Forget wrinkles - many adults battle acne
13:58:26 EDT Jun 10, 2006

TORONTO (CP) - One of the best things about bidding farewell to the teen years is being rid of pimples. But some adults are waking up in their 20s, 30s, 40s and even 50s to a bright-red, unpleasant reminder of high-school embarrassment.

"When you're a teenager everyone has acne and it's not so bad," said Dr. Lisa Kellett, a Toronto dermatologist and founder of DLK on Avenue.

"When you're an adult and you're the only one in your office with it, it can be quite debilitating."

About 25 per cent of the clients who come to her skin-care facility are afflicted with adult acne - a problem she says is growing.

Leanne McCliskie, education manager for the International Dermal Institute in Toronto, agrees.

"If you look at the role of the average woman today, you know, juggling so many more balls ... definitely adrenal stress levels are up and adrenal stress is linked to this adult acne phenomenon," she said from the institute, where certified estheticians receive further training in skincare.

"It's not like the hormonal dance that you're having when you're 13 or 14."

Adult acne definitely looks different from teenaged zits, which are usually present in the T-zone - across the forehead, down the nose to the chin. The grown-up version shows up on cheeks, chin and along the jawline.

McCliskie explains that if breakouts are occurring along the jawline, neck, temples and eyebrows, it signals adrenal overload. The adrenal gland secretes adrenalin as well as steroid hormones including testosterone.

When teaching, McCliskie tells estheticians to ask questions and not just treat the client's acne during a facial.

"You can't say 'I'm going to clear up your spots for you.' It's going to keep coming back unless the source of the stress is removed."

There has been an explosion of products aimed at adult acne, beyond the old choices of the powerful bacteria-zapping potions aimed at teens. Now cosmetic companies are tapping into the demographic that wants to fight wrinkles and acne at the same time, offering products that come in pretty packages with high pricetags.

Publishers, too, are having a field day. After the huge success of his book The Wrinkle Cure, Dr. Nicholas Perricone produced The Acne Prescription: The Perricone Program for Clear and Healthy Skin at Every Age (HarperCollins). He writes about yoga, diet and products that will help people affected by acne (yes, he sells a line of products).

But not every author is hawking a skin-care line. The Acne Cure (Rodale Inc.) by Dr. Terry J. Dubrow and Brenda D. Adderly, outlines a cleansing and treatment regimen advocating certain ingredients based on skin type (oily, dry or combination).

Dr. Leslie Baumann, a Miami-based dermatologist, believes there are more than three or four types of skin.

In her book The Skin Type Solution (Bantam), she explains there are 16 skin types based on oiliness versus dryness, resistant versus sensitive, pigmented versus non-pigmented and tight versus wrinkled. She outlines product ingredients to be used for each of the different skin types and even recommends some brand names based on feedback from her clients.

The biggest complaint she hears is from women who are old enough to have wrinkles but who still have acne.

"With all these anti-aging creams - people are not buying the right ones. Even though it's anti-aging, it's not right for their skin type," she said, admitting she knows all too well how a company's promise of beautiful skin can attract even the most astute consumer.

She recalled that on a recent book tour, she was given a sample of an expensive anti-aging cream. She took the bait, applied the cream and the next day regretted it.

"I know not to do that ... and then here I was on my book tour with pimples and I was so mad at myself for not following my own advice," she said, adding that it wasn't that the particular cream wasn't a good product, just that it wasn't right for her type.

McCliskie agrees, adding that blemishes on the cheeks usually indicate a reaction to a product. A moisturizer, a foundation or even a blusher that is not right for a person's skin type could be behind an outbreak.

Kellett said the lotions women use to deal with wrinkles may well be the source of their acne.

"I tell my patients 'nothing white or creamy."'

Kellett recommends a gentle, gel-based cleanser that exfoliates, twice a day followed by a benzoyl peroxide lotion and a water-based, oil-free moisturizer.

And for adults who want quick treatment, she recommends a levulan and light treatment. Levulan is a photosensitizer drug which is applied to the skin and then activated with different types of light.

The hormonal imbalance that comes with menopause can also cause a woman who has had flawless skin for decades to be stricken with acne.

But McCliskie thinks something beyond stress, rich creams and hormonal changes may play a part in the acne that plagues women and men well beyond the teen years.

Pollution, toxins, fast foods may all play a role, she said.

"We all live in more toxic environments ... none of these things really help for healthy skin."