Sunday, May 10, 2009

Adult Acne - The Frustrating Problem

I just turned 30 and was ready to embrace the next new chapter in my life. But this is not to be so...not when a flare of adult acne comes in a seemingly mocking way to congratulate me on my life's next chapter. It is extremely frustrating, embarrassing, depressing... just about any sad words you can think about.

To seek solace, I had been reading up loads on this... here's to share one enlightening article form It is really genetics... when you get acne, how many, how bad, and when it would end.... When would mine end?

Adult Acne
Not just for teens: how to handle this frustrating adult problem.

A common problem in adolescence, acne may appear for the first time or worsen in midlife for reasons not fully understood. Hormonal fluctuations associated with menstruation and menopause make women more susceptible to adult acne.

Acne is generally attributed to an excess of male hormones known as androgens. Androgens stimulate the production of oily, waxy sebum by sebaceous glands in the dermis associated with acne. Overproduction of sebum may lead to blocked pores in the skin and a rapid growth of normal skin bacteria.

Symptoms of adult acne:
- Whiteheads (closed, plugged oil glands)
- Blackheads (open, plugged oil glands)
- Pustules (swollen red bumps), sometimes filled with pus

Treating Adult Acne

Several effective treatments for acne are available. If you have mild acne that's not inflamed, treatment with a nonprescription cream or lotion that contains benzoyl peroxide will help keep pores open and inhibit bacterial growth. Salicylic acid and sulfur in nonprescription lotions, creams, or gels can't prevent new eruptions, but they can cause existing ones to dry and peel. Topical antibiotics — erythromycin, clindamycin, and others — kill bacteria and are available with a prescription. So are oral antibiotics, which are even more effective. Both kill Propionibacterium acnes, the bacterium involved in the development of acne.

Retinoids, available by prescription, are derived from vitamin A and are a common and useful acne treatment. They cause several changes in skin cells that reduce the formation of pimples. Retinoids are especially effective when used with antimicrobial drugs — either antibiotics or benzoyl peroxide. Using a retinoid and an antimicrobial agent works better than using either drug alone. Tretinoin (Retin-A) is the retinoid most commonly used for treating acne, but it can irritate your skin. A microencapsulated form of tretinoin is less irritating. Tretinoin and two similar drugs, adapalene and tazarotene, are available only by prescription. Another treatment is azelaic acid, an antibacterial agent for mild or moderate acne.

The most powerful retinoid is isotretinoin (Accutane), which you take orally rather than apply topically like tretinoin. Isotretinoin is very effective for severe acne, but has some side effects, such as dry skin and chapped lips. Less common side effects are increased sun sensitivity, muscle and joint aches, headache, hair thinning, and impaired night vision. The drug is known to cause severe birth defects and must not be taken during pregnancy. A few patients taking isotretinoin have developed psychiatric problems including depression and, more rarely, suicidal behavior. As a safeguard, the federal government placed further restrictions on isotretinoin prescriptions. Doctors must register each patient in a national database and see the patient monthly, renewing the registration with each office visit.

Many women — up to 60 percent, according to the American Academy of Dermatology — show no response to routine acne treatment or find that their medications become ineffective over time. Because of this, isotretinoin has become a more common option, despite its drawbacks. The same is true for hormonal treatments. Estrogen-dominant oral contraceptives often are effective in treating adult women with acne. The combined estrogen and progestin that they contain decrease androgen levels. Undesirable effects include nausea, headache, and breast tenderness, but oral contraceptives may help decrease bone loss and lower the risk for ovarian and colorectal cancers. The anti-androgen drug spironolactone may be added if oral contraceptives alone are not effective.

Women with hypertension or a history of stroke, blood clots, breast or uterine cancer, or who still smoke after age 35 should not use oral contraceptives. Alternatives include spironolactone, used with antibiotics or by itself. Light and laser treatments are also useful for treating acne and acne scars.

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