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The Fitzpatrick Skin Type Classification system was developed in 1975 by Harvard Medical School dermatologist Thomas Fitzpatrick, MD, PhD.
Although acne is oftentimes as much a part of being a teenager as dating and Friday night football games, a new study examining the prevalence of acne in adults age 20 and older confirms that a significant proportion of adults continue to be plagued by acne well beyond the teenage years. In particular, women experience acne at higher rates than their male counterparts across all age groups 20 years and older.
In the study entitled, “The prevalence of acne in adults 20 years and older,” published online in the Journal of the American Academy of Dermatology, dermatologist Julie C. Harper, MD, FAAD, associate professor of dermatology at the University of Alabama in Birmingham, Ala., and her colleagues at the University of Alabama at Birmingham School of Medicine, surveyed a random sample of men and women aged 20 and older to determine the prevalence of persistent acne that continued after adolescence or new adult-onset acne.
“Although acne is one of the most common skin diseases, there is a general misconception that it only affects teenagers,” explained Dr. Harper. “As dermatologists, we treat acne patients of all ages – from those who have experienced acne since they were teenagers to others who have developed the condition for the first time as adults. Our study set out to determine just how common acne is among adult men and women.” A total of 1,013 men and women aged 20 years and older at the University of Alabama at Birmingham campus and medical complex were asked to complete a one-page questionnaire designed to evaluate the prevalence of acne in adults across various age groups. Survey questions gauged whether the participant had ever had acne or pimples, including during their teens or later in life (in their 20s, 30s, 40s, and 50s or older). The survey also asked participants to judge whether their acne had become better, worse or stayed the same since their teenage years.
When asked whether they had ever had a pimple or acne, the vast majority (73.3 percent) of participants responded that at one time or another they had dealt with acne. The majority also reported that they had experienced acne as teenagers, with the number of men and women affected by the condition nearly identical (68.5 percent of male participants and 66.8 percent of female participants).
Interestingly, the survey found that for every age group following the teenage group, the reported
incidence of acne was significantly higher among women than men. Specifically,
- During their 20s, 50.9 percent of women and 42.5 percent of men reported experiencing acne.
- During their 30s, 35.2 percent of women and 20.1 percent of men reported experiencing acne.
- During their 40s, 26.3 percent of women and 12 percent of men reported experiencing acne.
- During their 50s or older, 15.3 percent of women and 7.3 percent of men reported experiencing acne.
A separate section of the survey, which included questions assessing aspects of acne specific to women, asked female participants to note changes in acne around the time of their menstrual period, their pre-menopausal or post-menopausal status, and the effect of any treatments for symptoms of menopause on acne. Of the pre-menopausal women surveyed, 62.2 percent noted that their acne gets worse around the time of menstruation. In addition, of the 86 women who reported using either hormone replacement therapy or over-the-counter medications for the side effects of menopause, nine women (10.5 percent) reported improvement in their acne with the use of these therapies. However, 75 of the women (87.2 percent) reported no change with these menopausal therapies, and two women (2.3 percent) reported that their acne symptoms worsened.
“Our findings demonstrate that acne is a persistent problem for people of all ages, but clearly women seem to be affected by this medical condition more than men when we examined the 20-plus age groups,” said Dr. Harper. “Research examining the role hormones play in the development of acne may hold the key to explaining why more adult women are affected by acne and could lead to future treatments to control this condition.”
Dr. Harper added that the majority of study participants reported that the severity of their acne improved after their teenage years, which is consistent with previous studies suggesting that post-adolescent acne is generally mild or moderate. For example, 63 percent of men and 53.3 percent of women stated that their acne improved after their teenage years, while only 3.6 percent of men and 13.3 percent of women reported that their acne worsened post-adolescence.
“Despite the fact that adult acne tends to be generally milder than teenage acne, this common medical condition can have a significant impact on a person’s overall quality of life – regardless of when it occurs,” explained Dr. Harper. “Involving a dermatologist in the diagnosis and treatment of acne is vital to managing this difficult condition.”
The American Academy of Dermatology recommends the following tips for the proper care and treatment of acne:
- To prevent scars, do not pop, squeeze or pick at acne; seek treatment early for acne that does not respond to over-the-counter medications.
- Gently wash affected areas twice a day with mild soap and warm water. Vigorous washing and scrubbing can irritate your skin and make acne worse.
- Use “noncomedogenic” (does not clog pores) cosmetics and toiletries.
- Use oil-free cosmetics and sunscreens.
- Avoid alcohol-based astringents, which strip your skin of natural moisture.
- Shampoo hair often, daily if it is oily, though African-Americans may prefer to wash it weekly.
- Use medication as directed and allow enough time for acne products to take effect.
An experimental drug called STA-4783 may prove an effective new treatment for skin cancer, according to research presented Wednesday at a meeting of the European Cancer Organization in Barcelona, Spain.
The drug causes tumor cells to self-destruct by overloading them with oxygen. A study of 81 patients with advanced melanoma skin cancer found that the 28 who received the standard chemotherapy drug paclitaxel went an average of 1.8 months before their cancer worsened. The 53 patients who received paclitaxel plus STA-4783 went an average of 3.7 months before their cancer worsened, the Associated Press reported.
The study also found that patients who received the combination therapy survived an average of one year after diagnosis, compared with an average of 7.8 months for those who received only paclitaxel. The study was paid for by Synta Pharmaceuticals Corp. of Lexington, Mass., which developed STA-4783.
The new drug, which has no effect on normal cells, may also prove effective against other cancers, the AP reported.
HealthDay News, September 26, 2007
By Steve Herman
Beyond the well-known ravagers of youthful-looking skin, sugar and the chemical reactions that produce sugar in our cells conspire against eternal youth.
Female smokers may be much more likely to develop non-inflammatory acne (NIA) than women who don't smoke, says an Italian study in the British Journal of Dermatology.
Researchers looked at more than 1,000 women and found that 40 percent of those who smoked had NIA, compared with 10 percent of nonsmokers. Blocked pores, large white heads and small cysts are characteristic of NIA, BBC News reported.
The team at the San Gallicano Dermatological Institute in Rome said they conducted the study in women because the condition seems to be more prevalent in women than in men. Compared to nonsmokers, smokers in the study had half the levels of skin secretions of vitamin E and had other skin-related variations. The study also found that smokers who had acne in their teens were four times more likely to suffer NIA than nonsmokers who experienced teen acne.
The findings add to previous research that links smoking with acne, Colin Holden, president of the British Association of Dermatologists, told BBC News.
HealthDay News, September 18, 2007
Although it's meant to protect the skin, a cooling technique may actually boost the risk of hyperpigmentaion (discoloration) in dark-skinned patients after laser treatment for mole-like skin lesions, Thai researchers warn.
"It is not life-threatening, but postinflammatory hyperpigmentation may cause substantial psychological problems," wrote a team from Mahidol University in Bangkok. "The treatment of postinflammatory hyperpigmentation is difficult and time-consuming, often lasting many months to achieve the desired results, which causes frustration in patients and physicians," they added.
Some experts have suggested that skin cooling -- which decreases pain and allows the use of higher laser frequencies -- may help reduce hyperpigmentation after laser treatment.
In this study, researchers used laser irradiation to treat 23 Thai women (average age 43) with Hori's nevus, blue-brown pigmented spots on the skin that develop later in life.
"One randomly selected face side of each patient was cooled using a cold air cooling device during and 30 seconds before and after laser irradiation, and the other side was irradiated without cooling," the researchers wrote.
Hyperpigmentation in the patients was assessed before treatment and one, two, three, four and 12 weeks after treatment.
Of the 21 patients who completed the study, 13 (62 percent) developed hyperpigmentation on the cooled side of the face, five (24 percent) developed the condition on the uncooled side, one patient (five percent) developed it on both sides of the face, and two (10 percent) did not have any hyperpigmentation.
The cooled sides were also three times more likely to develop hyperpigmentation than the uncooled sides, the authors said. Most cases developed two weeks after treatment. All but one of the cases were completely resolved 12 weeks after treatment.
The study was published in the September issue of the journal Archives of Dermatology.
HealthDay News, September 18, 2007
The average student in the United States earns only a "D" when it comes to understanding and practicing basic hand hygiene, according to this year's annual report card from the Soap and Detergent Association.
Parents fared slightly better, getting an overall grade of "C." Moms averaged out at "B-," while Dads earned only a "D+," the trade group said in a statement.
School nurses and health professionals surveyed earned the highest average marks at "B+," while teachers were awarded a "B-."
The group's 2007 "Clean Hands Report Card" was based on telephone interviews and on-site surveys.
The SDA offered this refresher course on effective hand washing:
- Wet hands with warm running water before using soap.
- With soap, rub hands together to a lather, away from the running water.
- Wash the front and back of the hands, between the fingers and under the nails for at least 20 seconds.
- Rinse well under warm running water.
- Dry hands well with either a clean towel or air dryer.
- Hand sanitizers or wipes will suffice if soap and water aren't available.
HealthDay News, September 7, 2007
For hundreds of years it’s been understood that water cleanses the skin of dirt and pollutants and that regular cleansing is not only indicative of good hygiene, it leads to better health. Unfortunately, that’s not the whole story. Water, while imperative to every facet of our lives, can actually remove skin’s natural moisturizing factors. Extended exposure to the warmer waters of a bath or shower can be particularly harmful. Cleansing agents in many body washes and bar soaps break down the skin’s natural moisture barrier, allowing moisture loss and leading to the itchy discomfort caused by dry skin.
“Prolonged exposure to water can be drying for skin, so it’s important to protect skin while in the shower,” said Dr. Karl Wei, Principal Scientist with P&G Beauty.
To understand how this happens, it becomes necessary to look into the top layer of epidermis called the stratum corneum. The stratum corneum is made up of 15-20 layers of cells known as corneocytes which are separated by natural oils or lipids. The corneocytes and lipids are responsible for holding moisture in the skin but, unfortunately, are also easily compromised.
When the skin’s necessary, natural oils are washed away, some clients will apply a moisturizer. However, many women lack the time, knowledge or convenience to replenish the lost lipids after they bathe. This can lead to dry skin and can exacerbate skin that is already dryer than average.
Taking an extra 60 seconds to examine your feet when you clip your toenails could save your life, says the American College of Foot and Ankle Surgeons.
Routine self-examination of feet can help detect deadly melanoma skin cancer at an early stage, when it's easiest to cure. Half of people diagnosed with melanoma of the foot die within five years, because the cancer had already spread through their bodies by the time it was diagnosed, the college said.
In cases where melanoma is detected early, 92 percent of patients are still alive after five years.
Doing routine checks of your feet increases the likelihood that you'll spot suspicious moles, freckles or other irregularities. The college recommends you focus on the three most common areas for foot melanoma: the soles, between the toes, and around or under the toenails.
See a doctor immediately if you notice a mole, freckle or spot that starts to change over the course of a month and becomes asymmetrical or changes its border, color, diameter, or elevation.
Melanoma can develop anywhere on the body, including areas that receive little sun exposure, such as the feet and ankles.
The farther a patient has to travel to see the doctor who diagnoses their melanoma, the more likely they are to have thicker -- and more lethal -- skin cancer at the time of diagnosis, a new study warns.
Patient income also makes a difference, with poorer patients getting diagnosed with thicker melanomas, the researchers said.
"Survival for patients with melanoma is dependent on stage at diagnosis. As Breslow (depth of tumor cells in the skin) thickness increases, overall survival decreases," wrote Dr. Karyn B. Stitzenberg, of the School of Public Health at the University of North Carolina at Chapel Hill, and her colleagues.
"Consequently, early diagnosis may substantially improve patient outcomes," the researchers added. But, "because melanoma can only be definitively diagnosed based on biopsy findings, diagnosis requires detection of the suspicious lesion and biopsy. Some primary care providers perform diagnostic biopsies, but many prefer to refer patients to dermatologists or surgeons."
Among the patients in this study, the median distance to a diagnosing physician was eight miles, and the median Breslow thickness was 0.6 millimeters. For each one-mile increase in distance to the doctor, there was a 0.6 percent increase in Breslow thickness, the study found.
Patients who had to travel more than 15 miles to see their doctor had about 20 percent greater Breslow thickness than those who were less than 15 miles away.
Compared to those in metropolitan counties, patients in rural counties traveled an average of 2.4 miles farther to their diagnosing doctor. Patients in counties with at least one dermatologist traveled an average of 8.3 miles less than those in counties without a dermatologist.
The study also found an association between Breslow thickness and age and poverty.
"For each one percent increase in poverty rate, Breslow thickness increased by one percent. Breslow thickness was 19 percent greater for patients aged 51 to 80 years than for those aged 0 to 50 years and was 109 percent greater for patients older than 80 years than for those aged 0 to 50 years," the study authors wrote.
The study is published in the August issue of the journal Archives of Dermatology.
HealthDay News, August 22, 2007