Many teenagers who develop acne grow out of it in their 20s, but some have to live with it in adulthood. Department of Dermatology and Venereology chairman Lawrence Scerri tells Stephanie Fsadni how a modern-day factor – stress – has led to a surge in post-adolescent acne, especially among women.
The prevalence of post-adolescent acne has increased considerably among women in the last 20 to 30 years. One major factor blamed for this phenomenon is stress.
“Stress has been identified as a key contributor to acne. The woman’s role has changed drastically in the last decades; working while raising a family has put a lot of pressure on women,” says Lawrence Scerri, chairman of the Department of Dermatology and Venereology at Boffa Hospital.
Post-adolescent acne affects roughly one in 10 women over 25 and may well carry into the 40s. It develops mainly around the lower face and jawline and spots and boils (furunculosis) can be quite deep.
Hormonal imbalance in women is the other major cause.
“Acne may fluctuate according to the cycle, with an outburst happening before pre-menstruation,” explains the doctor.
However, it may also be a manifestation of some other deeper problem.
Post-adolescent acne affects roughly one in 10 women over 25 and may well carry into the 40s
“Certain patterns may show that the underlying cause is Polycystic Ovary Syndrome – in which many small cysts grow on ovaries – or problems with the adrenal glands.
“There are also certain tumours that may produce acne, so there needs to be proper investigation and treatment.”
Another possible cause is a common intrauterine contraceptive device that releases a hormone that may trigger acne.
Post-adolescent acne in men, which occurs most often on the trunk, may also be caused by stress but could also result as a complication of abuse of anabolic steroids for sports-related purposes. Such acne can cause very bad scarring.
Dr Scerri emphasises that acne is a medical condition that by and large needs medical and not cosmetic treatment.
It is also a long-term condition that “requires continuous control”.
“Every time you leave a gap in treatment, it can regress.”
Treatment varies for men and women, with the Pill being the standard treatment for female adult acne.
“We prescribe a whole package, including topical and oral antibiotics in the short term, together with good cleansing agents.
Every time you leave a gap in treatment, it can regress
“But then you need to ‘maintain’ the results in the long term, and the Pill is the best treatment for that.”
Not everyone, however, can take the Pill, such as women with high cholesterol, cardiovascular disease, blood disorders predisposing to thrombosis, diabetes, heavy smokers and those with a personal history of breast cancer.
“Family history of breast cancer is, on the other hand, not proven to be an important contraindication for the Pill,” Dr Scerri says.
In these cases, one would need to rely on alternative hormonal or non-hormonal therapy.
As for men, there is a certain medication, consisting of special pills, of which they can take repeated courses.