"Acne", Zits, Blemishes, Pimples in Adults

[MisterSmith]

This is kind of an embarrassing question for me, but I am bringing it up here in case it can help somebody else too.

I have been dealing with adult acne for years now, primarily on my nose but also some in the rest of my "T Zone." Even if the pimples are not bright red, the pores are clogged with gook and it is often painful. the problem is annoying, embarrassing, and I really want it to go away, but nothing I try works.

I have tried regular face washing, over the counter cleaners and astringents, Pro-Active clean/tone/prevent solutions, and a topical ointment prescription a doctor gave me many years ago. Nothing has gotten rid of the problem. Although Pro-Active did help to minimize the redness and number of full-blown "pimples," the pores were still clogged and breakouts still happened.

My doctor has not been helpful at all (one of the many reasons I am looking for a new one), so I thought I would ask the illustrious Dr. Steve. Is there any way to get rid of this adult acne for good?

[Dr Steve]

This is kind of an embarrassing question for me, but I am bringing it up here in case it can help somebody else too.

I have been dealing with adult acne for years now, primarily on my nose but also some in the rest of my "T Zone." Even if the pimples are not bright red, the pores are clogged with gook and it is often painful. the problem is annoying, embarrassing, and I really want it to go away, but nothing I try works.

I have tried regular face washing, over the counter cleaners and astringents, Pro-Active clean/tone/prevent solutions, and a topical ointment prescription a doctor gave me many years ago. Nothing has gotten rid of the problem. Although Pro-Active did help to minimize the redness and number of full-blown "pimples," the pores were still clogged and breakouts still happened.

My doctor has not been helpful at all (one of the many reasons I am looking for a new one), so I thought I would ask the illustrious Dr. Steve. Is there any way to get rid of this adult acne for good?

Mister Smith:

Adult acne is a really irritating condition and indeed, there is help for you.

The thing is, what you have may not be regular run of the mill acne at all, but rather a thing called "acne rosacea". Rosacea is easily treated with metronidazole gel (sold as "Metrogel") and is a different beast altogether. If you feel like it, send me a picture and I can tell you which it might be. Rosacea is usually described as red and waxy, usually around the nose and mid face, but it can show up as pimply eruptions on the face, too.

http://skinbeautifulblog.files.wordpress.com/2008/03/rosacea.jpg

Also, if the "pimples" are around the mouth area, it's a thing called "perioral dermatitis" which is also treated differently from acne.

http://i.pbase.com/g6/87/721887/2/81809527.j4Svotcd.jpg

If you've just gotten the runaround with acne medications, it'd be worth a trip to a good dermatologist; tell them that you've tried every damn thing with no results and that you wanted an expert to take a look at it because it does affect your appearance and your lifestyle enough to seek medical attention for it. This'll butter them up and put them in a position to want to look like a genius...so they'll spend a few extra ergs of mental energy on it.

One caveat: acne blemishes (eccchhh, I hate the words "pimples" and "blemishes", my skin is crawling just typing them) take SIX WEEKS to form, from irritations of the keratin layer of the skin to full blown zit. What this means to you is that if you found a magical cure that would stop all zits from forming, you'd still see NO IMPROVEMENT in pimple formation or healing for at least 6 weeks. So you gotta give any treatment you try at least 3 months before you can declare it a failure.

http://www.e2121.com/acne2.jpg

Most MDs will use some algorithm like this to treat acne (and you've already done some of this, so you'll get to skip some steps):

1) Skin washes with benzoyl peroxide x 3 months
if that doesn't work, try
2) topical antibiotic wash (clindamycin) plus benzoyl peroxide
if that doesn't work try:
3) oral antibiotics (tetracycline)
if that doesn't work, consider
accutane (not for fertile women; has some serious side effects for men, too)
or
consider a different diagnosis!

there are lots of other ways to treat acne; go see a dermatologist and let us know what they say!


your pal,


steve

[KingGeno]

Isn't it true that a Colon Cleansing (http://en.wikipedia.org/wiki/Colonic) will reduce acne? Just sayin' (http://www.google.com/search?q=colon+cleansing+acne&ie=utf-8&oe=utf-8&aq=t&rls=org.mozilla:en-US:official&client=firefox-a). Not really being an ass by saying it.