Aggravated by Adult Acne?

I’m 32, and I’ve got acne. I thought this was something that happened only to teenagers. What causes acne at this age and what type of treatment would you recommend?

– July 27, 2004

Acne can occur at any age and can be a recurrence of teenage acne or a first-time development. If you haven’t had acne before, it is a good idea to consult a dermatologist who can look into the underlying cause. Among the possibilities: an endocrine imbalance or side effects of medications (including anabolic steroids, some anti-epileptic medications, drugs used to treat tuberculosis, lithium and iodine-containing medications).

Acne isn’t caused by diet, poor hygiene or stress. The reason it develops so often in adolescence is because of the hormonal shifts that occur between the ages of 12 and 21, which affect the sebaceous glands attached to hair follicles. The glands form sebum, an oily substance that can combine with dead skin cells to clog hair follicles, resulting in pimples. This scenario occurs less frequently among adults, but it is not uncommon.

You can try treating your acne with over-the-counter products, but a visit to a dermatologist could short-cut the time, error and expense of trying various treatments in search of one that works. The most effective prescription medications are the vitamin A derivatives tretinoin (Retin-A), applied to the skin and the oral medication isotretinoin (Accutane), which is taken orally and is prescribed for severe cases that haven’t responded to other treatments. Women taking Accutane must be careful not to become pregnant, since the drug can cause severe birth defects if taken during pregnancy.

The following self-care measures can also help:

  •  Wash your face or the acne-affected skin twice a day with soap and warm water as well as with special acne formulas containing benzoyl peroxide, an excellent cleansing agent.
  • Don’t scrub your face – you’ll only make matters worse.
  • Don’t squeeze pimples – it can lead to scarring.
  • As a natural alternative to benzoyl peroxide, use calendula products or a 5 percent tea tree oil gel. Both are available in health food stores.
  • Try consulting a Chinese medicine practitioner; Chinese herbal treatments, both topical and oral, can be very effective against acne.

Andrew Weil, M.D.

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