Learn how to deal with adult acne with the help of dermatology experts at Mediclinic City Hospital
8 April 2019| Last updated on 9 April 2019
Acne has been a big part of my life both personally and professionally since my early teens.
Now as Consultant Dermatologist still battling with acne intermittently myself, it has certainly shaped my career and how I approach my own patients. Acne is not a condition of teenage years alone, and I regularly see women in their 20s, 30s, 40s and 50s who need treatment.
With an estimated 20% of adult women suffering from the condition, it is more common than you may think. I feel strongly that acne is not just a cosmetic problem – it can be painful, cause life-long scarring, and can impact on confidence, self-esteem and relationships. Even we dermatologists are not exempt from this. Over the years I have had patients questioning me why I have acne – as if it is a choice.
One patient asked me if I could be trusted to treat her acne given how bad my own skin was at that time. That was hard to swallow, but perhaps reflects the impression that we have a choice in controlling our own skin. The truth is that many women are plagued by acne, and finding the right approach to treat and manage it can take time, effort and professional help.
As a hormonally-driven process, acne peaks at different times in our lives.
As well as puberty, acne can also be driven by other factors including pregnancy, breastfeeding, stress, and menopause. None of these are easy to control, and may also limit our treatment options at times.
For those reasons, the approach to acne management needs to be personalised for each patient carefully.
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Does diet affect my acne?
This is one of the most commonly asked questions in my clinic. The role of diet is uncertain from the scientific evidence, but it is an area that researchers are starting to focus more heavily on. Certainly the typical Western diet of carbohydrate-rich foods and refined sugar is under scrutiny.
There is an increasing body of work and anecdotal evidence to support that following a low-GI index diet is beneficial for a number of conditions, including acne. High-carbohydrate foods result in a spike in blood sugar and the production of insulin and IGF-1 (insulin growth factor 1). These in turn can increase oil production and promote the production of androgens, male hormones which can exacerbate acne.
I don’t believe in dietary exclusion but I do recommend minimising sugar intake, and making good carbohydrate choices, along with including pulses and vegetables in your diet. Patients are often interested in the role of dairy and that is a little less clear.
There is a suggestion that low-fat milk is more likely to be associated with acne than full-fat, but no studies have demonstrated conclusive links with dairy consumption. Many patients do chose to limit their dairy intake, but interestingly it may be wise to pick full-fat dairy options than low-fat. On a personal level I have found that my skin tends to breakout less when I am am minimising sugar and carbohydrate intake.
When should I see a Dermatologist?
If you are struggling with acne at any age, it can be really helpful to see a Dermatologist. For some patients all that is required is putting a good skincare routine with active ingredients in place.
For others, prescribed medication may be required, for example potent topical retinoids, oral antibiotics or hormonal manipulation with the pill or spironolactone. Many adult women will benefit from oral isotretinoin, the strongest medication for acne, which needs to be prescribed with caution but is an excellent treatment.
The days of high-dosing and significant side-effects from isotretinoin have gone, and we are now using much lower dosing to clear acne. Further down the line, acne scarring be approached with microneedling and lasers.
Acne is a medical condition and should not be accepted as the norm at any age. A lot can be done and I recommend seeking professional help if you are struggling with it. It is hugely satisfying for me to help patients with their acne journey, and one of the reasons I chose to become a dermatologist. We are here to help.
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Dr. Victoria Scott Lang
Mediclinic City Hospital