Acne can last into adulthood
Dear Dr. Donohue: My daughter, who is now 55, has had a serious acne problem since her early teens. About 12 years ago she tried Accutane, which worked for a while but then stopped. Her acne is now so severe that it erupts all over her face. She has just begun a new treatment where her skin is bathed with a blue light. Is it safe? Any advice you can give would be appreciated. — J.W.
Answer: About 12 percent of women older than 25 must still deal with acne, so it’s not something limited to adolescents. Your daughter, however, is an exception to the general acne rules in two respects. Female adult acne most often tapers off as women approach menopause. And her acne far exceeds the severity of most.
Acne is due to the plugging of oil ducts together with the action of a skin bacterium that thrives in oil. The ducts become distended with oil and eventually break and release oil and bacteria into the surrounding skin. Acne pimples then pop up on the skin surface.
Acne treatments aim to unplug the plugged oil ducts or to reduce the number of skin bacteria involved with acne outbreaks. Creams, gels or lotions like Retin-A, Differin, Tazorac, Azelex and benzoyl peroxide unclog oil ducts. Similar preparations with antibiotics such as clindamycin or erythromycin act on the acne-causing bacteria.
Oral medicines are used when the above medicines, which are applied directly to the skin, aren’t getting the job done.
Medicines that counter the action of male hormones are also useful for acne control. It’s the male hormone that promotes oil production. Birth-control pills are frequently prescribed. Spironolactone, a medicine originally designed as a water pill, has an anti-male-hormone effect and can help rein in acne.
Accutane (isotretinoin) is a powerful acne drug, reserved for the most resistant cases. It’s surprising it didn’t work for your daughter. It has serious side effects and has to be used with utmost caution. It can cause birth defects and is under investigation as possibly contributing to depression and suicide.
Facial peels, which are most often used for acne scars, can sometimes resolve resistant acne. Narrow-band blue light destroys the acne-causing skin bacterium. It’s safe. Its place in acne treatment is being evaluated.
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Dear Dr. Donohue: A friend tells me it is not healthy to sleep under an electric blanket because the electric current could cause cancer. Is this nonsense? — J.R.
Dear Dr. Donohue: On the radio I heard about a study that dealt with digital alarm clocks close to one’s head as possibly leading to brain cancer. What do you think? — R.G.
Answer: I have heard both allegations for many years, and I have seen arguments on both sides. I use an electric blanket and a digital alarm clock. I intend to keep using them. I don’t find any substantial evidence that either constitutes a danger. That’s my opinion, and that’s all it is — my opinion.