Adult Acne
by Alison
Cole
zone3
Adult acne (also called “rosacea”) is a common inflammatory skin
disorder that tends to arise between 30 and 50 years of age. It is a
disease of uncertain etiology and is more likely to affect faired skinned
persons.
The basic adult acne lesion, called the comedo, is a sebaceous follicle
plugged with sebum, tiny hairs, dead cells and sometimes bacteria. Closed
comedones with some pathological changes in pilosebaceous duct
(hypercornification of the duct) are called whiteheads. Open comedones
that present when whiteheads reach the skin’s surface and touch air are
called blackheads. Their black color is not dirt, but the melanin (skin
pigment) that accumulates in the opening of the oil gland. Other
troublesome acne lesions can develop such as papules, pustules, nodules,
and cysts. Papules and pustules are blockages of oil glands that are
inflamed. Papules are red lesions (pimples). Pustules are pimples topped
by pus-filled lesions that are usually red at the base. Nodules are large,
painful, solid lesions that are deep-seated within the skin. They may
develop additional infection and have the potential to produce long-term
scarring. Cystic acne is considered the severe acne form. They are tender,
sensitive, deeper, painful, pus-filled lesions that cause scarring.
The goals of adult acne treatment should include clearance of acne,
prevention of scarring and, morbidity minimization. Patient education is
the first and at times the most crucial step for effective acne treatment.
It is essential to dispel myths that consumption of greasy food, potato
chips, sugar and chocolates are responsible for the development of acne.
The patient must be advised to cleanse the skin gently and use a
non-comedogenic moisturizer. The patient should also avoid picking and
rubbing the skin and using scented or harsh skin products. Other important
preventive measures should include use of proper shaving technique and
being consistent with the skin care regimen. Drinking more water can also
help skin stay healthy. Evidence states that modification of the
testosterone dose; dosing schedule or delivery method helps improve acne
symptoms.
Patients with mild to severe adult acne form can be treated with
topical or oral medicines. Although systemic therapy is mainly used for
treatment of severe form of adult acne, it is sometimes needed for
moderate cases. A variety of systemic agents used to clear adult acne
include interlesional corticosteroid injection, isotretinoin, oral
antibiotics (tetracycline and erythromycin) and oral contraceptives.
Azelaic acid, benzoyl peroxide, clindamycin, erythromycin, and sodium
sulfacetamide are the prescription topical antimicrobials used to treat
adult acne in the United States. Several types of prescription topical
retinoids used to treat adult acne include adapalene, tazarotene, and
tretinoin.
ABOUT THE AUTHOR
Acne Care provides
detailed information about acne care, acne care skin tips, acne skin care
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