Acne in adult women

ACNE is often thought of as a teenage complaint. You believe that when you’re in high school you’ll probably get these bumps, but once you reach your twenties you expect them to be gone. Actually, we’re seeing acne in women over 20 more often nowadays. This is defined as adult acne.

Not many people are aware of the 40-30-20 rule, that is — 40 per cent of women in their twenties will have acne, 30 per cent of women in their thirties will have acne, and 20 per cent of women in their forties will still have acne.

Sounds depressing, doesn’t it? In fact, many women are going from bumps to wrinkles without a break in between.

What are the causes of adult acne?

Hormonal causes

Androgens are hormones that influence the development of the reproductive systems of both sexes. Androgen excess is the most common disorder in women of reproductive age. This excess can affect different tissues and organs, causing various clinical features such as acne, hirsutism, and reproductive dysfunction. Some women tend to see acne breakouts around the time of their periods because the hormones rise and fall with a woman’s natural cycle.

Polycystic Ovarian Syndrome

This disease seems to be on the increase. More women are developing ovarian cysts, stemming from an increase in the hormones which are released by the ovaries and showing up as acne, more hair on the face, around the nipples, on the chest, and on the abdomen (hirsutism). They may also experience irregular periods and an increase in weight. While the exact cause of this disease is not known, doctors believe that hormonal imbalances and genetics play a role. The consumption of meat from animals injected with growth hormones could also be a factor. What we do know is that we can treat this disease with good results.

Stress

When we undergo stress there is a small gland above the kidneys – the adrenal gland – which secretes a hormone called cortisol to combat the stress. Unfortunately, some androgen might be squeezed out at the same time that the cortisol is released, and this may show itself as acne.

Diet

Your diet may be contributing to your acne. The verdict seems to be out on this, but we see many people who eat vegetarian foods and avoid ice cream, fried food, and skim milk in particular, who seem to do better than those who indulge.

Research carried out on a tribe in Paraguay found that they knew nothing about our Western diet and ate only locally grown foods and vegetables. Their complexion was totally free of acne. Similarly, a tribe found in Papua, New Guinea, whose diet was limited to local foods, showed no trace of acne. It appears that diet plays a major role in preventing acne.

I tell my patients that if peanuts or chocolate cause your acne to break out, then avoid eating peanuts or chocolate. Ice cream and skim milk should also be avoided.

Using the wrong products

You may be using the wrong products on your face. The skin becomes drier as you age. Many of the products we use to treat acne may cause the skin to dry out even more, and the skin may compensate for this by putting out more oil, so you end up with more bumps and more spots.

It may be very helpful to use cleansers, moisturisers, etc once a day or even every other day until the skin grows accustomed to them. In some cases you may need to space out your application even further until the skin settles.

Not removing make-up at night

Every so often a woman comes in who is lazy or confused about removing her make-up at night. I ask patients to keep some witch hazel in the fridge, and every night before they go to bed to wash their faces and use a ball of cotton wool and wipe off the make-up with this. I always encourage my patients to develop the habit of using witch hazel to remove their make-up.

Dr Neil Persadsingh, MBBS, Dip Derm, Fellow of the American Academy of Dermatology, is a skin specialist practising from 6 Caledonia Avenue, Kingston 5. Contact him at 906-9999, 960-2797, or e-mail neilsin13@hotmail.com.