Solutions to Treat Adult Acne

Posted on Wed., Jan. 02, 2008
By Dr. Thomas Paige

WHO IN THEIR mid-30s wants to look like a pimply teenager? Adult acne is more common than people think, especially for women.

It's among the top 10 skin diseases and a serious problem that can lead to permanent scarring and pitting of the skin. Fortunately, there are effective treatments.

What is acne?

Acne forms when skin follicles (pores) become blocked and sebum (oil) starts to build up, allowing bacteria to grow. Most people experience mild acne occasionally, but for some it becomes a bigger problem.

There are two types of acne: noninflammatory and inflammatory. Noninflammatory acne includes skin blemishes such as whiteheads and blackheads (the trapped sebum and bacteria is partially exposed to air and turns black).

Inflammatory acne happens when the follicle wall ruptures under the skin, causing pustules (also called pimples) that form after white blood cells develop to fight the infection and make their way to the skin surface.

If the inflammation worsens, the acne becomes nodular (a deep red bump) or cystic (a large inflamed bump). Inflammatory acne can cause scarring.

What causes acne?

In both adolescents and adults, acne is usually caused by hormones. Eating greasy foods or chocolate doesn't cause it. Usually we outgrow acne after our teen years, but for some people the problem returns or even appears for the first time in adulthood.

Causes of acne

Hormonal fluctuations cased by menstrual cycles or pregnancies
An underlying hormonal disease such as polycystic ovarian syndrome, which can cause increased acne, facial hair, irregular periods and fertility problems. It's a serious condition so get a medical evaluation if you experience these symptoms.
Anabolic steroids (used to build muscle mass)
Stress

Treatments

Depending on the severity of the acne, different medications can be used from over-the-counter creams to powerful prescription drugs.

Over-the-counter washes and creams such as benzoyl peroxide (.025 percent) and prescription drugs like Retin-A work well on mild acne and help fight bacteria and inflammation.

Always test the medicine on a small patch of skin first for a few days, and use only every other night for the first few weeks. For Retin-A, apply a pea-sized amount to problem areas and massage in to the zone areas 20 minutes after washing the face.

Topical antibiotics such as clindamycin lotion (1 percent) is an alternative for people with mild acne whose sensitive skin can't tolerate benzoyl peroxide or Retin-A.

Oral antibiotics such as doxycycline and tetracycline require a prescription and often are used with over-the-counter treatments.

It's important for women taking cycline antibiotics to not get pregnant. These medicines also can make the skin sensitive to the sun.

Some oral contraceptives have the added benefit of clearing up acne in women but can take some time to work.

Accutane is a powerful prescription drug used to treat only severe acne that doesn't respond to other medications.

Usually patients take it for four or five months and their acne will go into remission. It causes severe birth defects if taken during pregnancy and may worsen depression, so it must be used with care.

If you're suffering adult acne, talk to your health care provider. There is something you can do about it.

Paige is a dermatologist at Contra Costa Regional Medical Center and has been practicing for 38 years.