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Published August 19, 2012, 11:30 PM

Acne frustrating for women in their 20s, 30s, 40s

FARGO - Rachel Olson of West Fargo says her acne made her feel self-conscious in her work as a veterinary technician and college instructor.

By: Meredith Holt, INFORUM

FARGO - Rachel Olson of West Fargo says her acne made her feel self-conscious in her work as a veterinary technician and college instructor.

“I’m dealing with people all day long, and I want them to hear what I’m saying and not be looking at my face,” the 29-year-old says.

When Olson’s acne was at its worst, she worried about what her patients and students thought about her skin.

“It can have potentially severe psychological impacts, and that interferes with day-to-day interactions,” says Dr. Nor Chiao, dermatologist with Catalyst Medical Center in Fargo.

Acne can be especially frustrating for adults.

“At least in the teen years, you figure, ‘Oh, it’s because of my hormones; there’s an end in sight,’ ” says Dr. Susan Mathison, founder of Fargo’s Catalyst Medical Center. “When you’re an adult, you’re like, ‘IS there an end in sight?’ ”

Chiao says adult acne is “extraordinarily common.”

“We see a number (of adult acne patients) every single day. In a course of a month, we’ll see 100 or so,” she says.

More women are suffering from breakouts than ever before, according to a study presented at the American Academy of Dermatology’s annual meeting in March.

Researchers at Massachusetts General Hospital found clinical acne in 45 percent of women ages 21 to 30, 26 percent of women ages 31 to 40, and 12 percent of women ages 41 to 50.

Olson’s problems with acne started in high school but worsened around age 20. Her breakouts moved from her forehead to her cheeks, chin, neck and even chest.

Dr. Rachel Ness, dermatologist with Dermatology Associates in Fargo, says adult acne typically appears on the lower one-third of the face, most commonly along the jawline. Pimples also tend to be deeper and more painful.

“Adult acne definitely can be worse,” she says.

Older skin presents additional challenges to successful treatment of acne. Standard treatment can be more drying, and scarring is more likely.

“Your skin doesn’t bounce back as well, so you tend to have marks that last longer,” Mathison says.

Ness says hormone-induced acne is the most common type in adults.

For some women, hormonal imbalances and fluctuations are what cause breakouts. Others have polycystic ovarian syndrome or hormone-secreting tumors.

Birth control pills can both improve and worsen acne.

Mathison says hormone manipulation – whether it’s starting, stopping or switching pills – is more common for the treatment of adult acne than adolescent acne.

Another culprit is stress, and with adulthood come additional stressors.

Stress increases hormone production, which stimulates the oil glands, causing flare-ups during times of stress or after stressful events, Ness says.

Women who suffer from acne often make the mistake of over-washing or over-exfoliating, which can further irritate the skin and lead to scarring.

“They think that because they have acne, their face is ‘dirty,’ so they think that cleaning more will help get rid of it,” Mathison says.

When you’re not (gently!) washing or treating your acne, keep your hands off your face.

“I recommend no manipulation, which includes picking, squeezing and popping the lesions,” Ness says. “It’s genetically ingrained in all of us to do that.”

Rather than assaulting your face with a multitude of harsh products, simplify your skin care regimen, all three doctors say.

Using too many products at once can potentially lead to more breakouts, Chiao says.

“If you switch too often, you’re not going to know what works,” Mathison says. “Six to eight weeks is probably a minimal trial for a product, whether it’s prescription or over-the-counter.”

Everything should be labeled noncomedogenic, meaning it won’t clog pores, Chiao, Mathison and Ness stressed.

Chiao says acne patients often rely on pore-clogging makeup with heavier coverage because they’re self-conscious about their skin.

“It was hard to wear makeup because it would make it worse, but you wanted to cover it,” Olson says.

Dermatologists Chiao and Ness recommend mineral powder makeup, though any makeup is OK as long as it’s noncomedogenic.

“I think powders have come such a long way,” Ness says. “I really do like them for my acne patients.”

When acne persists and doesn’t respond to over-the-counter treatments, it might be time to see a dermatologist.

“Only about 1 in 5 adult patients actually visit a dermatologist,” Ness says.

Everyone’s skin responds differently to prescription creams, Chiao says, and it takes trial and error to find the right one for each patient.

Olson started noticing a difference after about a month on a topical medication. “I finally found something that worked,” she says.

The bumps that plagued her for most of her 20s are no longer a concern, and she’s enjoyed clear skin for the past two and a half years.

“Now even if I don’t put makeup on, I know that people are actually looking at me and listening to what I’m saying,” she says.