We’ve all done it. After the alarm goes off, we get out of bed, stare into the mirror and do the morning “pimple patrol.” Inevitably, we find one. Then, we suffer through the day, thinking that everyone is staring at the boil on our face. At night, we proceed with the familiar ritual of stop, pop and roll on the Clearasil, and we repeat the cycle every morning.
For some, this nightmare ended when we received our high school diplomas. But, for others, this cycle has continued into young adulthood. Tracy Favreau, D.O., assistant professor and director of dermatology at the College of Osteopathic Medicine, offers answers and advice to those who suffer from adult acne.
Why do people continue to struggle with acne past adolescence and well into their 20s and 30s?
“Many different sources of acne investigators report that there seems to be an increase of acne in adults. Experts think that this may be due to the amount of stress people are under as well as pollutants in our environment.
Acne affects approximately eight percent of adults aged 25-34 and three percent aged 35-44. Most teenage boys can anticipate their acne clearing between 20 and 25 years of age. For women, the news is not so good. The majority of patients with adult acne, including adult-onset acne, are women. This can last up to, and beyond, age 40.”
Though it is not highly recommended, many people still “pop” pimples. What is the best way to do this in order to fully extract the pus and minimize scarring?
“First and foremost, try not to ‘pop’ pimples. This will only lead to additional scarring. When a person picks or squeezes at these blemishes, it causes more trauma to the area, inducing a possible infection. The inflammation alone leads to hyper-pigmentation of the area, creating a darker scar, which makes it harder to treat.”
One of the most painful problems young adults encounter is cystic acne. How would you recommend people treat the disorder?
“The best thing a person can do is to go to their dermatologist or primary care physician at the first signs of developing acne. It takes some time to develop cystic acne. That’s why if they get an early start on acne treatment when the acne is only mild to moderate, they can actually prevent cystic acne from forming. Cystic acne is [the] worst type of acne because it has the largest amount of inflammation in the pore and creates such a painful cyst that it can create a large amount of scarring. Once deep scarring has [been created] from the rupturing of the cystic acne, it can be difficult to treat.”
There are many expensive treatments available to erase acne scars. What are some of the cheaper ways people can erase them?
“At the dermatology clinic at NSU, we treat a lot of acne from mild to the worst type, cystic acne. For scarring, we offer chemical peels that work well for the discoloration part of scarring, but do not work that well for the deep scarring some patients with cystic acne end up with. This type looks like indentations in the skin. It is very difficult to undo.
“Laser resurfacing, such as Fraxel lasering, is really [a] state-of-the-art way to go because it helps remodel the collagen that was damaged from the inflammation, which creates the indentation appearance.
“Generic medications can help decrease inflammation to prevent cystic acne from scarring. They are reasonably inexpensive but cannot treat the deep scarring if it is already done.”
What are some foods that can improve the health and appearance of skin?
“Mostly antioxidants can help maintain healthy glowing skin, but that won’t work completely if the person is under a lot of stress. They should decrease the intake of certain foods that have been speculated to worsen or induce acne, especially dairy.
A recent study examined data from the Nurses’ Health Study II to see if there was a positive association between milk in the teenage diet and acne. Intake of milk during adolescence was associated with a history of teenage acne. The association was more marked for skim than whole milk. Interestingly, soda, french fries, chocolate candy and pizza were not significantly associated with acne. The authors hypothesized that the hormonal content, not the fat in milk, may be responsible for the acne.
One should modify the amount of chocolate or caffeine products ingested, [which] can increase your sympathetic nervous system [activity], activating your oil glands into overdrive and producing an excess amount of oil, which increases the bacteria that causes acne. This can lead to further outbreaks of acne. Everything in moderation — I would be the last person to tell somebody, ‘No more chocolate.’”
What is the ultimate advice you would give to people to make and maintain healthy skin?
“The best way to keep our skin healthy is to eat a nourishing balanced diet rich in antioxidants. Exercise on a regular basis, and, most importantly, wear sun block on a daily basis. It should contain an SPF of at least 30. You should reapply it every two hours if you are in direct sunlight. This includes ones that are waterproof, because, as you sweat, it loses its protection somewhat.
Be sure to wear a hat to protect your scalp, face and ears. The eyelids have the thinnest skin on our bodies so sunglasses are a must for UV protection. Be sure to have your eyes examined by an ophthalmologist or an optometrist every year because you can develop cancers not only on your eyelids but also inside your retinas. Be sure to have a full-body skin examination every year. If you notice any change in your moles or notice new ones, be sure to see your dermatologist. It could be a difference between life and death.”
Whether it’s a balanced diet or medication, there is hope for those who suffer from adult acne. Cystic acne can be stopped and scarring can be scorched away. So, go forth, follow your dermatologist’s directions, and have faith that your pimples will not multiply.
