Ah, looking in the mirror and seeing that blemish … it can make us crazy. We’re not supposed to break out after the age of 15, right?
Those who suffer with adult acne know how irritating and frustrating this affliction can be. For many, the thought, “I should be past this stage,” is a recurring concern. But acne has no bounds: there are no age groups exempt from acne, and it is not limited to any specific gender or race.
Healthy skin is made up of many tiny pores, which contain oil glands. When pores become clogged with too much oil, dead skin or bacteria, acne is born.
In its most common form is adolescent acne, but it can also occur from neonatal through postmenopausal periods. Within these forms, there are two varieties: acne vuglaris and acne rosacea (a red rash across the face). Most adults are affected by acne vulgaris, also considered to be “regular acne.”
Judith Feldman, M.D., a Board Certified dermatologist practicing in Southern California has researched and treated acne for years. She claims that there are a variety of factors that cause breakouts — some are more prominent in certain age groups. Post-adolescent acne and acne that occurs before menopause are often attributed to significant hormonal factors that affect the skin.
“That doesn’t mean cosmetics, genetics, climate and stress don’t play a significant role,” Feldman said. “But generally speaking, it is not hygiene that is a significant factor in this group of acne sufferers.” She excludes one caveat: cosmetics, brushes, applicators or products that have been kept for a long time, which could have developed bacteria and may be contaminated and therefore adversely affect the skin.
Feldman believes that there are certain underlying causes of severe acne that must be ruled out such as thyroid disease, estrogen or androgen hormonal imbalance or bacterial infection. Once those factors are eliminated, then breakouts should be treated in the following manner:
“The most important choice that an acne sufferer must make is to pick the right creams, foundations and cosmetics,” Feldman said. “Natural cosmetics are not a benefit in preventing acne, as many may believe.” One should also avoid natural vitamins that often contain kelp, which is high in iodine, and a believed cause of acne. Some organic herbs that are manufactured out of the United States may be contaminated with heavy metals like mercury and lead and do not meet FDA standards.
Make-up and cosmetics that are water-based or have been tested for non-comedogenicity are crucial in reducing pimple flares. One must apply these foundations with a disposable cotton ball or sponge so that contamination during application is eliminated.
Because it’s impractical to wash brushes daily, they are generally not recommended for those who are acne-prone. Any topical products, including sunscreens, concealers, emollients and moisturizers should be carefully chosen. The ones that are recommended by dermatologists or tested for non-comedogenicity are preferred. It’s important to be diligent and educated, because incidental use of products that are believed to be safe can be a serious culprit, causing breakouts.
Feldman suggests three major products that will help to control acne: “Once any underlying medical conditions have been ruled out, which again could be thyroid disease, endocrine problems or bacterial infection, antibiotics like doxycycline or the like are still the gold standard and first choice for severe acne treatment,” she said.
Topical application of a group of medications called retinols such as Retin-A, Differin or Tazorac will reduce blackheads, the first stage of acne, over a period of six to eight weeks. These are often used as a preventative treatment. Since it takes a good four to six weeks to develop proper skin levels by these medications, one must be patient. The last group of medications that is used to treat the active legions are usually a combination of benzoyl peroxides and or topical clindamycin.
Lastly, dairy products especially the ones that are treated with hormones should be avoided to reduce the intake of undesirable excessive hormones that can result in acne.
In really recalcitrant acne, birth control pills with the use of spironolactone may be needed to reduce acne and the facial hair issues that can sometimes be associated with it. Accutane is the most powerful and effective treatment for acne but must be used with extreme caution and with strict monitoring. It is the only medication known to cure acne regardless of cause.
It is highly recommended that acne-prone individuals never touch their face; touching a pimple or picking at it must be avoided, because residual oils and bacteria from the hand can exacerbate the inflammation.
For minor breakouts over-the-counter remedies that contain salicylic acid can help to dry up and clear excessive oil. If you need to rid your face of a break out before a big event or party, a dermatologist can administer an intra-legional cortisone shot on a blemish. This option however should be used in moderation, as cortisone is believed to affect osteoporosis. In a bind, though, the option works.
When treating your skin, determine what works best for you and consult your dermatologist.
“Acne can be stubborn, but it is treatable,” Feldman said. “Using the right approach with diligence is the most effective way to achieve healthy, break out-free skin.”