Dear Reader,

Most people think of acne as a problem of the teenage years, however, acne can plague women throughout their life cycle. About half of all women, for example, experience significant breakouts of acne in the week or so prior to getting their period.

Other women develop severe acne for the first time after age 25 years or so. This acne can be resistant to the usual acne treatments, such as tretinoin (brand name: Retin-A), benzoyl peroxide preparations, antibiotics, or medications such as isotretinoin (better known by its brand name, Accutane). Some women with this kind of acne also notice other symptoms, such as an increase in hair growth (including on the face), oilier skin, and irregular periods. This kind of acne is usually due to abnormal hormone levels, specifically androgens. Sometimes this condition also interferes with a woman's ability to become pregnant. When blood tests reveal abnormal hormone levels, a variety of medications may help put things right again, including birth control pills, anti-androgen medications, or steroids.

Another cause of pimples cropping up in thirtysomethings is a condition called acne rosacea. This condition causes redness and flushing of the face (which may increase when the woman drinks hot beverages, alcohol, or eats spicy foods), pimples, dry skin, and reddish-purple streaks that look similar to broken blood vessels (called telangiectasias). This type of acne does not cause whiteheads or blackheads. Acne rosacea is treated with antibiotics: pills, gels, lotions, or a combination.

Whenever you develop a new, troublesome symptom that seems to be hanging on despite your best efforts to treat it, make a visit to your health care provider or dermatologist. For more information on possible acne treatments, visit the American Academy of Dermatology web site.

Alice

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