Author Topic: Adult acne - the quest for clear skin  (Read 8293 times)

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Adult acne - the quest for clear skin
« on: Saturday March 08, 2003, 09:52:56 AM »
Adult acne - the quest for clear skin
(Saturday, 8th March 2003)

By Catherine Wilton

'I didn't suffer from acne when I was a teenager, but by the time I was 20 I was fighting a losing battle with my skin,' says Jane Allen, a teacher from Hampshire. 'It was really getting me down - I didn't feel I could wear any fashionable clothes because I was constantly worried whether my skin would be good enough.'

Not just a teenage problem

For the thousands of adults in the UK who are affected by acne Jane's story may sound all too familiar. Often thought of as a teenage problem, acne can last well into adulthood. In fact, a study published in the Journal of the American Academy of Dermatology in 1999 found that up to 54% of women and 40% of men are affected by spots after the age of 25.

Alison Dudley, Chief Executive of the Acne Support Group, estimates the prevalence of severe acne as slightly lower. 'More than 5% of women and 1% of men in their 40s are affected by acne,' she says.

'For some people it's actually the first time they experience acne and this can be, for example, brought on by coming off the pill for the first time, or going on the pill, or pregnancy or childbirth.

'We seem to be getting quite a large group of particularly women in their 30s who are still experiencing a problem with acne,' she says.

Psychological impact

And spots and blemishes can go more than skin deep. Jane, now aged 30, says, 'You've just got through your teenage years and you're feeling more confident about yourself when this happens!

'I tried not to let spots spoil my social life. But they do stop you doing things you want to. It's not that people look at your spots - it's the way it makes you feel.'

It's all in the hormones

So what causes acne, and can it be prevented?

Dr James Cave, a GP in Berkshire, says, 'It's probably all down to hormonal imbalance. Some people's skin is more sensitive to hormones than others, which can result in excess production of sebum, or oil, creating ideal conditions for the bacteria which cause spots to flourish.'

Dr Cave admits that some people can improve their acne by looking at their diet or by avoiding heavy, oil-based products, but stresses, 'the idea that you can do definite, definitive things to stop you getting acne - no I don't think there is anything.

'I find that a lot of people find their skin is better if they stop using wax-based conditioners in their hair. I think you forget that wax is just a fat by another name and the bugs that tend to cause acne¦are fat-loving bugs - that's why they live in the sebum glands.'

He adds, 'Wearing makeup can actually be beneficial as it makes many women feel better about their appearance.'

Alison Dudley agrees, 'Many people with acne feel the need to take care of their skin. It's just the case of finding the right products.'

Help is at hand

But for those who suffer with acne there is no need to suffer in silence any longer. According to the British Association of Dermatologists, 'Most patients with mild acne will respond reasonably well to treatment applied to the skin.'

These treatments, known as 'topical' preparations, are in the form of lotions and creams containing benzoyl peroxide, retinoids (chemicals related to vitamin A), or antibiotics. Some can be bought over-the-counter, and others need a doctor's prescription.

If lotions don't work, GPs can prescribe antibiotic tablets, or the hormonal treatment called 'Dianette'. This is only suitable for women, as it is similar to the contraceptive pill.

The British Association of Dermatologists warns, 'Acne is usually one of the easiest of the persistent skin conditions to treat, but it must be treated sooner rather than later. Early treatment minimises the risk of scarring.'

Hannah Sinclair, aged 23, a pharmacist from London, has suffered from acne since she was 13 years old, and has tried most of the treatments on the market.
'Because I had an older brother who'd had acne and he had developed a little bit of scarring¦my mum took me to the doctors to try and do something about it, to stop it from becoming a problem.

'The first thing the doctor suggested was be put on antibiotics, so I was on doxycycline on varying doses for about a year¦It kept them at bay but there were always spots on my face.

'When I was 15 I asked I asked if I could be put on Dianette treatment - it cleared them up completely. But I've no need to be on a contraceptive pill at the moment, and I've got a new GP who doesn't want me to be on Dianette - I've already been on it for seven years, so I felt it was time to come off it. And about two months after stopping taking it they've come back.'

Controversy over acne drug

An option for patients with severe acne is Roaccutane. The drug, which can only be prescribed by a dermatologist, is derived from vitamin A and, has a considerable drying effect on the skin. A four-month course of treatment is usually sufficient to banish acne for good.

Although Roaccutane is very effective, it has been the subject of controversy, following claims by some patients that they suffered psychiatric side effects from it, including depression. The Government's drugs watchdog, the Medicines Control Agency, warned doctors in 1988 to monitor patients who were taking the drug for signs of depressive illness.

However, many people who have used it for severe acne would not have done without the treatment. Alison Dudley maintains that the drug should remain an option for patients who need it, as long as the potential side effects are explained fully to the patient and they are provided with fair and balanced information in order to make an informed choice.

Dr Cave agrees, 'If you're worried about taking it you probably haven't got bad enough acne. What you have to remember is once you've got facial scarring you've got facial scarring for life.'

Further information:

Acne Support Group
PO Box 9
Newquay
Cornwall
TR9 6WG
Tel: (020) 8841 8400
Fax: (020) 8845 5424

British Association of Dermatologists
19 Fitzroy Square
London W1T 6EH
Tel: (020) 7383 0266
Fax: (020) 7388 5263
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