Disorder of the Hair Follicles
Acne is a disorder of the hair follicles and sebaceous glands. Most children and young adults will have acne at some point. We treat a variety of different types of acne that affect newborns, infants, younger children, and adults. Treatment will depend on how severe the condition is. The goal of acne treatment is to improve the skins appearance and to lessen the chance of scarring.
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Adult acne effects people in their 20s, 30s, 40s, and even 50s. Usually adult acne is hormonally caused and appears along the jaw line.
Those most likely to get adult acne, include; women with high androgen levels (hyperandrogenism), people with increased androgen sensitivity in sebaceous glands, and people with decreased estrogen.
The goals of treatment are to keep new acne blemishes from forming and to prevent scarring and changes in skin color. You will usually need a combination of treatments, some of which include:
- Oral contraceptives (Estrostep, Ortho-Tri-Cyclen, Yaz) - inhibit androgen production, reduce free serum-androgen levels, and inhibit androgen action within sebaceous glands.
- Spironolactone: blocks androgen receptors, inhibits androgen biosynthesis, and decreases sebum excretion.
- Topical Retinoid (Adaplene, Tretinoin, Tazoretene): inhibits inflammatory biomarkers and normalizes follicular keratinization.
If you have acne scars, you may need surgery or medicines to help improve the way your skin looks. Be sure you understand your treatment plan and any side effects it might cause - you play an important role in the success of your treatment.
Acne in Elderly
When acne occurs in the elderly it is called Favre Racouchot Disease and is primarily due to sun exposure or smoking history and causes cysts/blackheads around the eyes, cheeks, and temples most commonly.
Treatment options include:
- Topical retinoid
- Comedone extraction (acne surgery)
- Sun protection (sunscreen, hats, staying out of the sun)
Physician assistant, Dennis Kordish, PA, discusses treatment options and how certain factors such as family history, stress, and diet can play a role in developing acne in the video below: