Severe Adult Acne
Acne is the most common skin condition in the United States, with almost half of adults suffering from some form, says the American Academy of Dermatology. Mild acne problems can cast a pall over important events like weddings, job interviews, and business meetings, but severe acne can lead to scarring, chronic low self-esteem and even depression. Fortunately, there are many procedures and treatments which can help.
Acne forms when hair follicles trap oily sebum from the skin and become inflamed, encouraging the growth of bacteria. Whereas teenage acne consists primarily of blackheads and whiteheads that form on oily skin, adult acne occurs with drier skin and often includes red bumps or cysts that last longer and don't heal as rapidly. Persistent acne is the most common form of acne in adults, especially women. It forms on the lower face, such as the mouth, chin and jaw, and causes deep, tender pimples and nodules. Late-onset acne forms on the face, chest, back, arms and buttocks and often is a problem that women face around menopause.
Genetics and hormones are likely causes of adult acne, says dermatologist Dr. Jeannette Graf. Stress can also contribute to the problem, as can allergies to foods or skin care products and the overuse of heavy skin creams and makeup. Occasionally, certain medications cause acne, such as birth control pills that only contain progestins, anticonvulsants, corticosteroids and sobriety drugs. Cornell University dermatologist Diane S. Berson adds that acne may be a warning of an underlying medical condition. Persistent acne accompanied by excess facial hair and hair loss can indicate polycystic ovaries or adrenal hyperplasia.
Over-the-counter products containing salicylic acid or benzyl peroxide can help, as can home microdermabrasion kits or light peels that exfoliate your skin can also help, says Dr. Graf. If those don't help, your dermatologist can prescribe a retinoid cream such as Retin A, along with a spot treatment or topical antibiotic like sodium sulfacetamide or an antimicrobial such as clindamycin or erythromycin.
Oral Medication Treatments
Certain medications work to minimize hormonal fluctuations in women, including oral contraceptives, spironolactone and hormone replacement, although these therapies should never be used during pregnancy, says the American Academy of Dermatology. Oral antibiotics like tetracycline or oral isotretinoin may also be prescribed.
Dermatologists can choose to inject a corticosteroid into persistent nodules or cysts, reducing pain, swelling and scarring. Large cysts that don't respond to medication may require drainage and surgical extraction. Another dermatologist procedure uses chemical peels of glycolic acid and other agents that loosen blackheads and decrease acne papules. Dr. Graf also recommends a relatively new technology called Isolaz, which vacuums out bacteria first then uses a laser to kill them. It's the only FDA-approved laser therapy for active acne lesions.
Use cosmetics and hair care products labeled noncomedogenic, which means they don't clog pores and are less likely to cause acne, says the American Academy of Dermatology. Avoid vigorous scrubbing of the skin and don't pick, squeeze or pop acne lesions, which can make matters worse and cause scarring. Don't wear clothing that is tight on the face or skin, such as collars or helmets. Minimize exposure to the sun, excessive cold or high humidity and eat a well-balanced diet with plenty of fruits and vegetables, which help to reduce inflammation.
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