But perhaps the most exciting new approach involves the off-label use of Oracea, an oral medication originally approved to treat rosacea, another inflammatory skin condition. It features an ultra low dose of the antibiotic doxycycline in a novel new configuration
"They dropped the antibiotic component of this drug extremely low, but at the same time they dramatically increased the anti-inflammatory component," says Crutchfield. The end result is a drug that targets the inflammation and, says Crutchfield, works extremely well for many acne patients, including middle aged women who also have rosacea symptoms.
Day often takes another "off label" approach when acne strikes women in middle age. Her solution involves use of the anti-androgen drug Aldactone.
"The results are incredible - the skin clears, there is no drying, and if you use the brand name and not the generic, there are almost no side effects and the women feel great - most say their skin never looked so good," says Day.
Crutchfield also prescribes Aldactone, and says it not only works for middle-aged women, but also for teenaged girls and young women, particularly when acne develops on the chin and jaw line.
"Acne is all basically hormonally driven, so in some young women anti-androgens are the answer," he says. Some women also find acne relief in birth control pills, which help regulate the cycle and control hormonal swings linked to many breakouts.
Acne Treatments: The Really ' Big Guns'
In the event that your acne is stubborn - or you are developing scars - doctors say there are several "big guns" available to help. Unlike topicals and antibiotics, which work to suppress breakouts, these treatments go to the root of the problem by shutting down oil production.
"When I see a patient whose skin is already scarring I don't mess around - I go right for the most aggressive treatment - and for me that's isotretinoin, otherwise known as Accutane," says Crutchfield.
As he explains, this oral prescription drug impacts oil production. Once the "oil faucet" is turned off, he says, you eliminate the traffic jam inside the pores, and the breakouts stop.