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By Melissa Tennen, HealthAtoZ writer
You may have thought the prom was the only time to worry about breakouts. As you grow older, you start to realize it's also your wedding, your child's kindergarten graduation, your job interview.
Yup. It's acne. Make that adult acne. For too many adult women, acne is a fact of life, lasting well into their 20s, 30s, 40s and even 50s.
It's a real medical condition that can make you feel embarrassed and affect your self-esteem. Some women have had it since their teen years. Others develop it later in life.
Just about everyone has had a pimple at some point in life. Usually, acne starts between the ages of 10 and 13 and can last for five to 10 years. Adult women with acne tend to see it worsen around the time of their periods, during pregnancy, when they stop birth control pills or if they wear greasy cosmetics.
The exact cause is not clear. It is believed that acne is linked to androgens (male sex hormones). These androgens stimulate the oil glands and hair follicles, causing acne flare-ups.
Acne can be passed down from your mother or father. Some medications can also cause acne, including lithium (for bipolar disorder) and barbiturates (used for seizures). Also, rubbing the face, scrubbing too hard or picking at lesions can make acne worse. Acne is not caused by greasy foods, chocolate or dirt.
If you have acne with too much facial hair and thinning hair on your scalp, it could mean you have a condition called polycystic ovary syndrome, in which cysts form in the ovaries. If you suspect you might have this, see a doctor.
The good news is that acne can be treated. You can try over-the-counter medications, such as products containing:
- Benzoyl peroxide.
- Salicylic acid.
- Sulfur.
- Sulfur and resorcinol.
If over-the-counter medications don't help, check in with your primary care doctor or with a dermatologist. Most cases of acne can be treated successfully with pills or with creams or ointments applied to the skin. Have patience. Acne is not a quick fix. It may take six to eight weeks before you see any improvement. If not, you may need a new medication. Bear in mind that what works for one person may not necessarily work for you.
For women with acne, your dermatologist may try:
- Topical retinoids, topical antimicrobials (such as benzoyl peroxide and antibiotics) or oral antibiotics that are prescribed for more severe inflammation. For acne that is resistant to all other approaches, your doctor may proscribe oral retinoids; these, however, can cause severe birth defects if you get pregnant while taking them. Women must use at least 2 forms of birth control while on these drugs.
- Birth control pills. These may decrease androgen activity in women who have flare-ups around the time of their periods.
- Spironolactone, which prevents oil production by androgen and decreases androgen production, causing fewer acne flares.
To clean your face, gently wash with mild facial cleansers and don't scrub - this can make your acne worse. Toners that have glycolic acid or salicylic acid may help remove surface oils that can lead to flare-ups. You may need a moisturizer if your acne medication is making your skin dry.
Talk to your doctor about getting treatment.
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External Sources
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The National Institute of Arthritis and Musculoskeletal and Skin Diseases
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The American Academy of Dermatology
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This article was reviewed and updated June 2007.
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