Q. Adult acne is increasing. Have you seen this in your practice or do you hear it in dermatologic meetings?
There is no "absolute" increase in adult acne. Rather, there is an increased awareness of adult acne, and therefore a greater frequency in diagnosis. There may be a "relative" increase in the number of acne cases simply due the population demographics (aging baby boomers) and greater awareness of the part of patients.
Q. Is it especially women or men that have adult acne?
In my practice, I tend to see adult acne primarily in women. However, that does not mean that men do not suffer from adult acne. The factors responsible for acne, regardless of age or gender, are the same - heightened sebaceous gland activity triggered by a genetic predisposition, hormonal influences, bacterial activity, hyper-keratinization, and individual inflammatory response. Women may be potentially more susceptible to adult acne due to hormonal fluctuations, and possibly due to the frequent application of topical cosmetic products to the skin, improper product removal, or some combination thereof.
Q. What causes adult acne? How do stress and the environment (i.e. pollution) affect acne in adults?
Acne is caused by the factors above regardless of age. Stress can affect the skin by increasing production of cortisol, which triggers increased sebaceous gland activity. Increased sebaceous glands activity can result in acne in genetically predisposed individuals.
Environmental stress may also play a role. Sun exposure may temporarily improve, and then worsen acne. Wearing a sunscreen that is not appropriate for skin type may also result in adult acne. Note that sun protection is vital to protect the health an appearance of the skin, however a formulation that is appropriate for your skin type must be used to avoid acne.
A very "dirty" environment (which few of us are in) or wearing a great deal of heavy makeup will certainly influence the skin.
Finally, as skin tends to become drier with age, more women (and some men) moisturize. Even older women need to choose the appropriate moisturizer for their skin type. Too frequent application of moisturizing agents, or a moisturizer that is too heavy for that particular skin type can result in adult acne, as can the use of a sunscreen that is inappropriate for skin type.
Q. What are the new techniques for acne?
New techniques to combat acne include a variety of lasers, which work by either decreasing sebaceous gland activity or destroying bacteria in the skin. Time-tested techniques include topical or systemic antibiotics, topical or systemic retinoids, hormonal treatments (such as oral contraceptives), and proper exfoliation.