Adult Acne is Frustrating but Treatable

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Medical Intel

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Acne is common in teenagers, but it can become a more persistent problem for adults. Dermatologist Dr. Sanna Ronkainen discusses how we treat adult acne and ways to protect your skin.   TRANSCRIPT Intro: MedStar Washington Hospital Center presents Medical Intel where our healthcare team shares health and wellness insights and gives you the inside story on advances in medicine. Host: We’re speaking with Dr. Sanna Ronkainen, a general dermatologist at MedStar Washington Hospital Center. Thank you for joining us, Dr. Ronkainen. Dr. Ronkainen: Thank you for having me. Host: Today we’re discussing acne, a common problem that’s often associated with teens but affects many adults, as well. Dr. Ronkainen, could start by discussing the reason adults develop acne? Dr. Ronkainen: Absolutely. So, for some adults that I see, their acne is carried on from their teenage years into their young adulthood. So, I see a lot of patients in their early 20s who are still struggling with acne. However, acne, particularly of the face, chest and back, can also linger or become a more persistent problem in women who are in their late 20s, 30s or 40s or even later than that because of the hormonal component of acne. Patients also come in reporting acne when they have inflammatory bumps or acne-like lesions on the body, which sometimes can be related to folliculitis, which is an infection of the hair follicles, which usually happens on areas of the skin that are covered by clothes, such as the buttocks or the thighs. So, we see a variety of different reasons that adults get acne. Host: Do certain demographics, such as race and gender, make a person more at risk for developing acne? Dr. Ronkainen: I think that gender, particularly females, in the kind of 20s, 40s range, tend to have more of a hormonal component of their acne, so definitely we see that patient population a lot in our dermatology clinics. Host: We know the face is a common area that people get acne, but where else can people get acne? Dr. Ronkainen: Classic acne tends to affect the face, chest and back. However, if it’s severe, it can also affect the shoulders. And, as I discussed earlier, folliculitis can affect the buttocks or other areas such as the thighs. Host: What treatment options are available for adults with acne? Dr. Ronkainen: So, even just starting at the local pharmacy, there are a lot of over the counter options for acne and there are many different ingredients that patients can experiment with. Benzoyl peroxide is a classic treatment for acne that really targets the bacteria that grows on the skin. There’s also salicylic acid, glycolic acid or sulphur washes it; work to more exfoliate the skin, help clear the pores that way. These are available over the counter in various products, however, they can be coupled very nicely with prescription products such as topical antibiotics or topical retinoids. These can also be accompanied by oral medications if the acne is deemed to be more severe. Host: How long does it typically take a patient to treat their acne? Dr. Ronkainen: Acne can be really frustrating to treat and, especially when patients are coming in to see me, they want results pretty quick. And, it’s frustrating to tell them that it takes up to three months to really see if a certain new acne regimen is going to work for them. So, I usually tell people that we should start seeing some improvement by the first month, but really by three months we should know if this treatment regimen is really working for them or if we need to change it up a little bit. Host: What are some tips people can follow to help them prevent or treat acne? Dr. Ronkainen: To prevent or treat acne at home, it’s very important to be mindful of what you’re putting on your skin every day. Number one, you need to make sure that the products that you’re using on your skin are not blocking your pores. And so, the products you would be looking for to be using are labeled non-comedogenic, meaning they don’t cause acne. Also, while at home, you can start out with some gentle cleansers and gentle topical treatments that are available over the counter and incorporate those into your daily regimen. Host: Why is MedStar Washington Hospital Center the best place to seek care for acne? Dr. Ronkainen: 353 Washington Hospital Center dermatologists have a wide breadth of experience in treating acne and all types of skin cancer in patients of all ages. So, we really have the dermatologists who work well with the patient to find a regimen that works for them, whether it is just topicals or if we need to go to more aggressive therapy such as oral antibiotics, anti-hormonal therapies, or Isotretinoin, also known as Accutane. Host: Could you share a story where a patient overcame acne after visiting you at MedStar Washington Hospital Center? Dr. Ronkainen: Absolutely. We see acne patients every day in our clinic and there’s nothing more satisfying than having a patient come back in three months, after you started them on a regimen, and have them just have a visible happiness on how well that they’re doing and the improvements that they’ve seen. Host:  Is there anything in people’s diets that could influence their risk of developing acne? Dr. Ronkainen: You know, this topic comes up a lot in my appointments with my patients. And, the only study that we have that has shown a correlation between a certain dietary component and increased development of acne, is skim milk. I don’t think we know exactly why that is, considering as compared to patients who drank regular or whole fat milk and there was no evidence of increased acne in that patient population. So, that’s the only piece of evidence-based medicine that I can point to, to say maybe switch over to the whole fat milk. Host: Some people can be tempted to pop their pimples when they arise. Is this something that’s safe to do? Dr. Ronkainen: As tempting as it is, I do not recommend that my patients pop their own pimples. Breaking the skin can cause more inflammation and can cause more scarring in the long run. Sometimes, if patients have a really deep, painful acne bump, sometimes they can come in to the clinic and have an injection of an anti-inflammatory medication to help soothe that area. However, usually trying to pop the pimple yourself is more trouble than it’s worth and will lead to long-term scarring which tends to be a more frustrating process for patients I see in the long run.  Host: At what point should a patient go to see a dermatologist to treat their acne? Dr. Ronkainen: I think if a patient is not satisfied with how their skin is looking at home, a visit to a dermatologist is an easy choice. We can always talk you through what you’re using as your home regimen - tweak that as well as add in prescription-strength products. So, if you’re at home wondering whether or not you should be seeing a dermatologist, even a one-off consultation certainly wouldn't hurt. Host: Thanks for joining us today, Dr. Ronkainen. Dr. Ronkainen: Thanks so much for having me. Conclusion: Thanks for listening to Medical Intel with MedStar Washington Hospital Center. Find more podcasts from our healthcare team by visiting medstarwashington.org/podcast or subscribing in iTunes or iHeartRadio.