Adult Acne

If you are living with acne and oily skin, ask our experts your questions.
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nessajae
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Joined: Sun Jul 20, 2014 11:53 pm
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by nessajae on Fri Sep 18, 2015 8:49 am

Adult Acne

Hi,

I have had bad skin since I was a teenager and had hoped of course that this would go away in time, however I'm still suffering as I approach my 30s and – although the issues would probably only be considered mild – I am tired of the way this is affecting my confidence and my conduct in both my personal and professional life.

I am a generally healthy person; I'm not overweight, I eat a varied (mostly vegetarian) diet, I go walking every day, I do drink but not to excess and I don't smoke. Checking the other posts on a similar topic I have seen that PCOS has been mentioned – when I was about 20, after coming off the pill, a long run without a menstrual cycle led me to be screened and I was told I had PCOS and put back on the pill, however I was then screened again several years later and told that I definitely did not have PCOS, this was confusing to me but I have just continued on the pill anyway and have no other symptoms associated with this condition.

Last year I tried going dairy-free for six months to see if this would solve some of my problems. Sadly I did not see any significant difference to my skin so I stopped the exercise although I have continued to kept my dairy intake much lower than it was previously.

Still determined to get a hold on the problem, for four months I have been keeping a diary and noting down everything I eat each day, the condition of my skin and any other significant factors that I feel may have had an effect on it. This has been a useful exercise but unfortunately it has not revealed anything that I could not have already gleaned from a google search; the issues are mostly around the lower part of my face and jawline, there is a peak about a week before my monthly cycle and the problem is worse if it's combined with any other kind of tiredness or illness.

I had really hoped that this would provide some answers but it did not seem to bring up any information that I could act on. I'm not keen on trying to see my GP – it's very difficult to get an appointment at the overstretched surgery and I don't feel comfortable pushing this for a superficial problem. As mentioned I'm already on the pill, I did bring up the issue over a year ago at an appointment for something else and antibiotics and benzoyl peroxide were mentioned but I would be concerned about taking antibiotics and do not have fond memories of the abrasive results of benzoyl peroxide from trying this as a teenager.

I feel slightly at a loss now. I had hoped to find a natural solution as I was daunted at the prospect of trying to unravel and understand the confusing information about other over-the-counter treatments but it seems this is the only way forward – is there anything that you can recommend?

Many thanks in advance.

Vanessa

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ckbridgett
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Joined: Sun Aug 12, 2012 8:21 am
Location: London,UK
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by ckbridgett on Fri Sep 18, 2015 10:12 am

Re: Adult Acne

It is important that you say your issues "would only be considered mild" - and "this is affecting my confidence and my conduct", because a mild skin condition is definitely a major problem for some of us, and needs to be taken seriously and properly tackled.
Stress makes matters worse and having acne on your face at your age is stressful.
I hope before the day is out the dermatologists can respond to your very sensible request for advice. Perhaps Roacutane will be mentioned - I hope so! It can be very useful indeed.
It is important to take account of how we all vary in our ability to cope with skin conditions that affect how we look. Part of treatment should include this consideration. That's where psychodermatology* comes in.
Discovering how to be more self-confident and how to deal effectively with pressures and stress generally is sometimes just as important as discovering the correct pill or potion!
I hope that helps. Good luck!

*See http://www.talkhealthpartnership.com/ta ... tology.php
Dr Christopher Bridgett
Consultant Psychiatrist

http://www.talkhealthpartnership.com/on ... idgett.php

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Dr Roger Goulds
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Joined: Tue Jun 02, 2015 1:41 pm
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by Dr Roger Goulds on Fri Sep 18, 2015 2:06 pm

Re: Adult Acne

Hi. It is very common for acne to continue into your 30's. The distribution of your acne suggests it may be related to a high level of androgen in your system. This is often helped by the combined contraceptive pill, but sometimes it can make things worse and the progesterone only pill can certainly do this. I would suggest that your symptoms certainly do justify a consultation with your GP and possible further investigation into the possibility of PCOS or further treatment options including possible referral to a dermatologist. Failing this I would suggest you at least discuss your symptoms with the person prescribing your pill.
Dr Roger Goulds
talkhealth Medical Director
http://www.talkhealthpartnership.com/on ... goulds.php

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Dr Anjali Mahto
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Joined: Wed Sep 09, 2015 12:23 pm
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by Dr Anjali Mahto on Fri Sep 18, 2015 9:32 pm

Re: Adult Acne

Dear Vanessa,

Many thanks for your question and telling us a bit about your background with acne. Firstly, I would like to say I wholeheartedly agree with Dr Bridgett's comments. I would not wish you to suffer in silence or feel that you are wasting anyone's time for acne. It is a serious problem that can profoundly affect self-esteem - we know this.

I also agree with Dr Goulds that you need to be re-screened regarding the diagnosis of PCOS. It is an extremely common cause of resistant acne. You may also require blood tests to check your hormone levels (androgens) - but even if these are normal, this does not rule out hormonal pattern acne.

If you are getting deep, red painful spots (cysts) flaring cyclically then you require one of two medications commonly used for female adult acne - either isotretinoin or spironolactone either with or without the pill. Both are good at tackling female adult acne and the choice of drug would depend on your medical history, type of acne, and your personal preferences.

I think your starting point is your GP and take it from there. This is not a superficial problem if it is affecting how you feel so I will say again, don't ever feel you are wasting anyone's time.

Best wishes getting this sorted out.

Dr Anjali Mahto
Dr Anjali Mahto
Consultant Dermatologist and British Skin Foundation spokesperson
http://www.talkhealthpartnership.com/on ... _mahto.php

nessajae
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Joined: Sun Jul 20, 2014 11:53 pm
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by nessajae on Sat Sep 19, 2015 11:43 am

Re: Adult Acne

Thank you all very much for your detailed responses. The psychological aspect is something that I have been aware of but getting control is definitely easier said than done! It's a good start and very reassuring though to know that this is a real problem that should be taken seriously.

The spots do escalate to cysts at the worst points during my cycle so it is good to have advice relating specifically to this. I am on a combined pill at the moment and will need a review shortly so I will bring up the issues in detail then.

Many thanks again for your help.

Vanessa

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