Clear skin for grown-ups

It’s a cruel irony that more than half of adult women are battling breakouts at the same time they’re coping with crow’s feet.

The culprit is hormones, which ebb and flow throughout a woman’s life rather than stabilise as they do in men.

“As estrogen levels fluctuate – or in the case of menopause, decrease – androgens, the hormones that stimulate oil glands, can lead to breakouts,” says Jonette E. Keri, MD, PhD, an assistant professor of dermatology at the University of Miami School of Medicine.

Also to blame: Stress, which raises hormone levels. One thing you needn’t stress about is controlling the condition. New remedies make it easier to get the clear skin you’ve always wanted – and erase signs of ageing in the bargain.


This skin care routine fights the main cause of acne: pores clogged by oil and cellular debris and inflammation from P. acnes bacteria.

But unlike topical teenage treatments – formulated for oilier complexions – these OTC solutions are less likely to dry mature skin and make wrinkles more pronounced.

The routine relies on products that address the dual concerns of acne and ageing by employing agents such as:

Salicylic acid, which unclogs pores and smooths skin by sloughing off dead cells.

Retinoids like retinol, a vitamin A derivative that improves acne, fine lines, and sun spots by normalising cellular turnover.

Humectants that attract moisture and anti-inflammatories, like green tea and allantoin, to quell inflammation.

Follow these steps to eradicate existing pimples and prevent new ones

In the morning

Cleanse gently

Use a facial wash with salicylic acid.

“It gets into the pores and dislodges debris,” says Diane Berson, MD, an assistant professor of dermatology at the Weill Medical College of Cornell University and board member of the American Acne and Rosacea Society.

Avoid gel cleansers (they can contain alcohol) and granulated scrubs, which strip the skin of oil, making it overcompensate and produce more, says Keri.

Treat affected areas

If you have a blemish, dab on a spot corrector with salicylic acid or benzoyl peroxide, which kills surface bacteria and dries oil. If you’re prone to breakouts in a particular area (say, your chin), apply it to the entire zone daily to help prevent them.

If skin is dry, apply a moisturiser with SPF 15 or higher

Choose one that contains an alpha-hydroxy acid like glycolic acid for a double benefit.

The AHA exfoliates pores as it sloughs off dead cells and moisturises skin. If your complexion is oily, use an oil-free sunscreen. UV rays thicken the outer layer of skin, which can block pores and lead to breakouts.

At night

Remove makeup with a gentle, non-medicated cleanser

The skin can’t exfoliate properly if it’s not clean.

Apply a retinol cream

The prescription retinoid Retin-A was approved for treating acne long before it became the gold standard for fighting wrinkles.

“Retinoids help clear up and prevent all kinds of acne, from tiny bumps and blackheads to inflammatory acne and red nodules around the jawline,” says Keri.

OTC retinoids like retinol don’t pack the same punch as Rx versions, but they can be less irritating and a good way to acclimate skin.

Moisturise as needed

Apply face lotion frequently to prevent dryness

What your doctor can do

If your skin doesn’t respond to at-home treatments within a few weeks or you have many pimples (especially cystlike nodules, which are large, painful, and can cause scarring), see a dermatologist.

They’ll prescribe a more potent retinoid and topical antimicrobial like benzoyl peroxide to kill bacteria and quell inflammation.

Bonus: New Rx meds are more appropriate for ageing and dry skin.

“If there’s not enough improvement after a few months, other drugs can be added,” says Berson.

Also available in a dermatologist’s anti-acne arsenal:

Oral antibiotics

A two- to six-month course speeds healing by targeting deeper blemishes.

These drugs travel through the bloodstream, so they also fight hard-to-reach back and chest acne.

Hormone therapy

To steady hormones and quiet premenstrual flares, patients are often put on a low-dose birth control pill.

One caveat: Women who are over 40 can be at increased risk of developing the same side effects associated with hormone therapy to reduce menopausal symptoms, including blood clots.

Also prescribed in conjunction with oral contraceptives or by itself: Spironolactone, an anti-androgen that decreases oil production.

Light therapy

These treatments are used in conjunction with other Rx remedies to boost their benefits.

Blue light therapy temporarily kills P. acnes in a painless 15-minute procedure.

The bacteria can return, however, so ongoing therapy – at up to $500 a pop – is necessary.

The new Isolaz Pore-Cleansing Acne Treatment suctions pores to eliminate excess sebum, while a laser targets bacteria.

Four to six sessions at $300 to $500 each are needed, followed by monthly maintenance.

Copyright 2008. All rights reserved by New York Times Syndication Sales Corp. This material may not be published, broadcast or redistributed in any manner.

Face-saving strategies

Today, more than any other time in history, we’re able to access technology and scientific research to make more informed lifestyle choices. Never before has our health depended upon that knowledge, especially with regard to the products we choose to enhance our beauty and wellness, two areas that are intrinsically linked.

We now understand that beauty is not just skin deep. Diet, exercise and even our behaviour all impact our inner state of being, the symptoms of which can be reflected through our skin. Looking good has become an holistic and organic conversation, one that scrutinises the depths of nature and science so that we can look and feel better about ourselves and the skin we’re in.

It is therefore imperative that we have a basic understanding about our skin and its function in order to make informed choices about the products we choose to protect and care for our skin.

The skin is the largest organ of the body. It is the meeting place between the inner and outer world, reflecting our internal state of health. It consists of two main layers, the top layer is the epidermis, the lower is the dermis, wherein lie sweat glands, oil secreting glands and blood vessels. Imagine the pores of your skin as little mouths with their own digestive system, what would you feed them?

The dermis contains collagen which gives the skin its elasticity. It is within the skin’s lower layers that new cells form and migrate to the epidermis, replacing dead and worn out cells. It is our responsibility to assist the skin in this natural function by keeping the skin clean and nourished. The epidermis acts as protection and shelter to the more vulnerable lower tissue. It protects against bacteria entering the body and from overexposure to the sun.

To maintain optimum condition of our skin we should cleanse and nourish it daily (try using certified organic foaming cleanser and certified organic moisturiser). Dead cells, sweat, dirt and bacteria must be removed – regular exfoliation is essential (every fourth day or once a week for sensitive skin).

The skin must also be fed using organic food and fluids and protected against the external environment using certified organic vitamin-rich skin and body care products.

It has been proven that an inclusive, holistic approach works best; starting with the face (including the throat chest and breast area), extending to the hands and finishing with the feet – and including everything in between.


Start with avoiding all products that have perfume or fragrance added – many upmarket ‘natural’ brands have this in their ingredients list. There is substantial evidence indicating that if we remove synthetic fragrance from our skincare products we would see a massive reduction in allergic reactions and skin sensitivities. Synthetic  perfume or fragrance is not allowed in certified organic skin care products, so always check the labels and buy products that are certified organic.