The adult acne can be divided into a few groups.
Acne after adolescence:
Statistics show that up to 25% will suffer from acne breakouts after the age of 20. This type is different than the regular adolescent acne :
People (mostly women) older than 20 that continue have acne breakouts. This type is more common in females and may continue to the age of 30, 40 and evan 45. included in this type are women, that have acne flare ups during pregnancy. This type of acne is usually worse during the first trimester of pregnancy when levels of progesterone are highest.
Folliculitis : Man in this age may have pimples/bumps in their beard area called folliculitis . Folliculitis is caused by an infection around the hair follicle – usually by a bacteria called Staph Aureus.
Acne due to hormonal imbalance:
Rare cases of acne can be induced by high level of hormones with testosterone like activity. This includes polycystic ovary syndrome , internal diseases/tumor that causes the body to ver produces, or external ingestion of hormones such as the steroids used by professional body builders.
| Before 20 | After 20 | |
| Comedones | Many | Less |
| Area | Nose, Forehead, Chin, Cheeks | Around the mouth, lower cheeks, under the jaws |
| Scarring | May be severe | Usually less or no scarring |
Treatment of post adolescent acne
First step would be to rule out hormonal imbalance, This can be done easily through a couple of blood tests.
Once the blood tests are normal – attention should be placed on cosmetics used. Everything used should be Oil free and non comedogenic.
Medications should be chosen according to the severity, starting with simple non drying topical antibiotics , combined with low percentage of benzyl peroxide, or in milder cases azelaic acid creams. In more severe cases a course of oral antibiotics may be very helpful followed by a followup prevention plan (The right cleanser and mild acne acne topical will be needed long term.) .
In the most severe cases that experience multiple relapses after antibiotics, low dose accutane combined with simultaneous blue light phototherapy will be the ideal choice.
Birth control pills for acne ?
Birth control pills are not a treatment for acne. The estrogens in the pill suppress the levels of testosterone in the circulation , decreasing its effect on the sebaceous gland and by that decreasing sebaceous gland enlargement and sebum secretion. These should be taken only if the women is sexually active. The pills may calm acne breakouts but a rapid relapse is expected when they are stopped. The best pills for acne will be the one that have minimal androgenic (testosterone like) effect . Examples will be Seasonale, Desogen, levlen. Two types of birth control pills have useful non hormonal ingredients that can further reduce the hormonal trigger of acne. Jasmin contains a non hormonal compund similar to spironolactone t and Diane (approved in Europe) a chemical called cyproterone both directely suppress androgen activity.
For the right contraceptive pill consult your Gynecologist…
