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

Unless you’re blessed with extraordinarily forgiving genes, chances are your face tells the story of your life.

If that life is filled with a little too much stress, alcohol, caffeine and sun exposure and not enough sleep, water and relaxation, you may develop lines, spots or sagging in places you’d rather not.

Here are some simple steps to give your face a natural lift without resorting to surgery:

1. Dehyration: that dreaded word we hear over and over again is one of the most common causes of poor skin health. If you don’t like the taste of water, add some chopped fruit such as lemons, limes and oranges.

Alternatively, try a herbal tea from the extensive range available. It will boost your hydration levels while giving you some added health benefits. Try peppermint, which is great for digestion, or lemongrass, which gives the kidneys a kick-start.

2. Have a facial. It will boost circulation to the skin, give it a deep scrub and relax the facial muscles, helping to smooth fine lines.

3. Find a product that works for your skin. Just because a product costs a fortune, or just because you’ve been using it for years, doesn’t mean it suits your skin now. If you’re dealing with ageing skin, try a product that focuses on active ingredients. If your skin is sensitive and prone to redness, use a product with all-natural ingredients.

Experiment with your beauty routine. If you’re prone to breakouts, a night cream may be too heavy for your skin. If your skin is looking a little dull, maybe you need to introduce weekly exfoliation to your beauty regime.

4. Watch your diet. An occasional piece of chocolate or glass of wine isn’t going to hurt, but if all you eat is greasy junk food washed down with soft drink, it’s going to show on your skin.

5. If you’re going through a particularly stressful time and you start experiencing breakouts, you may need a vitamin and mineral boost. Zinc and B-complex vitamins play an important role in skin health and are easily depleted when you’re stressed.

6. Look at your environment. Overheating the body at night under lots of heavy blankets; constantly being in air conditioning or heating; having hot showers; or just spending a lot of time in stale air doesn’t do your skin any favours.