Adult Acne: Really? It isn't high school any more!!

The medical name for acne is Acne Vulgaris, and unfortunately while men are more prone to scaring on their face from acne, women are more prone to being a victim of adult acne. It can be pretty devastating, but there are a bunch of things you can do to prevent further break outs and decrease the extent of break outs, and I'll let you know some products that you should use and those that you can skip!!

What is it? and WHY???
Acne is formed by a build up of fat, skin debris, and keratin in a hair duct, when it is open, it's a black head and when it is closed, it is called a whitehead.  White heads often cause the duct of the hair follicle to rupture.  There is inflammation around the site and redness which causes irritation.  At this point most people want to "pop" said pustule/cyst, and I am a huge offender of this, but popping at home can lead to a risk of dirt getting in and further infection and can lead to a spreading of the acne.

Showing A)Normal follicle B) Blackhead C) Whitehead D) Papule  E) Pustule

Just to debunk a myth, acne is not caused by poor hygiene.  Adult and teen acne are caused by fluctuating hormones leading to increased oil productions, faulty closing of the hair ducts, stress, cosmetic use, and infections.  But adult and teen acne should be treated differently. And leads to my next point: face washing with a gentle soap twice a day is much better than washing your face a billion times a day, that can actually dry your face out and cause more irritation.

So often people spend large amounts of money on over the counter treatments, one being proactiv, whereas if they bough a cheaper low strength benzoyl peroxide face wash and a cheap prescription from their HCP.  Of course depending why you are getting the acne is key to the treatment.  Most topical treatments just exfoliate the skin to allow for healthy new skin to grow and refresh your face, and then oral supplementation can help to change the internal mechanism causing the acne internally.

Best skin care ingredients for acne:
Benzoyl peroxide: long decided as a great treatment, and the base treatment, for acne. It eliminates bacteria, dries up excess oil, and is a mild exfoliator. Also, the 2.5% treatment is the same as the 10%, it has no increased effects of treatment on your face, so no need to waste any extra money!  Plus, be sure to wear a light oil free moisturizer after using this to prevent over-drying of your face.
Salicylic Acid: one of the best exfoliators on the market as an over the counter prescription.  Not as effective as Retin-A (a prescription exfoliant that is amazing)but it is generally effective for most adults with acne.
Antioxidants: These supplements eliminate naturally occurring free radicals in the skin. Vitamin C is one of the strongest antioxidants that helps to prevent wrinkling and skin damage.
Sunblock: while sun will help to clear up acne in the short term, it causes which causes long term skin damage and can cause over irritation and drying of the skin which can lead to oil build up over time.  So, use a daily SPF 15-25 daily, preferably oil free.
Moisturizer: A daily light oil free moisturizer can prevent over drying and help to make your skin feel less irritated and smooth.
Tea Tree Oil: A natural antiseptic, that also helps to soothe the skin and decrease the redness and irritation associated with acne.

Treatment types:
Topical Antimicrobial: Kill off the P. Acnes bacteria. example are: azelaeic acid, benzoyl peroxide, erythromycin, clindamycin.
Topical Retinoids: Work to unclog pores and prevent white and blackheads. Retin-A (derived from Vitamin A)and tretinonin.
Oral Antibiotics: used to treat and kill the P. Acnes bacteria at the source internally, to prevent blemishes and decrease the inflammation associated with acne.  Erythromycin, tetracycline may be used.
Interlesion corticosteroid Injections: For severe cysts and will decrease the risk of severe scaring.  Cortisone is used for these shots.
Isotrentinoin: A strong oral retinol used for severe acne; Accutane (AKA clavaris, sotret, amnesteem). But you must be aware that Accutane is a very strong drug that can have long term effects, and causes severe birth defects, so women are required to take either and oral birth control or some other type of strong contraceptive if sexually active.  It literally shrinks the oil glands in the skin and usually takes a 16 to 20 week course, in severe cases a second course is required. And you need to make sure that you aren't getting too much Vitamin E or A (watch that carrot intake!!)

What are optimal OTC products?
To prevent breakouts (i.e. keep acne away): Neutrogena Oil free Cleanser, H20 Plus Marine Cleansing Gel and use an alcohol free toner (such as the matching Marine Toner from H20 plus), MD Skincare All-Over Blemish Solution
For blackheads:  Bliss Clog Dissolving Cleansing Milk (an at home treatment is to make a paste out of baking soda and water, apply to blackheads, leave on for 3-5 minutes, then wash off...can be repeated)
For active acne: Purpose Gentle Cleansing Wash, Dermalogica Special Cleansing Gel, Zeno Acne Clearing Device, Tea Tree 100% Pure Essential Oil 
Moisturizers: Biore Pore Minimizing Lightweight Moisturizer SPF 15, dermalogica intensive moisture balance 3.4 fl oz (100 ml)

What can I do to prevent outbreaks?
Avoid over scrubbing face and over washing, wash twice a day with a gentle cleanser, moisturize, avoid touching your face and popping blemishes.   Also, try to change your make up every 6 months, avoid putting make-up over blemishes, and wash your make-up brushes regularly. Try to de-stress using yoga, or meditation, drink lots of water (at least your 2 liters a day- for anyone without renal problems), and .  Always apply acne treatments to clean skin, and apply to all acne prone areas, not just the area of breakout, as well be aware that it can take 4--12 weeks to see full results.  And best of all?  Go to a dermatologist recommended spa and get a facial, to deeply cleanse, exfoliate, and rejuvenate your skin!  Now, it is Nurse ordered, and not because you want to pamper yourself!!  It will help to moisturize the skin, relax you, and it can tame current breakouts, and prevent further breakouts.  Also, while expensive, the Zeno Acne Clearing Devices, help to use heat treatments to zap pimples at the site by using heat to kill the bacteria at its source, and they really work, for active blemishes.

If the OTC treatments don't work, go see your dermatologist and get another course of treatment, but there is no need to live with adult acne; it is easily prevented and treated!

Yours in Good Health
B