The Clear-Skin Makeover

From the WebMD Archives

By Jenny Bailly

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Fighting pimples and wrinkles? Here’s how to give your old routine a grown-up overhaul for radiant results.

Like high school pop quizzes and awkward prom dates, pimples are supposed to be distant bad memories. If only. But these days, even moms of teens are battling blemishes — and wrinkles, too. In fact, between 15 and 35 percent of women in their 30s, 40s, and 50s suffer from breakouts, according to a report published last year in the Journal of the American Academy of Dermatology. And those numbers are on the rise, says dermatologist Richard Fried, M.D., Ph.D., author of Healing Adult Acne. Doctors attribute this increase to everything from skyrocketing stress levels and hormone fluctuations to today’s carbohydrate-heavy diets.

If you’re tempted to treat your acne with a few old tricks from your teen years, don’t. Adult skin is more sensitive and less resilient than adolescent complexions, and it calls for treatments that also fight the signs of aging. Luckily, many of the best zit zappers out there happen to be top anti-agers, too. So whether your breakouts are an occasional annoyance or a constant struggle, find the updated plan that’s best for you.


What you did then: Scoured your face every chance you got

What you should do now: Cleanse no more than twice a day. Since your skin is likely drier than it once was, over-washing can remove the surface oils that keep it supple, says New Orleans dermatologist Mary Lupo, M.D. Look for a cleanser with salicylic acid to break up pore-clogging sebum, plus a skin softener like glycerin. Try Bioré Blemish Fighting Ice Cleanser ($6, drugstores) or Garnier Nutritioniste Nutri-Pure Detoxifying Gel Cleanser ($6, drugstores). If your skin is sensitive or extra-dry, alternate with a mild product like Cetaphil Daily Facial Cleanser ($11, drugstores). And if you only face a pimple or two a month, make that your only cleanser and rely on acne creams for treatment.

What you did then: Applied drying masks to soak up oil

What you should do now: Focus on exfoliating, not degreasing. As we age, skin’s cell turnover slows, and pores can get clogged with dead cells. Slough them away with an at-home peel. (Bonus: Peels soften lines and fade dark spots.) If you break out regularly, use a 10 percent–glycolic acid solution. Try Patricia Wexler M.D. Dermatology Exfoliating Glyco Peel System ($60, Bath & Body Works). For occasional breakouts, opt for lactic acid, the most gentle, moisturizing choice. Find it in Philosophy The Microdelivery Mini Peel Pads ($35, Sephora). And toss the scrubs. “Abrasive grains can rupture acne cysts and increase their life span,” says Jeannette Graf, M.D., a dermatologist in Great Neck, NY.


What you did then: Slathered 10 percent–benzoyl peroxide (BP) creams on zits

What you should do now: Keep on slathering — but with a 2.5 percent cream. BP is the best fast-acting acne healer, says Boston dermatologist Jeffrey Dover, M.D. Higher strengths can irritate dry skin, but studies have shown that the milder version works just as well. Try Skin Effects Acne Spot Treatment ($10, CVS) or Proactiv Repairing Lotion ($22, 800-950-4695). Apply in the morning, just to problem areas. If you suffer from stress or period pimples, use BP on known breakout spots for a week or two prior, as a preventive measure. And since adult acne tends to manifest as deeper, inflamed pimples, Doris Day, M.D., a New York City dermatologist, also recommends applying a 1 percent cortisone cream like Cortaid ($9, drugstores) after BP twice a day to calm redness.

What you did then: Swore off all moisturizers

What you should do now: Use oil-free lotions to smooth skin and reduce the look of lines. Apply one with sunscreen over your BP treatment in the morning — Olay Complete All Day Moisture Lotion with SPF 15 ($7, drugstores) is a good choice. At night, choose retinol to exfoliate skin and soften lines. Try Neutrogena Healthy Skin Anti-Wrinkle Anti-Blemish Cream ($13, drugstores). Since alpha hydroxy acids and benzoyl peroxide can reduce the efficacy of retinols (and their prescription cousins, the retinoids), make retinol your only P.M. treatment — or wait 10 minutes before layering on top of it.


If you haven’t seen results from your OTC regimen after three months, it’s time to see a dermatologist. “Aging skin doesn’t heal as well and scars more quickly if you don’t get breakouts under control,” warns Dr. Graf. Most doctors will start you off with a retinoid to clear pores of dead skin cells. (Retinoids help build collagen, too, which fights lines.) Be sure to apply the treatment at night — retinoids break down in the sun. (You also must use sunscreen religiously.) The doctor may also prescribe a topical antibiotic such as clindamycin to destroy acne-causing bacteria.

If six to eight weeks of prescription topicals don’t clear up skin, oral antibiotics may be next, along with continued use of a retinoid. Since hormone fluctuations can bring on breakouts, low-dose birth control pills are another option. “They work to improve the skin in about one-third of women,” says Dr. Fried. (He often recommends a hormone test to women who suddenly start breaking out as adults.) If you’re still seeing severe outbreaks after several months, talk to your doctor about oral isotretinoin (common brand: Accutane). “It’s a magnificent medicine; it clears up almost everyone,” says Dr. Fried. Side effects, however, can be significant, ranging from dry skin to, more rarely, depression. And the link to serious birth defects means that you have to use two forms of contraception during treatment and take monthly pregnancy tests.



Many dermatologists have been reconsidering their longtime stance that there are no links between diet and acne. One potential culprit may be a high-glycemic, processed-food diet (think white bread, pasta, rice). Colorado State University researchers theorized that these sorts of foods may elevate hormones and thus stimulate sebaceous glands. In 2006, Australian scientists found that eating a low-glycemic diet (high in protein, with fewer refined sugars and flours) for 12 weeks reduced acne by almost 50 percent. Another possible trigger: dairy. Hormones in milk are thought to stimulate sebum production and, in turn, provoke pimples. Dermatologist Jeffrey Dover, M.D., now asks his patients with stubborn acne to try a dairy-free diet. “After they cut out milk, cheese, yogurt, and ice cream, their acne often becomes easier to treat,” he says.


If you’ve tried everything and are still seeing red, consider Isolaz Deep Pore Lazr Therapy, an FDA-approved, in-office combo of light (to kill acne-causing bacteria) and a pore-clearing vacuum. In a company-sponsored test, 64 percent of intractable-acne sufferers had more than 75 percent clearance after four treatments. While it’s pricey ($300 to $500 per session), patients see improvement within 24 to 48 hours of the first treatment, and full results after four or five sessions, says Miami- and New York City–based dermatologist Fredric Brandt, M.D.


...Zap it. Consider new handheld gizmos that deliver low-level heat directly to blemishes to destroy acne-causing bacteria. “These devices aren’t going to help with blackheads or whiteheads, but they can shorten the duration of inflammatory pimples by a few days,” says Mary Lupo, M.D. Try Zeno ($150, Target) or ThermaClear ($150,

...Hide it. Here’s our beauty editor’s secret for disguising a real zinger: First, gently buff away flakes using a damp washcloth. Then, put on any spot treatments, smooth moisturizer all over your face, and apply foundation. Next, concealer: Stick versions are best (blemishes need something with staying power). We love Clé de Peau Beauté Concealer ($68, Saks); Maybelline New York Cover Stick ($5.65, drugstores) is great, too. Use a finger to apply it, lightly tapping the product directly on the pimple and nearby skin. Blend the edges, and you’re good to go.


Originally published on: March 20, 2008

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