What causes adult acne & blemishes?

Though frustrating, it’s not uncommon to continue to get acne well into your 30s, 40s and beyond, or even to get acne for the first time in adulthood. Dermatologists call this 'adult-onset acne'. It’s more common in women than men and always starts with a clogged pore which may be linked to one more of the following causative factors:

• Fluctuating hormone levels: Women often experience fluctuating hormones around their periods, during pregnancy, peri-menopause and menopause or after discontinuing (or starting) birth control pills. A hormone imbalance can trigger breakouts.
• Stress: When we’re stressed, our bodies produce more androgens—a type of hormone that stimulates the oil glands and hair follicles in the skin, which can lead to acne.
• Family history: Don’t blame your parents, but research shows some people may have a genetic predisposition for acne.
• Hair and skin care products: If you have adult acne, make sure your cleanser, moisturizer and sunscreen are labelled non-comedogenic and oil-free so they don’t clog pores.
• Medication side effect: Acne can be a side effect of some medicines. If you suspect that a medicine is triggering your acne or making it worse, continue taking the medicine—but talk to the doctor who prescribed it.
• Undiagnosed medical condition: Sometimes, acne is a sign of an underlying medical condition. Once the medical condition is diagnosed and treated, the acne often clears.

How to get rid of acne & blemishes

Adult acne can be incredibly frustrating, but there are effective treatments available. Here are a few tips from Dermatologists to keep pores clear and free of blemishes:

• Choose products for acne-prone skin. Look for non-comedogenic (meaning they won’t clog pores to start acne) and oil-free on the packaging. Products that exfoliate the skin’s surface help keep pores clear.
• Know your acne ingredients. Acne treatments target the different causes of acne. Benzoyl peroxide decreases P. acnes bacteria which can grow after the pore is clogged; salicylic acid unclogs pores to keep them clear; and retinoids unclog pores and reduce oiliness.
• Follow directions. How much you use and how often you use it can make a big difference. Using too little could be the reason you still have acne, but using too much can irritate skin further.
• Don’t over wash or scrub your face. Dermatologists recommend gently washing your face when you wake up, when you’re ready to go to bed, and if your face gets sweaty. Scrubbing or washing more often and drying skin out can actually make your acne worse. If your skin senses it’s dry, it will produce more oil.
• Spread acne medication on all acne-prone skin, not just your blemishes. Applying a thin layer on your acne-prone skin helps treat existing acne and prevent new breakouts.
• Give your treatment a chance. Acne treatments take time to work. You may see improvement in 4 to 6 weeks, but it can take months or longer to see clearing.

A few more tips to prevent acne & blemishes

• Try not to touch your face throughout the day. Resist picking and popping your acne, it can lead to scarring.
• Wash hands frequently, especially before applying lotions, creams, or makeup.
• Always remove makeup before going to bed.
• Frequently wash everything that comes in contact with your acne-prone skin. Dead skin cells, bacteria, and dirt tend to build up on sheets, pillowcases, hats and glasses, which can clog pores.
• Keep skin hydrated to prevent rebound oil production.
• Choose makeup for sensitive skin and avoid oil-based products.
• Avoid direct sun exposure - it can cause the skin to produce more sebum. Certain acne medications can also increase the risk of sunburn.

What’s the difference between a generic and brand-name drug?

Generic medicines are copies of an original branded medicine. A generic drug must have the same active ingredients, strength, and dosage form e.g. pill, liquid, or injection. The generic drug also must be therapeutically equivalent - it must be chemically the same and have the same medical effect. They work in the same way in the body and are associated with the same risks and benefits of the original branded medicine.

Are generic medicines as effective as branded?

Generic medicines are produced by companies who are subject to the same tight controls as companies who make branded products. Generic Medicines are medicines that are equivalent to an originator product.  They are put on the market when an originator’s patent runs out.  Licensed by the Health Products Regulatory Authority (HPRA), these products are interchangeable with the originator product*.  Because the companies producing them do not undertake initial research, they can be produced at a lower cost and so are cheaper to the patient.

* With a small number of drugs, changing brands is not recommended.  Our pharmacists will be happy to advise

Reference Pricing

The HSE sets a price for groups of medicines that are the same, called a reference price, which will usually be lower than the cost of the branded product. Due to these HSE rules you may be switched to a generic version of your regular medicine. This is designed to save medicine costs for you and for the taxpayer. The Health (Pricing and Supply of Goods) Act 2013 was enacted on 28th May 2013.  This act provides for the introduction of a system of generic substitution and reference price for interchangeable medicinal products. 

If you would prefer to have the branded medicine on your prescription even if it costs more than the reference price you will be required to pay the difference between it and the reference price.  If your doctor decides that, for medical reasons, your medicine should not be substituted then they must write the words “DO NOT SUBSTITUTE” in their own handwriting beside the medicine on your prescription.  In these cases the HSE will pay the full cost of the medicine.  Your doctor is required to keep a record of their clinical reason for doing this and may be asked by the HSE to provide this.

For further information please visit www.hse.ie/generics and http://www.hpra.ie. 

What is osteoporosis and who can get it?

Osteoporosis is a medical condition that affects the inside of your bones making them fragile and at risk of injury (Irish Osteoporosis Society, 2021). Although the interior of the bone is affected, there are no symptoms of osteoporosis and it may not be identified until a bone has been broken. Some common signs are loss of height, back pain and unexplained broken bones. Although women over 65 are 4 times more at risk of developing this condition, both men and children can also be affected. In addition to this, athletes who over train and those with eating disorders are more at risk. Some other risk factors include weight, some cancer treatments, steroid use and family history to name a few.

Why are women more at risk?

There are several reasons why women are more at risk of developing osteoporosis than men and hormonal changes tend to play a large role. Up to 30% of bone mineral density can be lost during the menopause.

How can I tell if I have Osteoporosis?

A DXA scan is a simple scan, similar to an x-ray that will measure a person's bone mineral density. A DXA scan can also identify osteopenia. If your bone mineral density is low, it is recommended to get a blood test as this can help to identify the reason for your bone loss. Calcium and Vitamin D play a large role in good bone health and a deficiency in either can increase the risk of developing osteoporosis.

What is osteopenia?

Osteopenia is diagnosed when a person’s bone mineral density is reduced but not at a level that would be low enough to be diagnosed as osteoporosis. It is common for osteopenia to develop into osteoporosis. If you have been diagnosed with osteopenia you should speak to a professional who will guide you and provide information on ways to improve your bone health and put preventative measures in place to ensure that your condition is managed optimally.

The role of exercise in osteoporosis

There is a large bone of evidence (no pun intended!) to suggest that exercise plays a significant role in the management of osteoporosis and can reduce the occurrence in high risk groups. Strength training, including weights, has been shown to be the most effective form of exercise, increasing bone mineral density and bone stiffness acting as a barrier to the development of osteoporosis. If you fall into the high risk group or have a diagnosis of either osteopenia or osteoporosis, you should speak to a trained professional who will guide you in developing an exercise regime to meet your needs. Exercise doesn’t have to be boring or unenjoyable so find something you love to do and work with your trainer to incorporate this into your weekly routine (2).

1. Irish Osteoporosis Society . Available: https://www.irishosteoporosis.ie/information-support/factsheets/. Last accessed 28 May 2021.
2. Senderovich H, Kosmopoulos A. An Insight into the Effect of Exercises on the Prevention of Osteoporosis and Associated Fractures in High-risk Individuals. Rambam Maimonides Medical Journal. 2018;9(1):e0005.

Sinead Coyle - Chartered Physiotherapist