Are you no longer a teenager, but still battling annoying breakouts while also fighting the signs of aging. A small consolation, but the good news is you are not alone. According to the American Academy of Dermatology, 40 to 50 million Americans have acne at some point in their life, and it is the most common skin problem in the US.
“Acne is always caused by hormonal imbalances, usually too much male hormone (testosterone) or not enough female hormone (estrogen) in a person’s system,” says New York City-based dermatologist Judith Hellman. “Even if the levels of those are in the normal range, an abnormal male to female hormone ratio can affect the skin.”
Red, inflamed bumps form when pores clog with p.acnes (bacteria that live on our skin) or excess oil gets trapped in hair follicles. Topical retinoids—Retin A, Adapalene, Tazarotene—and products with salicylic acid or benzoyl peroxide are usually the first line of defense when it comes to treating acne. Retinoids increase cell turnover and de-gunk pores as well as help smooth fine lines and wrinkles; salicylic acid exfoliates and disintegrates the oil and dirt in pores and fights inflammation; and benzoyl peroxide kills the bacteria that cause acne.
For moderate to severe cases of acne, topical and oral antibiotics are often prescribed, which kill bacteria and ease inflammation; however, once you go off oral antibiotics the acne issues often come back.
Over the past few years, derms have been favoring the use of high-tech lasers and light therapies to help treat the underlying causes of acne. “Not all laser systems are equally effective,” says Hellman. “Some laser and other light-based techniques aim to eliminate p.acnes. These treatments do not work for the long term, since the p.acnes organism returns to the hair follicles and continues to cause pimples.”
Hellman prefers the Pulsed Dye Laser (PDL), which targets redness and inflammation, and after just a few treatments gets rid of acne for the long term. “Once the blood vessels specific to those pimples are treated and gone, those spots do not flare up anymore,” adds Hellman. “I prefer lasers to oral medications, since they only aim at the skin, and do not pose any potential harm to other organ systems in the body.” Prices for PDL or light therapy treatments can vary depending on the size of the affected area, but expect to pay about $400 per session.
Often times, once you get rid of acne, you are left with scarring. Sublative rejuventation laser treatment—eMatrix, eTwo, and elos Plus—significantly transform acne scarring by heating the deep layers of the dermis with bi-polar radiofrequency to increase collagen production and smooth deep acne scars with minimal downtime. Prices range from $500 to $1000 per treatment.
There’s an abundance of good over-the-counter acne fighters these days, many containing quality ingredients that do not dry the skin; however, if your acne does not get better after a few weeks of using the product, it’s best to go see a dermatologist.
Biore Acne Clearing Scrub ($7.49) dissolves dirt and oil deep in pores with alumina crystals and 1 percent salicylic acid.
ClarityMD Acne System ($49.95) is a two-step blemish busting cleanser and treatment gel containing bakuchiol, a botanical with anti-inflammatory and antioxidant properties, and salicylic acid for clearer skin in less than six weeks.
Used overnight as a spot treatment or applied for 10 minutes a few times a week on blemish prone skin, Dr. Dennis Gross Clarifying Colloidal Sulfur Mask ($42) shrinks pores, blasts bacteria, and absorbs excess oil for clearer skin.
For those still getting breakouts while also fighting wrinkles, SkinCeuticals Blemish + Age Defense ($80) contains a blend of acids—dioic acid and alpha and beta hydroxy acids—and 1.5 percent salicylic acid to control oil production, unclog pores, and even out skin texture.
These dual-sided Skin Clarifying Acne Treatment Pads ($25 for 60 wipes) are infused with 2 percent salicylic acid, witch hazel, and soothing aloe to help calm inflammation.
Neutrogena On the Spot Acne Treatment ($5.99) contains a high-concentration of benzoyl peroxide to zap pimples without drying skin.
Tanda® Zap ($49) at-home device uses blue light technology to destroy p.acne bacteria, clearing up blemishes in just a few days.