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Dermatologists Discuss Treatments For Acne In Adults

PITTSBURGH (KDKA) -- When you hear about acne, you might think it's a problem that only teenagers battle. But a lot of adults get it, too. And it's just as embarrassing and frustrating, perhaps more so.

One reason is the older you get, the tougher acne can be to treat. But if you've tried all the creams and medicines out there and nothing's working, there are a few other alternatives.

This isn't your teenager's acne.

"Every year I'd think, by next year it'll be better. I'm getting too old for this," said Kim Bruneau, of Venetia. "Even after my 45th birthday, here I still am dealing with it. It's uncomfortable. It's frustrating."

Adults get acne, too. It's a problem one dermatologist sees multiple times a day.

"At least a quarter of women in their 40s with acne, and 50 percent of men in their 40s," said Dr. Brian Horvath, of Horvath Dermatology. "So, it's pretty common."

"I remember my brother's wedding; I was having such a horrible breakout and just having to pack on the makeup," said Bruneau. "And maybe other people can't tell because you get really good at doing your makeup, [but] you can still feel it underneath. You feel that irritation."

Instead of pimples, adults tend to get deep, painful nodules, typically on the cheeks and neck.

Blocked oil glands, bacteria, hormones, diet and genetics can all be factors.

"In teenagers, it seems to be strongly driven by oil gland blockage. In adults, hormones seem to play a larger role," said Dr. Horvath.

Topical treatments, such as benzoyl peroxide and Retin-A, don't work as well in adults. Instead, grown-ups may have to take antibiotics, hormones or the prescription drug, Accutane.

But what do you do when those treatments don't work?

One option is light therapy. The doctor applies a cream that sensitizes the skin to light. The light exposure then creates inflammation, shrinking oil glands and destroying acne bacteria.

"It also ends up smoothing the face out too, which also improves the cosmetic appearance for scars," said Dr. Justin Vujevich, of Dermatology Associates. "The photodynamic therapy works best for people with inflammatory acne, and also for patients with active comadones, or what we call blackheads."

It usually takes multiple treatments two to four weeks apart, at $200 to $400 per treatment.

Another high tech option is laser therapy. It treats scarring from severe acne.

It isn't your typical weekend peel -- this goes deeper and your skin will take one to two weeks to heal.

"These procedures will not only strip away the superficial layer of skin, so part of the epidermis, but they will actually also go into the dermal layer of the skin," Dr. Ana Busquets, of Premier Plastic Surgery & Dermatology, said.

To treat bumps and divots she recommends three treatments, four to six weeks apart - as the best acne treatment. Depending on how many and how involved they are, it could cost you anywhere from $500 to $2,000.

And maybe someday, thanks to work being done right here at the University of Pittsburgh, viruses could be used to attack acne-causing bacteria.

Researchers say results are promising. They're now studying things like side effects and how best to administer the virus, most likely a cream or ointment.

"And so the hope is that essentially because we're sort of fast tracking what is otherwise a natural process, that the likelihood of serious side effects is probably minimal," said Graham Hatfull, Ph.D., a Pitt Microbiologist. "It's probably at least a couple years away, but we'll keep our fingers crossed this moves forward as quickly as possible."

The long-term prognosis for adult acne is quite good. By the time people are in their 50s, true acne is very rare. The main goal while the acne is active is to limit its severity and prevent future scars.

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