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Adult Acne: Why You Get It, How to Fight It

Adult acne can really put a crimp on your life. Last year, for instance,
Christine Janssen considered posting a new photograph of herself on her
business web site but ultimately resisted the idea. With my acne, I just
wanted to put a paper bag over my head, says Janssen, 41, who runs a Manhattan
marketing research company.
Skin problems afflict almost everyone growing up, but some never outgrow it,
says Jonette Keri, MD, PhD, assistant professor of dermatology at the
University of Miami Miller School of Medicine and chief of dermatology at the
Miami VA Medical Center. She estimates that nearly 30% of women and 20% of men
ages 20 to 60 (and beyond) are troubled by breakouts.
What Causes Adult Acne?
Adult acne is caused by sebum, an oily substance produced by the skins
sebaceous glands. Sebum clogs pores, which attract bacteria and become
inflamed. For most adults, breakouts are a result of hypersensitivity to
androgens (male hormones). But an imbalance in both male and female hormones
(estrogen) can also cause breakouts. For women, this can happen during
pregnancy, perimenopause, and menopause. Some medications, such as
corticosteroids, and cosmetics are also triggers.
How Is Adult Acne Treated?
Treating adult acne is tricky. Most acne medications are geared to teens’
oily skin, a bad choice for drier adult skin. Effective treatment often
requires a trial-and-error approach that takes time, Keri says. Her
recommendations include:

Cleansers: Cetaphil and Aquanil are the most gentle. Avoid too-strong
gels and products containing beads or granules, which are abrasive and can
irritate and worsen sensitive skin.

Creams and lotions: Use an over-the-counter retinol product to clean
pores and help reduce fine wrinkles. Prevent discoloration and fade acne scars
with products that contain salicylic and glycolic acids. And to spot-treat a
breakout, use a product with benzoyl peroxide, which helps kill bacteria.

Prescription medications: The topical antibiotic clindamycin helps
fight bacteria in the skin; so does tetracycline, another antibiotic, taken
orally. Oral contraceptives and spironolactone, a blood pressure drug, can help
balance hormones.

High-tech solutions: Laser and intense pulsed light treatments mainly
target scars, but blue light therapy treatments kill acne-causing bacteria.
These treatments are costly, though, so explore your other options first.
A Skin-Care Regimen for the Acne Prone
Believe it or not, theres a trick to skillful face washing. To start, try
to keep your face clean during the day. Then wash your face twice daily
with the cleanser (if your skin is dry, try using water the second time). Use
only warm water (hot water is drying). Wash for just 1-2 minutes (more can
irritate your skin). And use your hands instead of a rough washcloth. (If you
must wash with a cloth, choose one made for babies, so its as soft as
possible.)
As for Janssen, she found that a doctor-prescribed regimen of gentle
cleansing, oral antibiotics, and a retinol cream did the trick, and her new
photo is now proudly posted on her web site. She says, All my friends comment
on how clear my skin looks.

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