Saturday, November 8, 2014

Why Adult Acne is not Always Benign: Diseases That Include Acne Symptoms



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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