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News
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A 28-year-old woman from Hertfordshire has written to ask about holiday acne. She has just returned from a fortnight in Spain but, instead of the sun improving her complexion, which is usually pretty good, it has given her some of the worst acne that she has ever had. Why is this?
How very disappointing. On returning from a holiday, everyone hopes to come back looking reasonably brown and healthy. It is a letdown for travellers if, instead of returning with tanned faces, they come back marred by inflamed pustules, papules, cysts and spots.
Our reader is not the only holidaymaker to whom this has happened. The condition is so common that it is sometimes referred to as Majorca or Caribbean acne. The problems occur because the increased sweating in hot sun, especially if there is high humidity, blocks pores in the skin that have been opened up by the heat. The sweat also spreads any bacteria that can usually be found on even healthy skin, especially around the nose and mouth, on to the rest of the face.
The forehead also often suffers holiday acne, as the sweat that drips off the scalp carries with it organisms that usually lurk among the hair roots. The pattern made by the sweat dripping from the scalp on to the forehead is similar to that made by rain as it runs off the roof of a thatched cottage. Just as around the cottage a heavy shower makes an imprint on the flowerbeds a foot or two from the wall and under the eaves, so in a hot, humid atmosphere acne begins to show an inch or so below the hairline. This problem can often be averted if people brush their hair back from the forehead, rather than allowing it to flop over the eyes.
There are other causes of holiday acne. It is worse during times of anxiety and, paradoxically, holidays often produce stress. It is tense preparing for them, the airport may be hot and crowded, the aircraft noisy and unrelaxing. Expectations for the holiday may be unrealistic and the possibilities of experiencing social difficulties are immense.
Another cause of holiday acne is that some of the creams or oils that are rightly applied, or even unwisely rubbed in, to the skin to prevent or ease sunburn can help to block up pores. Sunscreens should be as oil-free as possible. It is said that Caribbean acne is more related to the traditional pomades applied to the skin and hair than to humidity and sun. A variation on holiday acne is that suffered by workers in hot, humid environments, including kitchens, laundries and launderettes.
The good news about holiday acne is that it usually clears within five or six weeks. The first basic treatment should be to wash the skin several times a day so that any excess sebum (skin oil) that has accumulated and may be blocking the pores is regularly removed. There are several over-the-counter acne remedies, available from good chemists, that should be tried. These usually contain benzoyl peroxide or salicylic acid. The former is designed to control the skin bacteria, the latter to prevent pores from becoming blocked. Doctors used to recommend various abrasive preparations to treat acne — but if these are used too enthusiastically they make the condition worse and have largely been abandoned.
If the holiday acne hasn’t disappeared within six weeks, or if the patient has important engagements for which he or she needs to look their best, they should consult their GP. The second line of attack is usually a course of antibiotics. These have the advantage that they not only clear up any skin infection, but also reduce the skin’s production of sebum and thereby keep the pores open. Doctors may also at this time prescribe retinoid creams.
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