Female Adult Acne: An Interview with Dr. Shari Marchbein, MD Part One

Happy Thursday!!! For today and tomorrow I’ve had the pleasure of interviewing Dr. Shari B. Marchbein, MD-Board Certified Dermatologist at Manhattan Dermatology! Her positivity is infectious and she is so incredibly passionate about her field- she’s wanted to become a doctor since she was a little girl, and today she’s sharing one of the conditions she is most passionate about treating: Adult Acne in Females

Ashli: “Thank you SO much for taking the time to chat with me today! Acne is such a HUGE self esteem buster for those who suffer from it….”

Dr. Marchbein: “Acne can affect people’s quality of life in a really severe way and if you look at studies that look at how a disease impacts a patients’ quality of life, acne and rosacea affect people the same way that diabetes and high blood pressure affect them. When I see someone who is spending an extra 20 minutes in the morning trying to put on makeup to cover up these large cystic bumps on the jawline… it’s really detrimental to how they feel about themselves, how they excel in the workplace. I mean, I struggle when I have to cover up just ONE pimple (she suffers from adult female acne too!), I feel like I can’t look somebody in the eye and my self esteem is totally down for those couple of days before it resolves. So, imagine having 20, or 50, or 100 of those cysts! As far as I’m concerned, no-one ever has to have acne! There are so many great treatments for it, and the goal is to get everyone on their own appropriate routine. I try to tell my patients ‘Look, I’m in this with you. We’re a team. Give me 3 months and we will get you where you want to be!”

SKB: “Wow. This is life changing for many patients! So, what is your treatment protocol and is it different for each patient?”

DM: “Yes- it really is. I always tell everybody that they are a unique individual. The routines may be similar but there will be some variation. I spend a large portion of my day treating adult female acne, which are patients in their 20’s, 30’s, 40’s and upwards who have acne. Women are very frustrated when they have acne and so I always like to quote the statistic that 50% of 20 year olds have adult acne. 30% of women in their 30’s have adult acne (1 in 3 women!) 1 in 4 women in their 40’s have adult acne. So we are not alone! It’s a very common problem and so we have to treat it like a chronic condition. There is no cure but we can control it, and we use a number of medications together to do that.”

DM: “I always start by going over- and Ashli this I know you know SO well- we go over what they are using on their skin on a daily basis. We need to make sure that everything you are using is oil free, that it’s non-comedogenic, because there is so many cosmetics out there that are not exactly geared towards acne prone skin. So I see a lot of my patients need to change some of the parts of their skincare routine. Also I often find that people tend to over do it as well. I vaguely remember but I think the statistic is that most people use 13 over the counter products before they even come to see a dermatologist for their acne. When you do too much you can actually irritate the skin and it can make the breakouts worse. So, we start with the regimen. Then, I use a combination of things. I always do some sort of Retin-A cream. Retin- A is so good for your skin because it is anti-aging and helps to build collagen, but it also treats a very basic acne lesion called a comedone. It prevents those comedones from turning into larger papules and pustules, and so this makes Retin-A paramount to any acne routine. Then, I tend to prescribe a topical antibiotic and often one with a benzoyl-peroxide for inflammation. There’s also a new cream that has come out in the last few years called Aczone, which is a topical antibiotic called dapsone, and the studies have shown that it works better in adult women than teenage women and it works better in women than in men. So, I use those creams as sort of the backbone of the acne routine, and then I prescribe a medication called spironolactone, which is a pill. It is literally a miracle drug. It’s a pill that’s FDA approved for high blood pressure and congestive heart failure. It’s a anti-hormonal agent classified as a diuretic (or water pill). It stops the hormones that you naturally produce from interacting with the skin at the level of the oil glands. It’s an amazing medication for women who tend to get breakouts with their menstrual cycles.”

Tomorrow, find out some of the common causes of female adult acne! Thanks for stopping by! XO, Ashli

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