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Dealing with adult acne
WRINKLES and pimples aren’t meant to go together. But a rise in adult acne
means many of us are dealing with what was meant to be a teenage curse.
If you thought pimples and the threat of acne disappeared when you bade farewell to
teenage angst, then the following news will surprise you: around the world, adult-onset
acne is becoming much more prevalent.
Dermatologist Jo-Ann See says she is noticing more and more cases of adult acne. “For
women in their 30s, we’re seeing a 43 per cent prevalence, which is very high.” What is adult acne?
There is a difference between adult and teenage acne. Generally, adult acne is located on the neck, chin and jawline, while teen acne tends to appear on the T-zone. Adult acne also tends to be more resilient, with deep, blind pimples that can last for weeks. Acne occurs when pores become blocked due to an overproduction of sebum. And the causes of this are varied. Dr See, who is the co-chair of All About Acne, says that the most common reasons for the development of adult acne are hormones and stress.
“You have to recognise what acne is first, then look at ways to treat it.”
Treatment-wise, Dr See stresses that it’s important to address the cause before fighting the symptoms. First, your doctor should rule out any medical conditions, such as polycystic ovary syndrome, then seek advice from a dermatologist. “What’s really going to help is medication,” Dr See says.
“This may involve a course of antibiotics, a low-dose contraceptive, or a treatment such as Spironolactone. Then it’s time to address other factors such as stress and consider how you can reduce the level of stress in your life.”
One of the annoying aspects of adult acne is that in an effort to cover up the pimples, many of us will slather our skin in greasy concealers and foundation, which then block the pores, causing more pimples.
Using non-comedogenic cosmetics and sunscreens that are specially formulated for acne-prone skin can help, says Dr See.
“Think about what you’re putting on your skin. For example, most people don’t really need to use moisturiser all the time, just when the skin is dry,” she says.
It’s also important to keep your skin clean, by cleansing your face twice a day with a mild, soap-free cleanser that is pH-balanced to help keep excess oil production down, and to stop pores from clogging up.
Dr See says that while some of the products designed for teenage acne don’t work on more mature skin, using a pimple cream directly on the spot can help if you persist with treatment. All pimple creams have anti-bacterial properties and this is what helps to heal the blemish.
Food for thought
Over the past 30 to 40 years many doctors have dismissed the idea that diet is a cause of acne. But recent research indicates that what you eat impacts on your skin.
Professor Neil Mann, professor of human nutrition at RMIT University, studied the link between diet and acne after chatting with an anthropologist colleague who noted primitive societies with a typical hunter/gatherer diet had no incidences of acne.
They didn’t even have a name for it. Sticking to a low-GI diet of whole, minimally processed foods, such as fruit and vegetables, lean meat and a small amount of whole, unprocessed grains, could help clear the skin.
“We know there are many metabolic processes going on in the body in regards to what we eat, so we were sceptical about claims that diet has no relation to acne,” Professor Mann says.
A basic culprit is high insulin levels, Professor Mann says. “High levels of refined carbohydrates elevate the levels of insulin,” he says.
“High insulin levels cause an overproduction of sebum and that helps to block the pore. High insulin levels also cause a certain type of androgen, DHEAS protein, to rise, which, in turn, causes the sebum levels to rise.”
Clearing the way
Once acne is under control, some bitter reminders can remain in the form of scarring. However, most scarring can now be treated, at least to some degree. Dermatologist Dr Adrian Lim, from uRepublic Cosmetic Skin and Laser Clinic, says there are two types of scars: pigmentary scarring, which involves a colour change, and the more difficult to treat textural scarring.
Dr Lim stresses that acne must be cured before attempting to treat the scars, but once the problem has been resolved for at least six months, there are ways to address the scarring. “Once you have scarring you can never get your skin back to 100 per cent, but you can get a 50 to 70 per cent improvement,” Dr Lim says. “That’s where the Fractional Erbium laser has made our job so much easier. It removes micro-columns of tissue to have a smoothing-out effect.
"The advance of fractional lasers has been a godsend for people with more severe scarring, and the downtime for recovery is short - only four to five days – as opposed to months with traditional laser.”
The good news is that what many of us think of as scarring is actually post-inflammatory hyper-pigmentation. Those flat red, pink or brown spots that remain long after the blemish has gone will fade, but it may take up to two years.
However, Dr Lim says that if you don’t want to wait, then the IPL (intense pulsed light) laser will treat any scars.
For deeper scars, or “icepick scars” as they are known, a drop of TCA or trichloroacetic acid can burn off the track and help the skin heal more conventionally.
Even large, shallow scars can be treated by cutting the fibres under the skin, thus lifting the scar so it reheals and looks less deep.
A good dermatologist can help you find the best treatment to minimise scarring and help you achieve a visible improvement.
There does tend to be a genetic link with adult acne, adds Dr See. “Your family history is quite relevant.
"If your mother or sister has problems with adult acne, chances are that you will too. It does tend to be inherited.”
Persistence is the key with treating adult acne.
Often people who suffer have tried many treatments, with little success. Understanding the cause, whether it’s hormones or lifestyle, and getting that under control is the only way to beat acne in the long term. Adult acne can be distressing, but it’s important to know you’re not alone, and that there are plenty of products and treatments that can help.
To find out more, visit www.acne.org.au, where a team of dedicated professionals have put together a concise, thorough investigation of the topic. Seeking help now may mean that the only spots you see this summer will be on a dalmatian.
ADULT acne is becoming more common but it can be treated.
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