I’m 24 years old and still have acne. Why is this and when will it stop?

ANSWER:

Roughly 25 percent of the adult males who come through my office are there because of acne issues, so this is by no means uncommon.

Part of the reason adults still have acne is simply genetics. The cause can also be environmental -- perhaps you are using a cream that is clogging your pores. Or you sweat a lot. Or you take medications like lithium or steroids. And men, because their bodies have higher levels of testosterone than women, are naturally more acne-prone.

Fortunately, no one -- teen or adult -- needs to live with acne. Medications and treatments have advanced greatly over the past several years, and there are effective treatments for just about everybody.

Of course, we will all get pimples from time to time, and this is nothing to be concerned about. For these occasional appearances, you might want to try an over-the-counter salicylic acid or benzoyl peroxide. But where there is a concentration of acne on the face, you should see your dermatologist, who will set you up with a treatment plan.

One of the most potent but effective remedies is Accutane. It’s not always recommended for teens (because it can hinder physical growth) or patients with any of the following:

• certain kinds of depression (especially suicidal depression)
• liver disease
• irritable bowel syndrome, colitis or Crohn's disease
• high levels of cholesterol
• those using medicines in the tetracycline family

Accutane can also make the skin particularly photosensitive, which presents an issue in summertime. But for acne sufferers who don’t fall in any of the above categories, Accutane remains a very good solution.

If you merely want to be vigilant about acne and take safeguards against it, cleanse your face twice daily and take care not to apply hair product within an inch of the scalp. (Otherwise, it can drip onto the forehead and clog your pores.)

Other tips: If you sweat a lot during sports, keep a cloth handy so you can wipe and clean your face and prevent a dirt buildup. Use sunblock and face creams that are noncomedogenic (those that won’t block your pores).

Shaving can also be an excellent safeguard against acne because it exfoliates the skin and helps remove dead layers from the epidermis. Just make sure you shave in the direction of beard growth, not against it (which can cause ingrown hairs), and use a clean blade (changing your blade every few shaves). You should also be using a shaving gel (not cream) designed to help prevent acne. Finally, allow your razor to dry between uses so it won’t harbor bacteria.

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