Fit & Proper: Is adult acne affecting your professional and social life?

It had been six months but Sunitha R, a 33-year-old employee of a software firm in Bengaluru, had not been able to get rid of the pimples along the sides of her cheeks, despite trying various creams. As someone who previously had clear skin, she was constantly aware of the acne and even began cutting down on socialising. At the workplace, she would be very conscious during Skype calls or video conferences with colleagues and clients overseas. Finally, she decided to consult a dermatologist, who told her she was suffering from adult acne.
Unlike what many people believe, acne is not restricted to your adolescent years which one grows out of. Adult acne can begin in the late 20s and 30s and up to the mid-40s. Apart from the late age of onset, adult acne differs from regular acne in a few ways. For one, though the pimples could be of the same size, they tend to occur along the margins of the face rather than the centre. And, one need not have oily skin to develop the condition. In adolescents, the greasiness of the skin precedes acne but this need not be the case with adults. Stress might be one of the factors that aggravates adult acne, especially for those anxious that their efforts at work might not be producing the desired results. High insulin levels also cause acne and pigmentation, with the pressures of modern life leaving little time to exercise.

Though the number of patients seems to be increasing, this could be because physical appearance is considered an important factor in employability these days, which pushes people to make the effort to take a day off and consult a doctor. Patients appear to have a level of concern about the issue which is disproportionate to their condition. If left untreated, one runs the risk of scarring. The condition could also continue indefinitely.

Critically, adult acne generally does not respond to local applications like creams as easily as with youngsters. So, one usually has to resort to oral medication. This broadly falls in three categories: antibiotics, hormones, or a vitamin-A compound. Once the acne is brought under control, you can keep it clear by applying something regularly, such as retinoids (vitamin-A derivatives).

QUICK TIPS

• Don't pick at the acne: Just as in adolescent acne, this will not help and could leave scars.
• Don't rub or scrub your face: There are many products advertised which claim to cure acne but avoid washing your face with these because these are not meant for adult acne. Repeated application will cause the condition to flare.
• Drinking a lot of water won't help much: Despite what people believe, drinking a lot of water will not cure it. Another common myth is that constipation causes adult acne.
• Cut on food with a lot of sugar: The one thing in the diet that seems to make a difference is reducing the intake of foods with a lot of sugar, which tend to make the treatment complicated. So, avoid all traditional Indian sweets, followed by cakes, ice cream, aerated drinks and sugarcane and fruit juices (you can have cut fruit). A spike in blood sugar seems conducive to the development or sustenance of acne, in both regular and adult acne.
• Consult a doctor: Since adult acne is usually cured with oral medication rather than creams, it would be best to seek a doctor's opinion.

D S Krupa Shankar
Consultant dermatologist, Mallige Medical Centre, and former president, Bangalore Dermatological Society