While pimples have traditionally been a dermat concern associated with adolescents, skin specialists in the city have observed a rise in the age of patients coming to them with aggressive acne. Most of them are over 25, says city dermatologist Dr Sushil Tahiliani. He sees between 10 and 15 new cases of adult acne every week at his clinics in Bandra and Malad.
"Although there is increasing awareness about skincare, I get several patients who believe their condition is an allergy caused by diet, medication or the use of cosmetic products," says Dr Tahiliani.
While some patients claim that they never managed to rid their faces of pimples that first made an appearance in their teens, another set complains of seeing them erupt for the first time in their mid-twenties.
How is adult acne different from adolescent zits? "Teenage acne typically appears more in the 'T' zone (forehead, nose and upper chin areas), while adult acne is seen more commonly on the 'U'/ 'V' zone (cheeks — especially near the jawline, areas around mouth and lower chin)," explains Dr Tahiliani. The latter also has the chance of showing up as larger lesions or nodules. They may be fewer in number than teenage pimples, and characterised by the infrequent occurrence of comedones (blackheads/whiteheads) but they have a higher chance of persisting for longer, sometimes well into the 40s, say experts.
Women are more prone to the attack than men since they experience greater hormonal fluctuations. The timing could coincide with their monthly menstrual cycle, during pregnancy, just before menopause or during menopause. The outbreak could even occur upon taking or discontinuing the oral contraceptive pill.
Other than hormonal imbalance, stress is another primary cause of breakouts. This occurs because under stress, our bodies produce more androgens (a type of hormone) which stimulate the oil glands and hair follicles in the skin, leading to acne. "Stress also leads to an increase in cortisol (referred to as stress hormone), which gets broken down into testosterone, a male hormone that can pump in excess oil through the pores. There are indirect effects of stress that will fulminate the acne lesions breakout," says Dr Manohar Sobhani, who runs a clinic at Colaba.
Ava Shamban, MD, assistant clinical professor of dermatology at UCLA and author of Heal Your Skin, says, "Even a moderate amount of daily stress — like balancing a career and social life, or coming home from work and having to cook dinner for your family — is enough to trigger a breakout."
Findings from research studies suggest that some individuals are genetically predisposed to acne, and they can be prime targets for adult acne. But sometimes, acne can be a sign of a dormant medical condition. An increase in levels of LDL cholesterol in the blood, or a diet high in glycemic index can be factors.
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