Adult Acne: Effective Treatment Available

AcneNet Spotlight Article
Adult Acne: Effective Treatment Available

While it may seem that nothing will clear a case of adult acne, the fact is that treatment can be effective. Often combination therapy (the use of two or more treatments), a dermatologist’s help, and a bit of patience are required.

The following describes treatment that can be effective for adult acne.

Topical Therapy
Topical treatment for acne includes creams, lotions, gels, and solutions. A topical medication that combines benzoyl peroxide and a topical antimicrobial such as clindamycin or erythromycin can be effective for adults with mild to moderate acne. Combining topical clindamycin with a retinoid also can be effective. These products require a prescription. An over-the-counter product that contains sodium sulfacetamide and sulfur helps some adults.

A topical retinoid is often used to treat the small bumps under the skin and blackheads. Some are available over-the-counter. The more effective ones require a prescription. Retinoids are the only medication believed effective for battling the microcomedone — the lesion that precedes acne.

While some patients shy away from using a topical retinoid because of the product’s reputation for irritating the skin, newer formulations are available that cause significantly less irritation. When using a retinoid, dermatologists recommend that patients apply sunscreen daily before going outdoors. A topical retinoid increases the risk of sunburn. An added benefit of using a topical retinoid is the product’s ability to reduce fine lines and wrinkles.

Acne-fighting cosmetics. Over-the-counter acne treatment for women is one of the fastest growing areas of skin care product development. Tried-and-true acne-fighting ingredients such as salicylic acid are finding their way into facial moisturizers and foundations. While the active ingredients are the same as those available in products tailored for teens, the products formulated for women are less drying. Many of these products include anti-aging ingredients.

While this may sound very promising, the active ingredients approved for over-the-counter products may not effectively control adult acne.

Oral Medications
As adult acne often involves hormonal swings, an oral medication may be necessary to minimize these fluctuations and control the acne. Medications that can minimize hormonal fluctuations in women include some oral contraceptive pills, spironolactone, and hormone replacement therapy. These therapies are not appropriate for every woman and should never be taken during pregnancy. Hormone replacement therapy is typically reserved for treating women when acne develops around or after menopause. This therapy is more likely to be prescribed when the acne is accompanied by mood swings, insomnia, anxiety, thinning hair, and decreased verbal skills.

An oral antibiotic also may be part of an adult’s acne treatment plan and can be used to help get the acne under control. Recent studies show that taking an oral antibiotic and using a topical retinoid for a few months and then stopping the antibiotic can be effective. The topical retinoid alone often can maintain the results over time.

If acne is severe or very resistant to treatment, oral isotretinoin may be prescribed. In some cases, intermittent therapy with isotretinoin can help adults maintain clear skin. Patients in their 50s and 60s who develop sporadic acne have been successfully treated with low-dose oral isotretinoin.

When oral medications are prescribed for acne, it is important that the patient consult a specialist trained in acne therapy, such as a dermatologist.

Physical Procedures
To treat the occasional persistent nodule or cyst, a dermatologist may inject a corticosteroid into the lesion. This treatment quickly reduces pain and swelling as well as lessens the potential for scarring.

While chemical peels and other physical treatments available in spa-like settings claim to effectively treat acne, their role in treating adult acne has not been determined.

Proper Skin Care Essential
When it comes to skin care for their patients with acne, dermatologists generally recommend gently washing the face with a mild facial cleanser. Avoid vigorous scrubbing, as it can irritate the skin and make acne worse. Daily sun protection is essential because some acne medications increase the skin’s sensitivity to sunlight. It is equally important to use only skin and hair care products labeled “non-comedogenic” or “non-acnegenic.” Above all, do not pick, squeeze, or pop the lesions. This tends to make acne worse and cause scarring.

Benefits of a Dermatologist’s Help
If over-the-counter acne treatments and good skin care fail to clear the acne, do not get discouraged. Seeing a dermatologist can give you peace of mind. The lesions may not be acne. Other skin conditions resemble acne. A dermatologist can tell. If acne is the problem, different medication may be required.

Getting the acne under control has benefits. It reduces the risk of scarring. The longer the acne persists, the more likely it is to cause scarring. Gaining control over acne also can improve one’s quality of life. Research shows that older adults report more negative effects on their quality of life from acne than do younger people.

References:
1 American Academy of Dermatology. New Oral Acne Medications Poised to Benefit Patients. News release issued August 4, 2007. Last accessed August 30, 2007 at www.aad.org/media/background/news/Releases/
New_Oral_Acne_Medications_Poised_to_Benefit_Patien/.

2 American Academy of Dermatology. Millions of Women Facing Adult Acne. News release issued July 30, 2004. Last accessed August 30, 2007 at www.aad.org/media/background/news/Releases/Millions_of_Women_Facing_Adult_Acne/.

3 Berger R, Barba A, Fleischer A et al. A Double-Blinded, Randomized, Vehicle-Controlled, Multicenter, Parellel-Group Study to Assess the Safety and Efficacy of Tretinoin Gel Microsphere 0.04% in the Treatment of Acne Vulgaris in Adults. Cutis 2007;80: 152-57.

4 Draelos, ZD. Acne Treatments in Adult Women. Presented during a forum (FRM 511) at the Summer Academy Meeting of the American Academy of Dermatology, August 2007; New York City

5 Shaw JC. Low-dose adjunctive spironolactone in the treatment of acne in women: a retrospective analysis of 85 consecutively treated patients. Journal of the American Academy of Dermatology 2000; 43: 498-502.

6 Williams C, Layton AM. Persistent acne in women: implications for the patient and for therapy. American Journal of Clinical Dermatology 2006; 7: 281-90.