What can I do about adult acne?

Besides PPx treatments, there are other options - including topical medications and pills  - for women who suffer from adult acne.

Q: I'm in my mid-thirties, and I get occasional breakouts if I do not have Photopneumatic Therapy (PPx) treatments once every four weeks. The pimples are large, painful bumps under the skin surface. They are not visible to most people, but I can feel them when I wash my face. If I do not have PPx treatments, they turn into angry, inflamed, headless patches the size of a 5-cent coin that can take weeks to subside.

I already use benzoyl peroxide regularly. What else can I do to calm down my face and stop relying on PPx treatments?

A: Adult acne may occur in individuals who have a genetic predispostion to clog (i.e. the lining of the oil glands tend to be hyperkeratinised). Combined with an oily skin such individuals continue to suffer from acne beyond the teenage hormonal flare ups.

Benzoyl peroxide helps to kill the acne bacteria. However some individuals may benefit from medicaments that prevent clogging. These include topical tretinoin, adapalene or azaleic acid. One can alternate these medicaments with the benzoyl peroxide. Using a topical acne wash that contains antiseptic may help. An astringent that contains salicylate may help to remove residue dead cells and temporarily reduce surface oil.

Avoid cream-based cosmetics. Lotions are water-based and are useful for acne-prone individuals. Any make-up and sunblock which contains titanium dioxide should be thoroughly cleansed. Avoid long hours of heavy make-up and always remove the last traces of make-up before going to bed.

If you are on oral medication, certain contraceptives may aggravate the skin. Ask your doctor for oral contraceptive pills (OCP) like diane 35 or Yasmin which may help acne and reduce oil production. Anti-epileptic drugs may also aggravate acne.

Some medical conditions like polycystic ovary syndrome (PCOS) and rosacea are associated with acne. Rosacea can be associated with painful inflammatory acne. Avoid spicy food and alcohol to reduce facial flushing and prevent flare-ups of rosacea. Photopneumatic Therapy (PPx) or Intense Pulsed Light (IPL) are very useful in the treatment of acne rosacea. A doctor can advise on the management of these conditions.

Treatment alternatives to PPx include microdermabrasion which may help acne and is a less expensive procedure. Occasionally, oral antibiotics help to reduce these painful inflammations.

Answer provided by Dr Yeak Hwee Lee, Medical Director, Singapore Aesthetic Centre, a subsidiary of Singapore Medical Group.

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