Let’s face it, acne is not just a spot: It can leave a mark

What if Helen of Troy’s face had been pocked with acne. One of the greatest myths of all time probably never would have been told, and literature would be void of one of its richest fables.
Having a face that could launch a thousand ships would be nice, but for many people having a face that is not blemished by black heads and pimples would be just fine.
Acne is a health problem that afflicts most people at some point in their lives. According to a recent report by Med TV 21, an Internet health site, about three quarters of Koreans will get acne between the ages of 15 and 17. The cause of acne vulgaris, its medical term, remains something of a mystery, but experts say it probably stems from several factors, including heredity. Basically, the mechanics of acne involve an oil called sebum secreted by the sebaceous glands, which travels to the opening of a hair follicle on the skin’s surface. Excessive amounts of male hormones called androgens, which typically occur during puberty, can spur this process. Blackheads appear when sebum mixes with skin pigments in plugged pores.
References to acne usually focus on teenagers and their anxiety over their appearance. But according to a recent study by Dr. Yun Sang-woong, a professor of dermatology at Seoul National University Hospital, up to 46 percent of acne patients in Korea are over age 25.
Sung Sae-yeon, 27, a political consultant, has a typical case of adult acne. For many years Ms. Sung was confident she had the perfect “pearly” skin. She had never suffered from skin problems, not even as a teenager. But about a year ago that began to change. She began to develop typical acne symptoms around her cheeks.
“I felt like crying when I looked at myself in the mirror,” Ms. Sung said. “I didn’t want to meet other people, not even my boyfriend. I was so depressed that I dressed in unusual clothes to shift the attention away from my acne-riddled face.”
Hwang Hyun-min, 28, recently visited Chung-Ang University Hospital’s dermatology clinic for acne treatment. She, too, says she never had a skin problem before.
“Before getting acne, I was pretty easygoing,” she says. “Now I always wear make-up when I go out.”
According to the New England Journal of Medicine, one in five adults between the ages of 25 and 44 experiences acne. Research by Dr. Yun of Seoul National University shows that 54 percent of acne patients over 26 years of age are women. Adult acne is often more stubborn to treatment than teenage acne. And the psychological toll for someone who passed through adolescence free of acne only to experience it as an adult can be especially heavy.
Mr. Yun’s research shows a notable difference in age among female acne patients compared with similar research conducted in 1995 by the Korean Dermatological Association. In the latter study, the average age of the patient was 22. Mr. Yun’s study links the surge in acne among adult females to the rise in pregnancies among older women, which, he says, triggers hormonal imbalances.
A modern lifestyle is also cited for the increase in skin problems.
“One of the biggest causes of acne among people in their 30s is the increased level of stress they experience at the office and in their everyday lives,” Dr. Yun says. “Another important factor is the increased use of cosmetics.”
Adult acne is usually milder than teenage acne, appearing as tiny zits near the cheeks or on the lower part of the face. This is one of the reasons many adult acne patients mistake the outbreak for ordinary skin blemishes and apply a salve, making the problem worse.
Countless treatments have been introduced over the last decade for acne sufferers, ranging from high-tech lasers to acupuncture. One of the most common acne treatments among Korean dermatologists, besides salves and antibiotic pills, is skin peeling.
Crystal peeling, the most popular type, involves the peeling of acne-plugged pores, using a crystal powder extracted from a natural mineral. The method first became popular in skin care centers to remove dead skin cells, rejuvenating the tissue and reducing acne scarring, large pores, brown spots and sun-damaged skin.
Crystal peeling has become the treatment of choice among Korean actresses, who heard that Jennifer Anniston of the hit American television comedy “Friends,” received the treatment.
Skin scaling is also a common treatment for acne. The process, similar to dental scaling, scrubs off an outer layer of the acne plugged pores with the tip of a needle. Both treatments ― crystal peeling and skin scaling ― require an average of five sessions to see results. They cost 100,000 won to 200,000 won ($85 to $170) per session, which last about 20 minutes each.
Acne treatments can be a major financial burden. The National Medical Health Insurance Corporation estimates that it spent 4.5 billion won ($3.8 million) on treatments for the 130,000 Koreans with acne deemed serious enough to be covered by national medical insurance payments. For students, the outlays for skin problems can be a burden since the national insurance does not cover milder forms of acne. Acne patients can easily pay as much as 200,000 won per session, including clinical soap and creams. That is perhaps why the emphasis is on “preventing” acne rather than “treating” it.
In cases of severe inflammation, doctors recommend laser treatment. In this technique heat is pulsated below the skin’s surface to reduce the size of the sebaceous glands. A topical anaesthesia is sometimes used during the process.
“Skin scaling is still the most popular form of acne treatment practiced at local hospitals,” says Dr. Lee Yu-deok a dermatologist at LJH Dermatology Clinic. “Patients can get just about the same effect of a laser treatment through skin scaling, and the scaling is cheaper than lasers and requires fewer hospital visits. But for patients who are more concerned about pain than cost, we recommend laser treatment.”
Doctors stress the need for clean skin, a healthful lifestyle and good eating habits.
Cha Mi-kyung, a dermatologist and director of CNP Dermatology Clinic in Yangjae-dong, Seoul, suggests in her medical guide that acne patients wash their face with soap no more than three times a day.
“Acidic elements in the soap can stimulate acne development,” she says. She also warns that patients should thoroughly rinse their face after using foam washes.
Women with acne should be extra careful when selecting cosmetics. The best make-up for acne skin, many experts say, is none at all. Avoid using compact and liquid-based foundations, which block the pores. But when you absolutely have to wear make-up, apply copious amounts of astringent and use an oil-free make-up base. For minor zits, crushed apricot seeds have been proven effective treatment by practitioners of Chinese medicine.
Skin care experts also advise that acne patients should keep everything that touches their face clean, whether it is a pillow cover, a make-up puff or their hands. Fabrics that can irritate your skin, such as a turtleneck or angora sweater, and hair bangs should be avoided.

by Park Soo-mee, Park Yun-ji