Like high school pop quizzes and awkward prom dates, pimples are supposed to be distant bad memories. If only that were the case. These days, even moms of teens are battling blemishes — and wrinkles, too.
In fact, between 15 and 35% 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.
So what's the best way to deal with it? Follow these steps and tricks for your most flawless skin ever.
1. Make a date with your doctor.
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.
2. Switch up your diet.
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%. 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.
3. Try something totally new.
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% of intractable-acne sufferers had more than 75% 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.
4. When you get a pimple…
…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 or ThermaClear.