Out, out damn spot: Treating adult acne

Out, out damn spot: Treating adult acne

By Maria Endah Hulupi

JAKARTA (JP): "Wati" stares at the mirror, surveying the
damage. Angry red spots of acne dot her face, with the one on her
nose getting bigger by the day and becoming more painful, like
the one under her jaw.

She is 35, but acne is still a part of her life.

"I always wonder why people say acne is a problem of teenagers
because I cannot remember a time when I didn't have pimples,"
said the private company employee.

Although there are no firm statistics for Indonesia,
acneworld.com reports about 27 percent of the 51 million acne
sufferers in the United States are adults, and the majority of
them are women.

Adult acne can break out on the face, shoulders, back and
neck. People prone to the condition are those with one or more
family members with an acne problem, those who lead stressful
lives and people who fail to maintain skin cleanliness.

The problem is usually triggered by androgen (male) hormonal
irregularity, stress, cosmetics and a high fat diet, said Lily
Soepardiman, a dermatologist with state-run Cipto Mangunkusumo
General Hospital in Central Jakarta.

Androgen hormonal irregularities and stress will activate
sebaceous glands, prompting the glands to produce excessive sebum
on the skin -- and pimples.

Middle-aged women are prone to the development of acne
rosacea, which usually breaks out in the T-zone area, often
accompanied by reddish skin, telangiectasia (the abnormal
dilation of capillary vessels and arterioles) and nodular
swelling of nasal tissue.

"Women from the age of 30 to 40 are experiencing hormonal
changes, which are aggravated by demodex mites which live on the
skin. For this problem, they will receive antifungal facial
treatment," she said.

People who consume asthmatic medicines or those who use
corticosteroids to increase their body weight are also prone to
developing acne because of attendant hormonal irregularities.

Lily said it was important to live a healthy life, such as
maintaining a low fat diet, avoiding excessive consumption of
carbohydrates and spicy food, drinking at least eight glasses of
water a day and trying to relax.

And women should not use heavy makeup which may clog the
pores.

Using cosmetics which contain acnegenic mineral oils, like
isopropyl myristate and myristic myristate, in the form of
foundations and moisturizers will alter the condition on the
epidermis, the top layer of skin, leading to clogging of the
pores.

"What's worse is that here in Indonesia, cosmetics producers
never clearly indicate the ingredients in their products, so the
consumers will never really know what they are putting on their
faces," Lily said.

Women with acne are advised to use a thin layer of mild
cosmetics, such as a water-based foundation, and thinly pat loose
facial powder to avoid clogging of pores.

As part of a daily routine, Lily stressed the importance of
maintaining personal hygiene by washing and cleansing the face to
remove dirt, cosmetics and sebum on the face twice a day.

"Choose pH balanced facial soap and gently clean the face from
impurities and cosmetics," she said, adding that using an
astringent after cleansing will help control sebum production.

People with a mild acne problem may use over-the-counter acne
medicines containing sulfur and resorcin tinctures. But Lily said
that if the condition worsens then people must immediately
consult a dermatologist, who may prescribe antibiotics such as
tetracycline, doxycycline and clindamycin in capsule or ointment
form for patients with infections.

For people with very oily skin, a dermatologist will usually
give an antiandrogen medication to control oil glands and
specially formulated treatment, containing sulfur, resorcin and
vitamin A acid, to clean out clogged pores and treat the
infection.

Cleansing

For proper daily facial care at home, senior manager of Swiss-
based La Prairie beauty clinique Jeanne Thong said thorough but
gentle skin cleansing in trouble areas, like the face, neck and
chest, is important, especially for people living in a heavily
polluted area like Jakarta.

She also said that acne breaking out along the jawline might
indicate possible digestive problems and stress, while eruptions
along the hairline can be caused by dirty hair.

"Choose the right skin products available, in this case the
ones for problematic skin. And for those with combination skin,
they may need different products for their facial area," she
said.

Jeanne advised people to evenly apply facial foam or jelly and
use wet white cotton pads to remove dirt for three minutes and
rinse with clean water. If the cotton looks dirty at the first
cleansing, repeat the step a second time.

"Rinsing with room temperature water is better than warm water
and using facial cotton is more effective to absorb dirt than the
hands, but don't overdo it, leave out the acne spots."

When doing facial cleansing, many people concentrate on the
cheeks, but this will lead to uneven skin tone, with a darker
hairline and lighter cheeks.

After the cleansing, use facial toner for oily skin to ensure
that the skin is clean and to balance the skin's acidity level.
For those with acne all over their face, use cotton to apply
toner by gently patting the face to avoid scraping the acne and
potential scarring.

A specially formulated acne cream prescribed by a
dermatologist may then be used, but only on the troubled areas. A
moisturizer for oily skin should then be gently applied.

"If they routinely perform this facial care at home, they will
see the difference in just seven days. They need to see a
beautician who will properly remove the acne every week," she
said.

As for makeup, Jeanne said using a thin layer of oil free
foundation is imperative, not only to give a fine look, but also
to protect facial skin against the sun's rays and pollution. The
next phase is to lightly dab loose or compact powder.

She warned women to avoid using a cheap makeup base that
contains mercury, as it will clog the pores and cause a
tightening sensation on the facial skin.

"It is also important to make sure that your hands are clean
when doing facial cleansing and keep sponges and brushes for
facial cosmetics clean to prevent spreading the bacteria to other
areas," she added.