Most people see acne as a necessary evil that will disappear along with the other scourges of adolescence. And for many people this does indeed happen. “But for 12 percent of women, adulthood is when their skin problems start, or get worse” says Dr Isak Marais, a Cape Town dermatologist.

What causes acne in older women?
“Mostly hormonal imbalances, of which most women have experience when they are premenstrual or when they are having their periods. Oestrogen and testosterone imbalances occur very easily and can be caused by a myriad of things, including stress, polycystic ovaries and medication prescribed for other things. In some women, the fitting of an IUD device or the taking of Depo Provera, the contraceptive injection, can lead to an outbreak of acne. Hormonal imbalances lead to an overproduction of sebum, an oily secretion of the skin, and this clogs up the pores, causing both blackheads and whiteheads.”

“Many women develop acne for the first time in their thirties, when they elect to go off the contraceptive pill, for whatever reason. The pill suppresses outbreaks of acne and women could be quite unaware of the fact that they have this condition until they stop taking oral contraceptives.”

“Certain types of Vitamin B supplements could also be a cause of acne, as can certain Vitamin E based face creams.”

“There are many other types of skin conditions that are often mistaken for acne, such as peri-oral dermatitis, acne rosacea and keratosis. A visit to a dermatologist should quickly identify the source of skin problems.”

Treatment for acne
“Prescribing the contraceptive pill for women sorts out the majority of adult onset acne in women. Second in line is the prescription of antibiotics, which, in the case of men, is the first choice. The problems with long-term use of antibiotics are many, such as the development of yeast infections, the lowering of the body’s natural defences and the development of drug-resistance to antibiotics. Antibiotics should not be seen as a long-term solution, and is not recommended for more than 3-6 months at a time.”

“Vitamin A treatments, such as Retinol, have proved to be as effective as the original clinical tests showed. These actually renew the skin, by getting it to form collagen, thereby not only leading to a more youthful appearance, but also to the partial restoration of acne-scarred skin tissue.”

Dr Marais stated that women have many more options of treatment today than a few decades ago and chances are that a visit to a dermatologist could help not only to discover the cause of skin problems, but also effect a cure.”