Are you in your 20’s and 30 ‘s and wondering why you still get pimples?? Ask many of today’s generation of women and they will tell you they get a premenstrual flare of acne, about a week before their period. Are you looking into the mirror and popping zits?
I get so many cases of women frustrated with their acne, not able to figure out why they are getting it now. Some of them never had it in their teenage years either!
Most patients come after having tried home remedies and applying many of the over the counter acne products.
Are you getting “Maskne” in the COVID era??
Let me clear some of your doubts.
What is acne?
It is a condition of the sebaceous or oil producing glands. These glands are present on the face, chest,scalp and back. Due to excess oil production,these glands may get blocked. These glands are also housing colonies for bacteria like Propionibacterium acnes which love to feed on all the oil. More oil makes the bacteria happy!
So, an initial bump or black head becomes more prominent, gets infected due to more and more bacteria and dirt and oil. Finally the gland cannot take it anymore and it bursts.
These glands have hormone receptors and produce more sebum/ oil in response to certain hormones.
Women with irregular cycles or PCOS who have lot of hormonal fluctuations, or have excess male hormone production face this problem of “Adult Acne”.
Why is this happening in our generation? Is it linked to stress, lifestyle, westernized diet, lack of exercise, quality of food produce?
Perhaps, yes!
What do I do when an Adult acne patient comes to me?
1. I take a detailed history of their lifestyle, menstrual history,treatments and products they use.
2. For women I advice a few tests for hormone levels.
3. I diagnose and grade the Acne, and then prescribe appropriate medications oral or topical based on this examination.
4. We also look for other signs of androgen excess like excess facial hair, or hair thinning.
Acne is one of the commonest skin conditions today. The market is flooded with products, creams, masks, packs and home remedies and so many things for acne. For mild to moderate acne these work well. Some of the acne is only due to excess make up or product use, or does not have underlying hormonal precipitating conditions. These may benefit from OTC products.
For moderate to severe acne and adult acne it is always better to see a Dermatologist. Severe acne can lead to scarring and pigmentation which is bothersome and requires further treatment.
What all is done by a Dermatologist for Acne:
1. Topical creams or oral medicines depending on the severity. Hormonal correction if necessary.
2. Procedures like comedone extractions.
3. Chemical peel is a great fast track method to deal with acne and reduce scarring. It penetrates the oil glands on a deeper level, prevents oil formation, reduces pus and inflammation, normalises exfoliation and treats pigmentation resulting from acne. Results are visible in about 4-5 sittings.
4. Lasers for acne
5. Scar treatments like microneedling and resurfacing lasers, PRP.
Dermatologists use researched guidelines and medicines for each and every class of acne.
It is a myth that doctor’s treatment effects last only for that time and acne comes back after doctor’s treatment. We have to understand that acne is an ongoing process, no matter whichever treatment you use.
Along with treatment I advise lifestyle change like exercise, low carbohydrate diet, low dairy or dairy free diet and other dietary advise. This needs to be followed by the patient.
Just like any other lifestyle disease, acne may need follow up for a year or so.
Please avoid home remedies like applying toothpaste, garlic, lemon juice and squeezing pimples. The complications caused by these can be worse than the acne. Also avoid any scrubbing procedures, massage to the face while having active acne. While some items like multani mitti , neem wash may be helpful for acne, people with sensitive skin should avoid it.
What you can do that does help adult acne is weight control, diet control, exercise, avoiding dairy products, avoiding sugary products, avoiding makeup or oily face products, good facial hygiene.
These days we are seeing many cases of Maskne or acne occuring in the mask area. Wash your masks everyday,dont wear makeup in mask area, do not put the mask on very tight
A specialist’s treatment and consultation may be little expensive, but isn’t your skin worth investing?
A Dermatologist ( or any specialist) spends years in training, hours studying the nitty-gritties of the subject like acne, hundreds and thousands of patients who become our teachers. We really enjoy our work and interacting with patients and making their life a little better.
