I am a thirty-year-old woman. Recently I have experienced terrible acne on my chest, neck, upper back, and face. No matter what I do, the problem will not go away. Could it be serious? What should I do?

Dear Reader,

Most people think of acne as a problem of the teenage years, however, acne can plague women and men throughout their life cycle. About half of all women, and a quarter of all men experience adult acne. Some people develop severe acne for the first time after age 25 years or so. This acne can be resistant to the usual acne treatments, such as tretinoin, benzoyl peroxide preparations, antibiotics, or medications such as isotretinoin (better known by its brand name, Accutane). Women with this kind of acne may also notice other symptoms, such as an increase in hair growth (including on the face), oilier skin, and irregular periods. This kind of acne can be due to abnormal hormone levels, specifically androgens. Sometimes this condition also interferes with a woman's ability to become pregnant. When blood tests reveal abnormal hormone levels, a variety of medications may help put things right again, including birth control pills, anti-androgen medications, or steroids.

Men may also experience adult acne, but it's more likely to stick around after adolescence rather than start for the first time during adulthood. For men experiencing adult acne, shaving more gently or less regularly might help with breakouts.

Another cause of pimples cropping up in thirtysomethings is a condition called acne rosacea. This condition causes redness and flushing of the face (which may become more pronounced when a person drinks hot beverages, alcohol, or eats spicy foods), pimples, dry skin, and reddish-purple streaks that look similar to broken blood vessels (called telangiectasias). This type of acne does not cause whiteheads or blackheads. Acne rosacea is treated with antibiotics: pills, gels, lotions, or a combination.

Whenever you develop a new, troublesome symptom that seems to be hanging on despite your best efforts to treat it, make a visit to your health care provider or dermatologist. For more information on possible acne treatments, visit the American Academy of Dermatology website. Best of luck breaking away from breakouts!


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