I HAVE WRINKLES AND PIMPLES? UGH. WHAT’S GO­ING ON?

Best Health - - ADVICE - DR. DIANE WONG is the founder of Glow Medi Spa, glowmedispa.ca

THE DOC­TOR SAYS… ADULT ACNE CAN REAR

A its ugly head at any time, even if you were lucky enough to es­cape ado­les­cent acne. In Western cul­tures, acne af­fects up to 95 per­cent of ado­les­cents and per­sists in up to 12 per­cent of women and three per­cent of men. It can be very frus­trat­ing – and even dev­as­tat­ing for some peo­ple.

Hor­mones, diet and stress play a vi­tal role in ex­ac­er­bat­ing acne. Other trig­gers can be linked to your men­strual cy­cle, ex­cess pro­duc­tion of testos­terone and even poly­cys­tic ovary syn­drome in se­vere or re­sis­tant cases. If you’ve re­cently stopped tak­ing the birth con­trol pill, you may no­tice an in­crease in acne. There are some stud­ies that sug­gest that milk has a neg­a­tive im­pact as well.

One of the key things to re­mem­ber when treat­ing adult acne is that ma­ture skin is dif­fer­ent from ado­les­cent skin. It pro­duces less oil, has a slower rate of cel­lu­lar turnover and may not heal as quickly. Adult acne tends to be chronic and low grade, with closed come­dones be­ing the most com­mon type of le­sion. A few papu­lo­pus­tules are usu­ally present as well. In adults, rosacea may present with pus­tules and be mis­taken for adult acne. Other signs and symp­toms, such as red­ness of the skin, should alert the prac­ti­tioner to con­sider rosacea in a dif­fer­ent di­ag­no­sis.

There is no known cure for acne, but there are many avail­able treat­ments. The goal is to con­trol acne and pre­vent red­ness, pig­men­ta­tion and scar­ring, which may oc­cur if left un­treated. There are many over­the-counter (OTC) prod­ucts, but we al­ways rec­om­mend see­ing a skin­care spe­cial­ist, who can cus­tom­ize your treat­ment based on your skin type and sever­ity of acne. OTC acne prod­ucts are typ­i­cally de­signed for ado­les­cent skin and may in­ad­ver­tently ex­ac­er­bate adult acne, par­tic­u­larly if the in­gre­di­ents cause ex­ces­sive dry­ness.

I fo­cus on a cus­tom­ized skin­care reg­i­men paired with in-of­fice treat­ments, such as fa­cials, chem­i­cal peels and/or laser acne treat­ments. The home-care prod­ucts and in­of­fice treat­ments of­fer ex­fo­li­a­tion and hy­dra­tion, as well as ways to calm in­flam­ma­tion and re­duce se­bum pro­duc­tion, ef­fec­tively re­duc­ing col­o­niza­tion of the P. ac­nes bac­te­ria. The added ben­e­fit of ex­fo­li­a­tion is an in­crease in cel­lu­lar turnover and collagen stim­u­la­tion, which im­proves skin tone and tex­ture and pre­vents fur­ther break­outs. An­tibi­otics are re­served for se­vere cases that are re­sis­tant to treat­ment or cases that re­quire im­me­di­ate res­o­lu­tion to re­duce the risk of se­vere scar­ring. Skin­care prod­ucts for acne typ­i­cally con­tain ac­tive in­gre­di­ents, such as ben­zoyl per­ox­ide. Ben­zoyl per­ox­ide has an­tibac­te­rial, anti-in­flam­ma­tory and comedolytic prop­er­ties. It’s a very ef­fec­tive treat­ment for acne, but it may cause dry­ing of the skin and needs to be used with proper guid­ance in adults. Sul­phur, sul­phur com­bined with re­sor­ci­nol and al­pha hy­droxy acids (gly­colic and lac­tic), beta hy­droxy acids (sal­i­cylic acid), retinol and tri­closan are com­mon in­gre­di­ents found in skin­care prod­ucts and in-of­fice chem­i­cal peels.

I also rec­om­mend mon­i­tor­ing your di­etary in­take. You should min­i­mize sugar con­sump­tion to re­duce in­flam­ma­tory in­flu­ences. Sup­ple­ments like zinc and mul­ti­vi­ta­mins that con­tain vi­ta­min A and niaci­namide can not only pro­mote in­ner health but also im­prove acne. That said, the use of zinc and vi­ta­min A as acne treat­ments should be care­fully mon­i­tored.

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