Adult Acne – “Like an Epidemic”

Below is a story from the Telegraph London I have republished.  Adult Acne has been on the rise for a number of years now, but rarely gets the attention that such a common and distressing condition deserves. I have been on a mission for some time now to raise awareness of this condition, which is 4-5 times more common in adult women than men and much more treatment resistant.

SGA ( Sebaceous Gland Ablation ) has been a godsend for our clients with Adult Acne and breakouts over the past four years and it is my goal for 2016, that everyone in Australia and New Zealand who has Adult Acne, will hear about SGA and find a permanent solution for their Acne and enjoy clear skin.

Wish me luck!

Vicky Eldridge breezed through her teenage years and twenties without so much as a blotch or blemish. But two years ago, aged 34, the unthinkable happened; she began to be plagued by spots.

“They started on my chin and came up around that time of the month, then lasted longer and longer until they were there all the time,” says Eldridge, now 36, who lives in Chelsea. “Dating was out of the question; I wouldn’t want to meet anyone with my face looking like that.”

“I tried everything to cover them up. Before then, I had always taken my nice, smooth skin for granted. I was miserable, embarrassed and self-conscious. I would apologise to friends in advance about it – if my skin was bad, I would even stay in. Dating was out of the question; I wouldn’t want to meet anyone with my face looking like that. I grew depressed, low and very emotional.”

As the editor of a beauty magazine and someone who prided herself on knowing how to look good, her shame was all the more marked; at worst, Eldridge would call in sick when she had a particularly “horrific” breakout.

And as extreme as her case sounds, Eldridge is just one of an increasing number of people in Western countries affected by adult acne, an affliction doctors and dermatologists agree is on the rise, largely due to an increase in stress and poor diet.

Dr Stefanie Williams, medical director of Eudelo (European Dermatology London), does not mince her words on the subject. “It is like an epidemic. We have so many sufferers [in this country]. It is important to acknowledge that it is a skin disease. It is not normal and not a right of passage.”

Indeed, a study of 92 private dermatology clinics last year found a 200 per cent rise in the number of adults seeking specialist acne treatment. A quarter of those who visit their doctor have skin problems – from acne to psoriasis or eczema – and women are five times more likely than men to be affected by late-life acne, due to fluctuating hormones during pregnancy, the menstrual cycle and changing methods of contraception (the pill, coil or patches) – Cameron Diaz and Victoria Beckham have, notably, suffered.

Acne is caused by the over-production of oil from sebaceous glands, usually driven by changes in hormone levels, leading to blocked and inflamed pores.

Low-level changes in stress have long been linked to problematic skin as the hormone cortisol contributes to breakouts. Dr Nick Lowe, a consultant dermatologist believes it is this stress that is fueling the rise, especially in women who are working full-time while simultaneously raising families. “There are so many triggers; perceived shortness of time, general instability in lots of parts of the world, women being pressured at both work and home.”

Eldridge agrees mounting stress was integral to the onset of her acne. “Skin is a reflection of what is going on in the inside and I was burning the candle at both ends. I was working long hours, partying and not sleeping enough. It was definitely a contributing factor.”

As well as causing physical scars, the emotional impact of poor skin can reverberate through relationships, work and home life. The British Skin Foundation found that 95 per cent of acne sufferers say it impacts their daily lives and 63 per cent experience lower self-confidence.

Vicky managed her acne with treatments and a strict diet
Vicky managed her acne with treatments and a strict diet 

Vicky switched to a diet with an emphasis on healthy eating and fresh vegetables. After committing to giving up alcohol and avoiding dairy and sugar, where possible, she finally saw an improvement in her skin.

After three months, her cystic acne subsided and a prescription vitamin A cream saw off the rest of her breakouts.

Now Eldridge is spot-free, 10 months sober and has been known to leave the house without make-up for the first time in years.

“It was a long slog and there was no one quick fix,” she says. “Making the dietary changes certainly had a dramatic impact and then the cream finished it off. I know it will need maintenance but my face looks amazing now and there is no scarring.”

Republished from The Telegraph London

 

Free Online Acne Consultation

If you would like a free online consultation with me, all you need to do is email me at [email protected]

Please provide me with the following information:

Your name, age, suburb and state

How long you have had acne and breakouts

What products and treatments you have tried ( please include any pharmacy or medical treatments ) What’s worked, what hasn’t

For female consultees – please tell me if your periods are regular or irregular, heavy or painful

Please attach three clear photos of your face, front on and each side of your face.

All this information is going to my private email account and will be kept confidential.

Please allow 5 days for me to answer your email.

I look forward to hearing from you soon.

Free Online Acne Consultation Service

I am really excited to tell you that within one week, my new free, online Acne Consultation service will be up and running. I have had a dream of offering this service for a long time, as I have been offering online consultations for my Clinics for a number of years. I have been inspired by an American website called Yo Derm ( agree, terrible name ) which is offering online Acne Consultations for $59, not so much for its service, which I think is a little limited ( I believe there is a lot more to managing Acne than giving people prescriptions ), but for its resounding endorsement of telemedicine, which is the name for conducting consultations via mobile, web or email, rather than face to face.

Diagnosis and management of Acne is ideally suited to telemedicine as the physical examination is visual and can be performed almost as effectively via photography.

I am completely passionate about giving every person with Acne the opportunity to clear their skin. This blog was the start of this mission and my online consultation service is the next key step.

So, from October 17th, 2013, you will be able to email me your photos and the answers to a small number of clinical questions and I will email back to you an individualised treatment plan. My next post will have my email address and instructions regarding what information I will need to assess your case.

 

I have posted some information about telemedicine from the Yo Derm site, which you might find interesting :

Effectiveness of Telemedicine

Telemedicine for dermatology patients is a great tool because skin conditions can be readily examined in digital still or video images,”1 said Armstrong, who also serves as director of the health system’s teledermatology program. “Our study found real and beneficial differences in the vast majority of teledermatology cases we analyzed,” said Armstrong. “With rapid improvements in interactive mobile platforms, connectivity speed and visual clarity, telehealth services like dermatology will play a bigger and bigger role in improving the quality of care and the access to specialty services that people deserve no matter where they live.”1

April Armstrong, M.D.http://www.ucdmc.ucdavis.edu/publish/news/newsroom/6127

Benefits of Telemedicine

“(Teledermatology) represents an excellent novel approach to treatment of a huge underserved patient group. Many people with moderate to severe acne live in areas without access to a dermatologist and may not be able to afford traditional care or may not even be aware that effective treatments are available. By using modern technology, acne treatment can be delivered remotely to this population to provide significant medical as well as psychological benefits at a significant cost savings.”

James Clint Jones, M.D.

Technological Advantages

“(Regarding teledermatology) In addition to increasing efficiency, the technology is a boon to patients and primary care providers seeking consultation, particularly those in medically underserved or remote areas. Travel time to a dermatologist is eliminated and there is no waiting.”2


California Healthcare Foundationhttp://www.chcf.org/publications/2009/12/storeandforward-teledermatology-applications

Patient Satisfaction

“Patient satisfaction with care received through teledermatology was equivalent to that with face-to-face dermatology.”3

Hsueh, Eastman, McFarland, Raugi, and ReiberTeledermatology Patient Satisfaction in the Pacific Northwest

Effectiveness of Online Acne Care

“Delivering follow-up care to acne patients via an e-visit platform produced clinical outcomes equivalent to those of conventional office visits.”4

Watson, Bergman, Williams, KvedarA Randomized Trial to Evaluate the Efficacy of Online Follow-up Visits in the Management of Acne

 

 

Best Skincare Products for Acne prone skin

There are thousands of products on the market that claim to be effective in controlling or eliminating Acne and breakouts. One thing I have learned treating thousands of people with Acne prone skins is that almost all  products deliver some short term improvement in breakouts, but there are very few products that are effective long term  in controlling Acne and breakouts for most clients.

Mild breakout is often readily controlled with a daily routine of cleansing and toning with a mild salicylic acid solution ( 0.5 – 2% ). Salicylic acid is very effective for controlling mild Acne and breakouts as it is oil soluble and therefore able to penetrate the sebaceous glands and help dissolve the mixtures of oil and dead skin cells that block the pores. Salicylic acid also assists in reducing the appearance of post acne marks. Other mild acids like glycolic acid and trichloracetic acid can also be helpful in exfoliating the excess dead skin cells and clearing the pores. These should always be used in low concentrations.

Benzyl peroxide is also a very commonly used medication for Acne and breakouts. All the  best known advertised Acne treatments are benzyl peroxide based and it can also be found in combination with some prescription Acne medications. Benzyl peroxide does work well for many clients and can be effective for long periods of time. It is less effective for moderate and severe breakouts and it can be very drying for the skin, particularly in higher concentrations. It is also a bleaching agent and will bleach clothes and bed clothes.

Topical antibiotics are often prescribed by doctors for Acne. They are also combined with topical retinoids in a small number of prescription medications. In my opinion, topical antibiotics are the least effective Acne treatments on the market. They promote the growth of antibiotic resistant bacteria and should be avoided.

Topical retinoids ( tretinoin ) are the most effective skincare products for breakout prone skin. Unfortunately, they have significant side effects ( sun sensitivity and skin dryness and cannot be used during pregnancy ) which has made them unpopular with many doctors. An alternative topical retinoid adapelene is more commonly prescribed by doctors but in my opinion, is not as effective as tretinoin. It has the advantage of not causing sun sensitivity but can be very drying to the skin. It is important to use tretinoin in low dosages to start with, to allow the skin to adapt to it ( 0.025% is recommended). It treats all parts of the Acne cycle and is also helpful for treating Acne scarring. In my practice, I combine tretinoin with a mild bleaching agent to help resolve the pigmented scarring that is so common with Acne. I also like my patients to use a 2% salicylic toner, preferably daily.

Before you buy any more skincare products for your Acne, read the ingredient list and make sure they contain something that will actually help your skin.

Abby’s Story

Abby is a huge success story for SGA. She has suffered moderate to severe acne for 5 years and tried absolutely everything to control her breakouts, including antibiotics and other acne medications. She describes the impact of acne on her life as paralysing. It impacted daily on her ability to complete normal everyday tasks we all take for granted. Because she wanted to fall pregnant , she was looking for a drug free solution.

What not to do for your Adult Acne

I would like to share with you an excerpt from an interview with Emma Stone about how she treats her Acne. Looking at Emma, you would never guess she had Acne, but she has suffered from breakouts from her teens and even resorted to Roaccutane, but had to stop it because her skin became too dry.

Emma Stone

Do you still break out?
“Yes, I’m breaking out right now!”

But you can’t see it!
“It’s because of Rach ( makeup artist ).”

What do you put on your face when you do have a zit?
“Usually, I use tea tree oil. I can’t go too crazy, or I’ll get a rash. My skin is really sensitive. Whenever it’s been really bad, I’ve gone to the dermatologist to get those cortisone shots. Those are amazing. They’re kind of a miracle. But also kind of terrifying because this huge needle is coming at your face. But no pain, no gain!”
( Reprinted from a Refinery 29 interview, Dec 6, 2012 )

 

I definitely do not advocate using steroid injections to control severe Acne. Pre Roaccutane, this was the only option for severe cystic Acne but, once we inject cortisone ( the commonest steroid used for the treatment of cysts ) we have absolutely no control over the outcome of the injection. Cortisone acts as a powerful anti inflammatory and, in most cases, will reduce the size of a cyst within 24 hours but it will often keep working too long and the result is an indented scar where the cyst was. So unfortunately, we are simply replacing one problem, the cyst, with another, a scar, if we use steroid injections for Acne cysts. I think it is a very brave doctor who injects her with steroids. She would be much better treated with SGA, which would give her a permanent solution for her breakouts.