What causes adult acne?
Looking around, there are teenagers
with acne, which does not surprise anyone. There are also those who should have
outgrown those kinds of skin problems because they are mature adults. Why are
they still suffering from what appears to be acne?
This leads to the question of
acne and what it is.
Who initially documented the presence of acne, medically
and historically? In other words, has acne always been around to plague
humankind or is this something new and different for this era?
The term acne appears to have
originated with the Greek writer, Aetius Amidenus where the word acne is used
"in the sense of a skin eruption". (1)
Acne refers to "the presence of pustules
or papules" (2) and it is usually "acne vulgaris" or
"common acne" (3).
The kind of acne that teenagers
have is acne vulgaris, which has comedones or blackheads. When there are
whiteheads present, these are unopened or closed comedones or pimples. (4)
Teenage acne vulgaris is
benign, whereas adult acne may not necessarily be benign. It would appear that
the presence of adult acne may be a manifestation of an unrecognized, disease
entity affecting the human body adversely or another condition that has yet to
be diagnosed.
"Acne is common among
teenagers, yet it could affect people over 20. Although acne is most prevalent
among teenage males, most can expect spontaneous treatment by age 25. Adult
females continue to experience acne into the adult years, sometimes beyond the
age of 40." (5)
If acne is not that uncommon in
females, particularly those who are over forty, look at it more closely and see
what is happening.
How is acne characterized?
It is suggested that acne is "problem
skin (skin implicated with acne) characterized by clogged enlarged pores,
excess production of sebum and fatty inclusions, abnormal bacterial function
and production of inflammation in acne lesions." (6)
Perhaps for older women, what
appears to be problem skin may prove to be acne vulgaris, adult acne or
something else that is causing the skin to erupt? Is it possible that there is
still another type of adult acne?
Discerning some of the known
causes of acne may lead to an answer.
Genetic - increased acne, if
both parents have had severe acne during their youth
Hormonal changes - acne is
affected by menstrual cycles and puberty as sebaceous glands are sensitive to
androgen stimulation
Dietary - many foods like milk
products, chocolate, highly processed foods and those high in refined sugar,
may make acne worse
Environmental - acne is worse
in winter - better in summer - sunlight may affect it either way
Psychological - stress causes
exacerbations of acne (7)
Those who have skin problems as
adults, need to be aware of other possible medical conditions and diseases.
Consider the following
examples:
"Development of acne
vulgaris in later years is uncommon, although this is the age group for Rosacea
which may have similar appearances." (8)
The right diagnosis becomes
increasingly important, as one realizes the possibility of other skin problems
that look like acne, but are not acne at all. They may be acne-like in
appearance.
"True acne vulgaris in
adult women may be a feature of an underlying condition such as pregnancy and
disorders such as polycystic ovary syndrome or the rare Cushing's
syndrome." (9)
This particular reference
suggests three distinct scenarios, namely the possibility of a pregnancy,
polycystic ovary syndrome and Cushing's syndrome. Hormonal levels and drugs can
result in acne.
What about the absence thereof?
"Menopause-associated acne
occurs as production of the natural anti-acne orvarian hormone estradiol fails
at menopause. The lack of estradiol also causes thinning hair, hot flashes,
thin skin, wrinkles, vaginal dryness, and predisposes to osteopenia and
osteopororis as well as triggering acne (known as acne climacterica in this
situation.)" (10)
Treatment for acne normally
includes the following:
Prevention of comedones
Sebum production reduction
Preventing rupture of comedones
Resolution of inflammation
concurrent with treating acne
Preventing and treating acne
scars (11)
It should be noted that in
order for what appears to be acne vulgaris or adult acne to be treated
appropriately, it must be properly diagnosed by a physician or a dermatologist.
All other medical conditions must be ruled out first, including those that are
benign or malignant.
A woman might smile, when it is
suggested that her adult acne may be a symptom experienced during her pregnancy
or a part of the natural course of life, as her female hormonal system ages.
"At my age?" she
might ask. "Yes," her physician might respond.
2. Ibid.
3. Ibid.
4. Ibid.
6. Ibid.
7. Ibid.
8. Op. cit., Acne
9. Ibid.
10. Ibid.
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