Alpha Hydroy Acids and Adult Acne Treatment

Recent studies have documented the trend noticed by many Dermatologists that post-adolescent acne is increasing, particularly in women. The reasons for why their are more women with acne are becoming better understood. It is hoped that this new understanding will lead to more appropriate therapies for adult women. New over the counter treatments are emerging, particularly combination therapies based on alpha hydroxy acids that are more suited for aging skin.Research show that up to 14% of adult women aged between 25 and 45 suffer from some form of acne. (Knaggs, et al) Reasons are not fully understood. Use of cosmetics, hormone abnormalities and prescription drug use are often cited as causes. For example the role of the hormone, androgen in adult acne has been extensively studied. Elevated levels of androgen have been correlated with excessive facial sebum, or oil in the facial skin, one of the primary symptoms associated with acne. However researchers find that the majority of adult women who suffer from acne do not have abnormal androgen levels or hormone disorders. Confusing the entire hormone/adult acne connection, is that oral contraceptives or other estrogen therapies effective in controlling androgen levels can be effective in controlling acne.Researchers also point to increasing levels of stress as the primary cause of periodic breakouts in adult women. Correlations have been found for example between acne and high stress occupations and a correlation between stress and androgen has been documented. (Karrer-Voegeli, et al)In general Dermatologists report utilizing the same general principles of acne treatment for both adult women and adolescents, but there are differences in adolescent acne and adult acne, that suggest different therapeutic approaches. Researchers see, for example, an increase in facial pore size in adult women. Also oral antibiotics appear to work slower in older women and oral contraceptives to control acne have different contraindications in adolescents than in adult women. Adult women are also less sensitive to the irritating effects of benzoyl peroxide, the active ingredient of most over-the-counter acne treatments. However, Adult women do suffer more from the skin drying effects of benzoyl peroxide. This is particularly difficult situation for adult women with persistent or adult onset acne. They are typically unable to use skin moisturizers to counter these skin-drying effects as moisturizers often aggravate acne.More nuanced approaches to over-the-counter topical adult acne treatments are needed. A number of studies have pointed to alpha hydroxy acids as therapeutic agents that could be particularly appropriate for older women. (Bowe WP, et al) Alpha Hydroxy acids have moisturizing properties and several products have been developed and used successfully, notably the prescription product, Lac-Hydrin, Alpha Clear Acne Treatment [] by Niora and a variety of products by Murad. These companies pioneered the use of topically applied fruit acids in moisturizers formulated for adult acne. Alpha hydroxy acids do not have the direct anti-bacterial effect of Benzoyl peroxide, but they do micro exfoliant surface tissue and tend to reduce pore size, two factors which indirectly inhibit bacterial growth, and as an anti-aging side benefit tend to improve the appearance and health of the skin.Because alpha hydroxy acids have both effective anti-acne and anti-aging properties the potential exists to utilize these safe and well known substances in more over-the-counter treatments. Dermatologists continue to research alpha hydroxy acids and the results from more studies are anticipated in the near future.Post-adolescent acne. Int J Cosmet Sci. 2004 Jun;26(3):129-38. Knaggs HE, Wood EJ, Rizer RL, Mills OH.Androgen dependence of hirsutism, acne, and alopecia in women: retrospective analysis of 228 patients investigated for hyperandrogenism. Medicine (Baltimore). 2009 Jan;88(1):32-45. Karrer-Voegeli S, Rey F, Reymond MJ, Meuwly JY, Gaillard RC, Gomez F.Effective Over-The-Counter Acne Treatments. Semin Cutan Med Surg. 2008 Sep;27(3): 170-6 Bowe WP, Shalita AR