Thousands of days lost due to adult acne

Adult acne flare-ups can be severe enough to reduce national productivity rates as sufferers frequently choose to take days off work rather than face colleagues, recent evidence shows.

Acne is a skin condition with symptoms that include small red bumps, clogged pores known as blackheads, cysts (whiteheads), and large painful lumps under the skin. As many as 53.3% of acne sufferers have experienced a relapse at some time after the age of 20.

Data shows that 57.8% adolescents in Europe have suffered from acne at some point. One in 20 acne sufferers admit to instances of absenteeism from work or school due to the condition.

Reports show that within the first year of an acne diagnosis, those affected are 63% more likely to develop depression than people who don’t have acne.

Cormac Loughnane, superintendent pharmacist at McCabes Pharmacy, said: “Acne can have a detrimental effect on a patient’s quality of life. Skin issues can affect a person’s self-esteem and cause them to avoid socialising.”

Absenteeism—employees taking time off work—costs small businesses in Ireland €490 million each year. One study says mental health absenteeism has increased by 71.9% since 2011’.

To avoid the need for acne sufferers to be absent from work, it’s important that they are aware of the possible causes of the condition, the best treatments, and what can provoke acne into flaring up.

woman with acne

What causes acne?

It’s widely acknowledged that hormonal changes can cause acne, which is why the condition often flares up during a person’s teenage years. That said, there are many hormone-related causes that can occur at later stages in life.

Acne can be a symptom of premenstrual syndrome (PMS) or pregnancy, or come about through the use of hormonal contraceptives (such as the oral contraceptive pill).

It can also be genetic. If someone has a family history of the skin condition, they too are likely to develop it at some stage of their life.  

“It’s a common misconception that stress and diet cause acne,” Loughnane added. “Although it is possible for them to result in flares, they aren’t primary causes.”

There are several other causes of acne that aren’t as well known, such as the following:

  • Applying steroids to the body (e.g. as creams) or taking steroids by mouth
  • Wearing helmets—these can block pores in the skin and cause acne
  • Greasy or oily substances—working in an environment such as a fast-food restaurant, or using oily cosmetics (e.g. hair styling products) can cause grease to seep into the skin and clog pores
  • Mobile phones—they come into contact with lots of bacteria from surfaces they touch, and this bacteria can cause spots

What should acne sufferers avoid?

Many acne sufferers are advised—whether it’s by other sufferers, family members or peers—that squeezing spots will make them go away quicker, when actually it can lead to infections, scars or further blemishes.  

“When you squeeze a spot, it releases bacteria, dead skin cells and so on which may block the surrounding pores. This causes spots to form next to the squeezed spot,” Dr Nicola Ralph, consultant dermatologist at Blackrock Clinic, said. “It may also cause scarring if the areas of skin are squeezed too hard.”

woman popping a spot

Other ‘quick fixes’ that people with acne may be incorrectly told to try include:

  • rubbing toothpaste on to spots
  • applying Sudocrem (a type of skin cream often used to treat nappy rash)
  • rubbing spots with alcohol

Dr Ralph added: “These treatments might dry out the spot more quickly, but they can clog the surrounding pores, leading to more spots.”

Teenagers with acne may be told they aren’t washing their skin enough, yet over-washing with harsh skincare products that may contain alcohol can make acne worse. It can cause the skin to become dry, which in turn causes the sweat glands to produce more natural oils. This results in more acne.

“It’s important to wash the face each evening before bed to remove the dirt, debris and excessive oils that have built up over the day,” Dr Ralph said. “You can also apply a moisturiser after you’ve put on any prescription acne products.

“The most common misconception is that all teenagers ‘grow out of their acne’. Some teenagers unfortunately scar as parents and some healthcare professionals may miss the signs of early scarring.”

How can acne be treated?

For mild acne, over-the-counter treatments such as the following are recommended:

  • Daily cleansing products which contain salicyclic acid/glycolic acids
  • Benzoyl peroxide topical preparations
  • Zinc supplements
  • Oil-free moisturisers, sunscreens and make-up

Loughnane said: “If you see no improvement after using over-the-counter topical products for between two and three months and keeping to a good cleansing routine, you might need to treat your acne with prescribed topical and/or oral therapies.”

acne scars

If the acne begins to scar, the patient should seek immediate medical advice. The scarring can be removed with laser treatment, combined with a vitamin A-based medication (known as oral isotretinoin), and prevented from recurring.

Physical symptoms of acne can include large and tender lesions under the skin, which may rupture and bleed or flare up once treatment begins. This may mean the patient has to take time off from work or education.

There are numerous misconceptions surrounding the causes of acne and ways to treat it, which rather than alleviate the condition can actually make it worse. It’s crucial is imperative that patients receive the type of treatment that’s most suitable to their symptoms, to prevent acne from intruding on their everyday life.

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