Acne Is Hard To Face Among Adult Suferers

Age lines and acne? This wasn't supposed to happen.

Acne, normally the bane of teenagers, was flaring up on Kim Noble's 50-year-old face, causing the Atlanta businesswoman no small degree of frustration.

"I started when I was a teenager with acne problems, and as I got older, it got worse," she says.

"I was told it was due to stress and hormones. I've tried everything that was out there, from (rubbing) alcohol to injections to Accutane to Proactiv," says Noble, who has been seeing a dermatologist for years but still has flare-ups.

She's not alone. Dr. Jodi Ganz, an Atlanta dermatologist, estimates half her patients are adults with mild to severe acne breakouts.

"There are a ton of people with adult acne. For women, flare-ups usually occur the week before their periods; that's what we call hormonally linked acne.

"And there is a lot of what we call 'graduate school acne' for both men and women, flare-ups that occur between the ages of 25 and 30 in populations that have not had a breakout since age 16," she said.

While teen angst over pimples is legendary, adults are floored.

"We see people who are extremely upset about this. They thought this was a normal part of teenager-hood and they would outgrow it," Ganz says.

Acne begins usually the year before puberty's onset, says Dr. Leslie Lawley, an assistant professor of pediatric dermatology at Emory University. And that age keeps getting younger. "We've seen girls having their periods at age 9, so they are getting acne earlier," she says.

Acne is caused by an increase of hormones, which causes facial glands to create more oil that clogs up the ducts, allowing certain bacteria to grow. "That can lead to blackheads and whiteheads and more inflammatory bumps," she says.

Females deal with acne flare-ups longer. A University of Alabama-Birmingham School of Medicine study by the American Academy of Dermatology shows women older than 50 are twice as likely as men to suffer from some form of acne.

Why some people travel through life with unblemished skin and others with acne scars is also due to genes. It's likely that if your parents suffered from acne, you will, too.

There is speculation that lifestyle and culture may also contribute to the incidence of acne. "The rate of acne is so much less in non-Westernized cultures," Ganz says. She cites a 2002 study by the Department of Health and Exercise Science at Colorado State University of people ages 15-25 in Papua New Guinea and Paraguay that found extremely few cases of acne.

Treatment options

Drugstores offer a mind-boggling array of products, from the Power Pimple Peel to the formidable- sounding Terminator 10, next to standards like Clearasil and Stridex. A stroll down most malls finds a kiosk marketing Proactiv, the skin regimen touted by celebrities such as Jessica Simpson, Vanessa Williams and Sean Combs as an acne cure-all.

"The over-the-counter stuff isn't necessarily bad for mild acne," Ganz says. "Look for topical cream products with salycic acid or benzoyl peroxide. That's what's in Proactiv, by the way."

You might want to see a dermatologist if over-the-counter products don't work after two months, Ganz and Lawley advise. But be patient, they say. Even prescription medications can take six to 10 weeks to show signs of working.

The following medications usually are prescribed by dermatologists for moderate to severe acne. Your health care provider often can prescribe a generic form, which is less expensive than a brand name.
* Retinoids, additionally accepted as Retin A. One of the gold standards in angry acne, retinoids assignment able-bodied on blackheads and whiteheads, Lawley says. Don't booty retinoid if you're pregnant, however, or appetite to become pregnant, back they accept been affiliated to bearing defects.

* Combination of articulate antibacterial and contemporary antibacterial creams. The articulate antibacterial acts as an anti-bacterial to abate infection; the contemporary antibacterial reduces inflammation.

Doctors generally appoint a tetracycline antibacterial for the articulate dose. Doxycycline, a accepted name, is usually assigned with a high-percentage benzoyl achromatize cream.

"But we do anguish about the all-around affair of antibacterial resistance," Ganz says. "We try not to accumulate a accommodating on an antibacterial for too long.

"If addition needs an articulate treatment, we alpha both on chrism and articulate antibacterial and abatement their assurance on articulate and advance the topical," she says.

* Accutane. "If the accommodating has apparent no after-effects and has been on articulate antibiotics, Accutane is an option, but you actually cannot booty it if you're pregnant," Lawley says. Accutane has been affiliated with abasement and suicide, according to the U.S. Food and Drug Administration.

* Bearing ascendancy pills. For women not aggravating to get pregnant, low-dose bearing ascendancy pills can be accessible in authoritative hormones, which aggravate acne. But Lawley doesn't appoint them afore cardinal out accident factors such as age, whether the accommodating smokes or has a history of migraines. And she about recommends an assay by a gynecologist.

* Corticosteroid injections. These shots deliquesce abscess cysts that do not acknowledge to added therapies and amusement blister tissue.

* Microdermabrasion or dermabrasion. Additionally accepted as "power peels," this adjustment can abate apparent scarring and birthmark marks.

* Photodynamic therapy, additionally accepted as laser treatments. "ALA (a 20 percent band-aid of aminolevulenic acid) is corrective on the skin, and a laser ablaze activates the solution, killing the capital bacteria. This is acceptable for bodies who don't appetite to be on antibiotics or accept problems with antibacterial resistance," Ganz says.