Tips for Understanding Acne in Adults

Jay L. Blake, DNP, of MedDerm Associates, and an affiliated practitioner with Scripps Affiliated Medical Groups, has some information and tips about acne.

For this article, I want to concentrate on a common condition, and one that has a plethora of misinformation surrounding it, despite its increasing prevalence. In fact, per the American Academy of Dermatology (AAD) it is arguably the most common skin problem in the United States, affecting about 40 to 50 million Americans annually (AAD). It is one of the most straightforward diagnoses for a practitioner make, yet treatment options are myriad and the approach to treatment should be tailored to the nuances of each individual’s problem.

I am speaking of course, of acne, a condition that affects numerous Americans in their 30s and 40s, despite the prevailing belief in our society that this is a condition that affects only people in their teens (AAD). Many cases of acne first present in adulthood, and it usually comes as a surprise to patients that the diagnosis is as commonplace as it is.

These are the most common reasons for adult acne:

• Genetic history: many times we see when taking a family history a strong prevalence of acne that runs in certain families. It is one of the factors your clinician will take into account when trying to determine your treatment plan.
• Increased stress: there have been a number of reports linking the increase of stress and an increase in androgens (hormones) which create a cascade ultimately leading to acne. The irony of this problem is that the condition itself can increase one’s stress levels, and explains why some individuals can have an ongoing problem during times of stress
• Hormonal acne: female patients often note that their acne symptoms flare around the time of their periods, when a change to hormonal birth control is initiated, or when they become pregnant. For these individuals, it is important that their clinician recognize the difference and tailor their treatment accordingly.
• Skincare products: ironically, we commonly see patients who have attempted myriad products to treat their skin. The “more is better” approach to the problem leads many people to assume that higher percentage or more abrasive medications would help solve their problem, where in fact many “exfoliating scrubs” when over-used contribute to the problem by breaking the skin barrier down, thus exposing the skin to more bacteria. Even some OTC medications can cause further irritation to the skin, making the area redder and even appear worse than before, not to mention the high costs incurred.

Acne is a socially isolating condition that can be very uncomfortable and even leave scarring if left untreated, and it can be frustrating to meet people who have either deferred their care or have attempted to use myriad OTC medications, costing hundreds of dollars, only to end up frustrated and with a condition that continues to flare. I would like to give some general guidelines which may help some patients to help their condition.

When selecting an OTC topical medication for treatment, please stick with the following guidelines:

• Choose sunscreens and moisturizers with the words “non-comedogenic” and/or “non-acnegenic” on the side of the tube. This will help to ensure the creams you are using will not clog pores, potentially making the condition worse.
• When selecting cleansers please choose those that are “oil-free,” and if you would like to supplement with an acne cleanser, it is a good general recommendation to stick with either salicylic acid or benzoyl-peroxide containing cleansers.
• The skin should be cleansed with a gentle cleanser twice daily, then apply sunscreen (in the morning) or a moisturizer (as needed) in the evening.

References: AAD website

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