Middle-age acne: Dermatologists treating more older patients

Acne -- the most common skin condition among teenagers -- isstriking adults through their 50s in growing numbers.

The numbers might reflect in part career and family stresses thatexacerbate breakouts, experts say, as well as an increasingwillingness to seek treatment.

Scarring is a bigger issue when aging makes skin less elastic. Andthe effect of blemishes can have on your confidence can leave youfeeling like an insecure adolescent.

Dermatologist Bill Halmi treats adults who have acne every day.They make up about 40 percent of his acne patients. Though geneticsis a big factor in adult acne, it's not inevitable that everyone in afamily will be cursed, Halmi said. Almost all of those who areaffected can control the condition with new and also tried-and-truetreatments, plus good skin care.

There's no cure for acne, which occurs when bacteria grow inplugged pores, leading to the lesions commonly known as pimples.

In women, dermatologist Kristine Romine said, "Acne is very muchrelated to hormones. You tend to hear a lot about women breaking outaround their period or midcycle."

She treats some patients with hormonal therapy, including birth-control pills to suppress androgen production by the ovaries orantiandrogen drugs to block oil receptors. Androgens, thetestosterone and other male sex hormones produced in women and men,make skin oily.

Topical retinoids (vitamin A derivatives applied to the skin) andoral antibiotics continue to be effective, Romine said. After theacne is controlled, patients usually can take the antibiotic pillsfor just one week a month when premenstrual flare-ups typicallyoccur.

With warnings that certain powerful acne medicines such asAccutane can cause birth defects, Romine also is excited aboutresults from alternatives, including lasers that prevent and treatscars, and blue-light treatment.

In Halmi's arsenal of acne remedies, topical antibiotics such asMetroGel are standard treatment. Antibiotic creams reduceinflammatory lesions and the redness associated with rosacea acne, hesaid. They also can prevent new lesions if used consistently."Sometimes, patients stop using them when their skin clears up,"Halmi said. "Then, the acne comes back, and they think the creams area failure. They need to stay with the topical medications day in andday out, whether they have a blemish or not."

Over-the-counter remedies, from Clearasil to dermatologist-created Proactiv, can manage mild acne, especially when patientsavoid scrubbing and blemish triggers.

Caffeine, alcoholic beverages and heat aggravate acne in somepeople, but often-blamed foods such as chocolate and potato chipshaven't been proved to be culprits.