From the Guidelines
Elderly individuals are more likely to experience intertrigo, a rash that develops in skin folds, rather than true acne under the breasts, which can be managed by keeping the area clean and dry, and using antifungal creams or powders. This condition is not directly related to the provided study on Behçet disease 1, which focuses on mucocutaneous involvement and its treatment. However, the principle of treating skin lesions based on their impact on the patient's quality of life is relevant. To manage intertrigo under the breasts, it is essential to:
- Keep the area clean and dry by gently washing with a mild soap and thoroughly drying afterward
- Apply an antifungal cream like clotrimazole or miconazole twice daily for 1-2 weeks
- Use absorbent powders such as zinc oxide or cornstarch between the breasts and chest wall
- Wear a properly fitted, supportive cotton bra to reduce skin-to-skin contact, and change it daily to maintain dryness. If the condition persists or worsens, a healthcare provider may prescribe stronger antifungal medications or low-potency corticosteroids, similar to the treatment approach for mucocutaneous lesions in Behçet disease, where treatment is tailored according to the patient's quality of life 1.
From the Research
Causes of Acne in Elderly
- Acne in elderly individuals can be caused by various factors, including exposure to comedogenic substances, drugs, and endocrine disorders such as androgen-secreting tumors 2.
- The variety known as 'persisting acne' is ordinary acne that continues into adult life, while 'sporadic acne' describes the sudden development of significant acne in later life for no apparent reason 2.
- All inflammatory processes are decreased in the elderly, which may be one reason for the persistence and intransigence of acne lesions in older age groups 2.
Treatment of Acne in Elderly
- The principles of treatment of acne in the elderly do not differ from those in other age groups, although the emphasis during counseling needs to focus on explanation and reassurance rather than prognosis 2.
- Topical retinoids and benzoyl peroxide can easily irritate elderly skin, so azelaic acid and even sulfur preparations are preferable 2.
- Low-dose systemic isotretinoin is reported to be helpful to patients in this age group and is certainly worth a trial 2, 3.
- Combination topical therapy, such as clindamycin 1%-benzoyl peroxide 5% gel, can be efficacious and well-tolerated in the treatment of acne 4.
Acne Under Breasts
- There is no specific evidence in the provided studies that directly addresses the cause of acne under the breasts in elderly individuals.
- However, it can be inferred that the same factors that cause acne in other areas of the body, such as exposure to comedogenic substances, drugs, and endocrine disorders, may also contribute to the development of acne under the breasts 2.