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    What can adults do about acne? continued...

    “Most of the over-the-counter products involve salicylic acid and benzoyl peroxide, which are good for whiteheads and pustules, but not so much for deeper adult acne,” Derick says.

    Talk to your doctor about prescription treatments. Your doctor may recommend one treatment, or suggest combining a cream with an oral medication.

    You have several options:

    • Prescription creams containing retinoids (derived from vitamin A) to help unplug follicles.
    • Gel containing 5% dapsone, which is thought to help fight inflammation involved in acne.
    • Combination creams that combine the cleansing agent benzoyl peroxide and antibiotics such as clindamycin.
    • Birth control pills, like Yaz, which can regulate the hormonal fluctuations that spark breakouts.
    • Oral antibiotics, which act as anti-inflammatories.
    • A blood pressure medication called spironolactone, which is frequently used off-label to treat acne.

    “We usually try to incorporate some type of retinoid into the mix,” Derick says. (Retinoids, like Retin-A, are related chemically to vitamin A.) “They keep the pores clear and the skin exfoliated, and they also help with wrinkles.”

    How long do you need to take oral medications for adult acne?

    “Sometimes you’ll only need it as the other topicals, like creams, are kicking in; other times you may need the medication a bit longer. Many people need them only when it flares, such as when they have a particularly bad period.”

    What about laser and light therapies for adult acne?

    There are several options, including Isolaz, a “photopneumatic” treatment that uses a suction cup apparatus to suck deep into your pores and deliver an intense pulsed light treatment to the hair follicles. Over time, the treatments shrink the skin’s sebaceous glands, leading to reduced oil production.

    “Those treatments are good, although they’re still not standard of care,” Derick says. And they’re expensive -- several hundred dollars per treatment, and you need more than one. “Still, some patients are turning toward options like this because they want to be free of taking a pill, and putting on creams twice a day. It can also help with uneven skin tone, texture, and brown spots.”

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