1 The Summer Acne Puzzle HealthWeek summer and another person s get worse? The long, hot days of summer mean more time to spend hiking, biking or just outside by the barbecue with a cool drink. For the average person, slathering on sunscreen, wearing protective clothing and limiting sun exposure is the best summer skin care prescription. But for people who suffer from acne, the relationship between summer and skin can be much more complicated. In a February 1996 study (the most recent available) published in the International Journal of Dermatology, 139 people with acne were asked how their skin fared in the summer. The results were evenly split: One-third said their skin got better, onethird said it got worse, and the remainder noticed no change. Many Acne Factors How can one person s acne clear up in the Because the relationship between summer weather and acne is a complex one that hasn t been completely figured out, according to Dr. Alan Moshell, skin disease branch chief at the National Institute of Arthritis and Musculoskeletal and Skin Diseases in Bethesda, Maryland. But the general feeling is that in summer climates that are dry and unpolluted, most patients with acne do better, he says. Acne is most common on the face, upper back and chest, where sebaceous, or oilmaking, glands are large and numerous. Each gland is connected to a hair follicle, which helps transport the oil, called sebum, to the skin s surface to keep it soft and supple. Acne occurs when the sebum can t get to the surface. Cells from the follicle lining shed too fast, clump together and block the follicle opening. Bacteria grow along with the sebum and clumped cells, causing whiteheads and blackheads. Eventually, the growing bacteria produce chemicals and enzymes that make the follicle inflamed. When the follicle can no longer hold all the substances, it bursts into the surrounding skin, causing a pimple. Dermatologists think that sunlight improves some people s acne for a couple of reasons, Moshell says. Ultraviolet light can
kill off the bacteria that cause acne. Sunburns make the skin peel, which opens up clogged pores and lets them drain. People with acne may also think that their skin improves in the summer because suntans and sunburns darken the skin, making acne less visible. But the dangers of skin aging and skin cancer far outweigh any benefit of using sun exposure to treat acne. It s not thought that those minor benefits are worth the risk, especially since there are treatments now that do better than sunlight ever could without those risks, Moshell says. Also, people who take prescription acne medications, especially oral antibiotics, need to be especially careful in the summer, Moshell says, because the medication can make skin more sun-sensitive. Consider the Climate Climate is another piece of the summer acne puzzle. While dry, sunny weather tends to improve acne, In climates that are sunny and humid or in which there is any significant air pollution, it s a much more mixed bag, Moshell says. In New York s hot, humid summers, Dr. Diane Berson finds that her acne-prone patients tend to break out more often. The increased humidity leads to more perspiration, which forms a film on the skin, says Berson, who has a private practice and is also an assistant professor of dermatology at New York University s School of Medicine. That film certainly could dispose (skin) to clogging and acne breakout, she says. For her acne-prone clients during the summer, Berson recommends a toner, astringent or cleanser that contains salicylic or glycolic acid. The acids help remove surface oils, unclog pores and prevent further acne breakouts. She is also less likely to have her patients use a moisturizer in the summer. If one is still required, she recommends a light, nongreasy one. Additionally, she finds that people who don t ordinarily have acne will break out on areas that usually aren t acne-prone, like the buttocks. The summer skin picture is quite different in temperate San Francisco, California. Dr. Katarina Chiller, chief resident at the department of dermatology at the University of California, San Francisco, doesn t
notice much of a change in her patients with acne when summer rolls around. I think most people have absolutely no change with acne in the summer. I think there is a small percentage of people who do get worse. And I think that there may be a percentage of people that get better, Chiller says. Summer s bag of mixed blessings is the reason why a few people get worse and a few others get better, she says. For example, summer has a psychological benefit for acne sufferers. Suddenly they have all these things to do and they don t think about their acne as much, she offers. On the other hand, summer activities can compound an acne problem. Finding noncomedogenic sunscreens, which don t clog pores, can be tough because many sunscreens are thick and need to be applied generously to work properly, she says. As the weather gets warmer, patients change their activity and become more outdoorsy, Chiller continues. The increase in physical activity can change the skin s balance and the number of bacteria living on it, she explains. Chiller also adds that some kinds of acne are sensitive to sunlight and will get worse with sun exposure. Summer Skin Care Tips for Acne Sufferers Despite the unpredictability of summer and acne-prone skin, there are ways to keep breakouts to a minimum. Look at the chart below for some tips to help you make the right choices: Look for alcohol-based gels or oil-free sunscreens. Shower after exercising or sweating heavily. If you live in a city with a significant air pollution problem, washing your face more often may help keep skin clear. Some kinds of prescription acne medications make skin more sun-sensitive. Doublecheck with your dermatologist or the medication s enclosed information to determine if sun sensitivity is a side effect of your medication. For overall sun safety, people with acne should follow the same guidelines dermatologists recommend for everyone: Minimize sun exposure, wear protective clothing and use sunscreen. More information can be found on the internet at these websites: National Institute of Arthritis & Musculoskeletal and Skin Diseases Question and Answers on Acne: http://www.nih.gov/ niams/healthinfo/acne/acne.htm. American Academy of Dermatology s patient information on acne: http://www.aad.org/pamphlets/acnepamp.html.
Wellness Questions 1 name Use the space provided to write answers to each of the questions. Make certain your answers are in complete sentences. 1. What is the best summer skin care prescription for the average person? 2. What did the study published in the International Journal of Dermatology show? 3. Why do dermatologists think that sunlight improve s acne for some people? 4. What are the dangers of too much sun? 5. What does Dr. Berson recommend for her clients during the summer? Why?
Wellness Wordsearch 1 name N B H H H C M S P T L S P L I T S B N S D M P S M I D A B D T E C C E N U R H E R D I N I S L K F N S S S C A S Z B B I K I N G L E T U N S N B T B M L E U L T C B A S S P N I E N H C A B S E H F C U I U A N E E S H R H A A C N E S M S K R P S H G D Z S L L L E R I I C O E N M E A C I D U S N U H C T G B T R I U I N I C E S S D A P E S R I T S E E E S L M R T G L A F N I I E S U N S C R E E N N D R T M C E A C H N S L R L R B D R S Y T M M O S H E L L P C D V C T S B A D P R U B C E C N A R C B D O C B M H I I I E T N M S A E M O I L H T I S B A L R U I E I C O K I S R E I E O S N S E O B I E R E N R O T B L A L I E H A D I N M I O U T L A R B U O T C C E E L T E L E A B B S L A L I N D O E A A N I R H E T C E I T E O I E N E K C I C B I G E P C L A C N E R G R O U H S R B C A R S T O U A I T O E A N E H O S I R N S A I R N A A N S L N R E C E O O D U A O R S D N R L I L M S I L D U O B N E A R C U M A S L A P N A N M A B L K T E A H E N N R L I N S E O N L I N O C B H I I N S C E R T E B E S O R S L P L P M B B D L U E I I Use the clues below to discover words in the above puzzle. Circle the words. 1. Berson 2. Bethesda 3. Chiller 4. Moshell 5. acid 6. acne 7. bacteria 8. biking 9. cancer 10. complex 11. hair 12. inflamed 13. medication 14. moisturizer 15. perspiration 16. psychological 17. sebum 18. sunburn 19. sunscreen 20. ultraviolet