Forget The Teen Cleansers And Find Out How To Treat Adult Acne Effectively
“But I never had acne as a teenager!” says the distraught 30-year-old woman.
Oh, how often those exact words are uttered in my office. Acne is a normal part of adolescence and something you will eventually outgrow, right? Conventional wisdom says that adults have cancer and heart disease to worry about, not pimples. For many women, though, the breakouts do not start until adulthood.
Adult Acne In Women
It has been estimated that 30 percent of adult women suffer with acne. Many of these women had their first breakout after high school and find themselves suddenly grappling with teenage self-image issues. And while pregnancy generally imparts a healthful glow, the hormonal letdown afterward leaves some women with chronic breakouts that will last years. The social and professional impairments, real and imaginary, of these women are significant. Even the appropriate medical term “Acne Vulgaris” makes one feel vulgar (even though “vulgar” in this sense is used to denote “common” and not something repulsive.)
Hormones And Adult Acne
Often a frustrated patient will bring in an entire bag of various cleansers, exfoliants, washes and potions they have used to no avail. Many are prescriptions for which they shelled out hundred of dollars. While adult onset acne generally benefits from a good face regimen, it often takes more. Chances are that the acne is not due to poor hygiene or simply haven chosen the wrong products; it is most likely a result of hormones. The face suddenly decides it wants to act like a teenage boy; excessive wax and oils leach into the pores and create a caloric smorgasbord for hungry bacteria. These hormonal breakouts often spring up along the jaw line, neck and cheeks. Sometimes they are at their worst in the days preceding a menstrual cycle.
Adult Acne Treatments
If you’re looking for a natural treatment recommendation, one only need Google it. Go to a site on nutrition; you will find the latest diet cure. Go to a holistic site; you find the colon cleanse to get toxins out of your skin. Even the iTunes store will sell you a laser app for your pimples. Oh and by the way, these are all found under the search term “Secrets your dermatologist doesn’t want you to know.” Yes, we evidently have nothing better to do than withhold the cure for acne from the public. (I’m twisting my evil moustache right now).
Adult onset acne generally responds well to birth control pills, antibiotics, or both together. Patients are happy to learn there are now other treatments available than just open-ended antibiotics. The growing issue of antibiotic-resistant bacteria is forcing us to greater stewardship in their usage. We have other treatments that help mask excessive male hormones without affecting your estrogen levels or endogenous bacterial flora. There is also the dreaded, but very effective Accutane. Even though brand name Accutane is no longer made, the molecule is still offered under several other brands. The name Accutane is as engrained on society as Kleenex is for referring to any tissue paper. And it is hard to watch TV without seeing a law firm’s commercial demonizing this medication or urging you to sue someone over it (usually your dermatologist). But it is still the most effective treatment I can offer someone. I share with patients that I’ve put my own wife, nephew, sister and hundreds of patients on it without killing anyone. It’s the only thing we can offer with the hope of permanently curing acne. (FYI: There is a combined chemical-light energy treatment that is safe and offers a reasonable cure rate but it is not covered by insurance and can run around $1,500 out-of-pocket.)
Perhaps one of the biggest farces in dermatology is the so called “acne surgery.” It is hard to even use the words “acne’” and “surgery” in the same sentence without laughing. When you do it at home it’s called “popping a zit.” When the dermatologist does it, it’s called “a $95 uncovered service for which you are responsible to pay.”
I actually quit offering the service several years ago unless patients are made aware in writing that it is likely not a covered benefit. There is really no reason someone cannot order the tool, a “comedone extractor,” online and become proficient at it themselves. Also a $60 facial from any of the good aestheticians in our area or a gentle medical-grade chemical peel will go a long way and is a much better use of your money.
For those pimples that fester deep in the skin without coming to a head, you can see a dermatologist to inject carefully diluted cortisone directly into the core. Picking at this type of acne yourself is likely to result in permanent scarring. Usually one can just show up without an appointment and get a quick shot and get on with the day. Many women find this approach suits them better than being on daily medication. We understand that acne doesn’t wait or necessarily care when your next scheduled appointment might be.
In summary, there is a reason those teenage acne creams aren’t working for you. The problem is more than skin deep. We all want to mature gracefully yet stay young at heart; but sometimes your oil glands just need to be told to act their age.
Dr. Derrick Adams is a board-certified dermatologist and the medical director of Vita Dermatology and Laser Institute, a division of Lassen Medical Group in Red Bluff. His office can be reached at 528-VITA or learn more at the main Vita Dermatology website.