne affects about 25 percent of adult men and 50 percent of adult women at some time during their adult lives. Women tend to get adult acne more often than men because of fluctuating hormone levels around their menstrual periods, during pregnancy, peri-menopause, menopause and starting/stopping /changing birth control pills.
It's even possible to get acne for the first time as an adult. Dermatologists call this "adult-onset acne."
Why do some people continue to have problem skin throughout their lives, or only experience acne as an adult?
Beyond the fluctuating hormone levels, there are several other triggers that may cause acne, especially stress. There's a definite relationship between stress and acne. Stress causes our bodies to produce stress hormones, in particular androgens, which stimulate the oil glands and hair follicles in the skin, aggravating acne.
Several medications — including lithium, anti-seizure drugs and corticosteroids — can cause or aggravate acne. If you suspect one of your medicines is triggering or aggravating your acne, talk with the doctor who prescribed your medicines. If it's not possible to take another medicine, you may want to see a dermatologist to help you control the acne.
Also, acne may be a sign of an underlying medical condition. For example, polycystic ovary syndrome is a common endocrine disorder where women have ovarian cysts, irregular menstrual periods, excess hair growth and acne. When the medical condition is diagnosed and treated, the acne often resolves.
Of course, some people may have a genetic predisposition for acne. If you have close blood relatives such as parents or siblings with acne, you are more likely to get adult acne.
Are there good habits that can help keep blemishes to a minimum, as well as good over-the-counter products to use (or not use)?
Definitely. Good habits to minimize blemishes include:
• Wash your skin with warm water and a gentle cleanser twice a day, using your hands or a washcloth. Cleansers wash away dirt, grime, pollutants and makeup, plus a good cleanser will allow other important skin products to reach your skin. Remember: Abrasive cleansers and excessive washing and scrubbing can worsen acne.
•Use sunscreens, moisturizers and cosmetics labeled with the buzzwords "oil-free, non-comedogenic, and non-acnegenic," which means they won't clog pores.
•Try not to pick or squeeze pimples because this may lead to infection or scarring.
•Watch what touches your skin, including oily hair and greasy hair products.
Many over-the-counter products are available to treat mild acne. A good start is a product containing benzoyl peroxide since it is an effective anti-inflammatory agent and it is easily tolerated. Start with a lower strength since it may be effective and will have fewer side effects, such as dryness and irritation. Another ingredient to look for is salicylic acid, which slows the shedding of cells inside the pore and prevents the clogging of the pore. Salicylic acid can cause mild stinging and irritation. Glycolic and lactic acid are two types of alpha hydroxy acids often used in OTC acne products. They treat acne by helping to remove dead skin cells and reduce inflammation. They also stimulate the growth of new, smoother skin. Sulfur, which may be combined with other OTC ingredients, helps to remove excess oil and dead skin cells, although some sulfur products have an unpleasant odor.
Apply just enough of the acne product to cover the problem areas and apply just after cleansing. Since acne ingredients work in different ways, you may find it helpful to use two products with different active ingredients to treat stubborn acne. Be patient. Treating acne takes two to three months of daily use to see results. You may need to experiment with different products before you find a regimen that works for you.
Can another problem be mistaken for acne?
There are many conditions that mimic acne but are altogether different diseases. Most involve the hair follicle. Gram-negative folliculitis is a bacterial infection of the hair follicle, most commonly occurring in those who have been on long-term antibiotics. Another type of folliculitis, pityrosorum folliculitis, is an itchy rash caused by an overgrowth of a yeast, called pityrosporum, which grows in hair follicles that have high oil levels. "Pseudofolliculitis" barbae is a common and painful eruption that occurs in the beard area of men who shave. This condition favors individuals with curly hairs and those of African descent. Peri-oral dermatitis occurs when itchy red bumps and whiteheads appear around the mouth. This condition is generally caused by using topical corticosteroids over a long period.
When is it time to see the doctor?
Acne is a treatable condition. If your acne does not improve after two or three months of home treatment, it is time to see your dermatologist. You want to prevent permanent physical and emotional scarring. Adult acne can be a distressing and frustrating problem that can cause depression and social anxiety in an adult the same way it can in a teenager. The good news is that acne can be effectively treated by your dermatologist based on your individual needs.