What to do when your theme song is “Breakout”

Recently I’ve been seeing more and more women in their late 30’s and 40’s with acne issues.  Typically most patients see dermatologists for this so if I’m seeing more patients there must be an epidemic.  So let’s go through this so your acne issue becomes just like the song, a one-hit-wonder.

Acne occurs because of hormone fluctuation, such that occurs during puberty, perimenapause or with certain contraceptives.  These hormone fluctuations lead to an increase in production of skin oils.  These oils then mix with dead skin cells and bacteria creating breakouts.  So the control of breakouts must be attacked on several different fronts.

The basics of skin care and acne prevention start with a good but gentle cleanser twice daily.  An exfolient must be used only one time per week.  Using an exfolient more than this can cause unnecessary dryness.  The next and I think one of the most important products is tretinoin (Retin-A).  Tretinoin was first cleared by the FDA for use in Acne Vulgaris in 1972.  Shortly thereafter the full extent of its uses were discovered.  Tretinoin increases cell turnover thus reducing cells that can cause breakouts, it reduces sebaceous gland output and the oils that can cause acne, hyperpigmentation is reduced due to decreased melanin production and elastin fibers are increased which all lead to a much more even, smooth skin.

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