Clear Victory

Braces and anguish are two things most of us can happily leave behind in our adolescence; acne, not as easily. In fact, breakouts are apparently becoming more common later in life! Studies published in “Journal of the American Academy of Dermatology” show that 50 percent of women will suffer from acne at some point in their adult years, and that the middle age of those affected have had an increase of 20.5 to 26.5 years old. Acne is not created equal however; younger acne will most always involve T-zone-centric blackheads and whiteheads, whilst adult acne starts around the jawline and neck, and often shows up as painful cysts and nodules. Adult breakouts might be more alarming due to the fact that skin becomes less resistant with age.

Gene Therapy

Skin scientists have used genomics (the study of genes), to adapt treatments for wrinkles, and now they’re tackling oil overload that could lead to acne with the use of their gene know-how!

According to Rosemarie Osborne, P&G Beauty principal scientist, “P&G’s Ohio-based genomics lab has identified the pathways that regulate lipid production, in order to help create the new “Olay Professional Pro-X Clear line”. In South Korea this summer at the World Congress of Dermatology (the skin-care version of the Olympics), this superb dermatology conference happens once every four years, and this was Osborne’s turn. She presented the results of a clinical study proving the efficacy of two of Pro-X Clear’s powerhouse ingredients: anti-aging niacinamide plus antimicrobial sodium dehydroacetate, to a packed lecture hall. Subjects applied a cocktail containing these actives twice daily and after six weeks, experienced a 40 percent reduction in oil production and a 16 percent reduction in the appearance of pores, without any redness or irritation.

Cover Art

The newest weapon on the treatment of acne does-it-all and on less-than-perfect skin. It is an overseas import that was originally popularized by Korean soap opera actresses, BB (aka “blemish balm” or “beauty balm”). The creams have become a sensation in Asia, thanks to their multitasking potential to conceal pimples and fine lines, boost moisture, soothe irritation, and protect skin from the sun, all while absorbing excess oil. Our BB favorites: "duty-free must Bobbi Brown BB Cream SPF 35" (which has yet to launch in the U.S.); Korean import and Sephora best-seller "Dr. Jart+ Water Fuse Beauty Balm"; and "Clinique Age Defense BB Cream SPF 30", with a seaweed extract that decreases the excess creation of sebum.

The Best Tips For Clear Skin

So, most people would probably confess to cancelling plans due to acne, and you are not alone in your overreaction. Something about acne manages to drive the rational among us to extreme actions. Even with a universe of products available nowadays to address it, we still turn to a cocktail of homegrown remedies and self-surgery to try to eliminate it. But why raid your remedies when there are drugstore aisles that are specifically dedicated to acne?

New York dermatologist Dennis Gross, MD states that “The conventional acne treatment for teenagers is to dry them out and get rid of the oil.” Although we have less sebum as we age, the oil we do have turns into a pore-clogging glue. With adult acne, it’s a problem with the oil chemistry. As hormones change, oil does too, therefore making it more viscous, as it flows through the gland and out through the pore, it gets stuck. Sometimes those products designed to strip away oil just worsen acne by increasing inflammation. Plus, when skin is dry, dead cells flake off, further blocking pores that already have a problem, leading to more acne.”

Rather than attacking skin topically, many dermatologists are playing with the hormonal precursors that lead to breakouts. NYC dermatologist Kavita Mariwalla, MD states that “During teen years (between the ages of 12 and 18), the hormone Insulin-like Growth Factor 1 (IGF-1) peaks; and then it decreases as people reach their twenties and may decline in many people.

Dermatologist David E. Bank, MD, of Mount Kisco, New York, states that “There are plenty of other hormonal irregularities that cause adult acne. For example, progesterone spikes each month when we ovulate. Progesterone, more than estrogen, resembles testosterone, and that’s the one that seems to be more evil when it comes to stimulating and driving the sebaceous glands”.

Another reason is when the hormonal cascade is released when we’re stressed. New Jersey–based Jeanine Downie, MD states that “Your adrenal glands that sit right above your kidneys secrete cortisol and trigger your fight-or-flight response. When you’re stressed, your adrenal glands secrete more cortisol, which can bring on those pounds around the waist and lead to more significant amounts of hormonal acne. So stress leads to acne, which, in turn, leads to even more stress, a vicious cycle”.

While facialists have condemned dairy for decades, clinical studies have only recently established a link between milk consumption and acne. New York dermatologist Francesca Fusco, MD states that “Milk contains testosterone precursors, which cause increased sebum production. What’s fascinating is that one study found that of all milk, skim milk has the strongest correlation with acne. We’re not sure why, but some hypothesize that skim milk has less estrogen than full cream milk.” Switching to organic milk won’t remove your exposure: Mariwalla stipulates that “All milk naturally contains androgens and IGF-1. There’s no such thing as hormone-free milk. Plus, milk contains sugar, a lactose, so it stimulates insulin.”

Another recent study suggests that following a low glycemic index diet (one with less refined sugars, carbohydrates, and foods-containing sugar), may result in fewer acne outbreaks. Fusco states that “As the glycemic index goes up, it affects insulin production and all the hormones. Your hormones are all in a delicate balance (your female hormones are in balance with your thyroid hormones), which are in balance with your insulin. When you have more in one area, it’s like a domino effect on the others. Since the dietary acne provoker may vary for every person, New York dermatologist Ellen Marmur, MD, recommends keeping a diary which outlines what you eat in the days before a breakout to determine what your triggers are.

Then you start a very slow reentry, introducing one new item, like dairy, every six weeks to see what happens on the skin. Marmur believes that it takes just 48 hours for what you eat to show up on your face. So you can look back two days ago and figure out what you were eating. It may not be the same foods for you as it is for me. “Personally, when I eat chocolate, I’ll break out 48 hours later”.

Historically, the premier hormonal mediator has always been the birth control pill, which works by replacing the hormones your ovaries are producing with synthetic varieties that won’t stimulate those pesky sebaceous glands as much. But this doesn’t have to be your first line of defense. Marmur points out that while the Pill may clear up acne, it can also provoke another unsightly reaction: melasma, a noticeable discoloration of the skin that she says is on par with acne in her practice as a top complexion complaint. If you do opt for the Pill, figure out an exit strategy first.

“Birth control pills can be very effective. But eight or nine times out of ten, when you stop them you are right back where you started,” says Bank, who’s a big fan of the controversial Accutane, the prescription-only vitamin A–derived pill, because it continues to work after you stop using it. “Accutane is still, hands-down, our most effective, lasting antipimple medication,” he says.  Although an Accutane prescription comes with significant FDA regulation (because of possible birth defects, patients have to agree to use two forms of birth control and undergo regular pregnancy tests during treatment and for one month after), most of the dermatologists that were interviewed believe it to be worth the trouble. Downie calls Accutane “the be-all end-all for really bad cystic acne,” and Mariwalla states that “it is phenomenal, after you stop the medication, many people have a durable response for many, many years.”

Topical acne fighters such as retinoids, benzoyl peroxide, and salicylic acid remain the solutions most frequently name-checked by our dermatologists; what’s new are the streamlined formulas, delivery systems, and accompanying ingredients. North Carolina dermatologist Zoe Draelos, MD states that “Old medications are being revived by novel combinations. She cites prescriptions like Ziana, a blend of the antibiotic clindamycin and the retinoid tretinoin, and Epiduo, which contains another retinoid, adapalene, plus benzoyl peroxide”.

Bank stipulates that “BenzEFoam short-contact cleanser is a great new vehicle for benzoyl peroxide. “It’s a mousse formulation that you leave on the skin for a couple of minutes and then wash off, so you don’t have to keep it on all night, which can be drying.” Though there has been some apprehension about benzoyl peroxide because of its ability to spike free radicals, no studies, according to Mariwalla, have shown that they are wrinkle-causing. “Actually, in the case of benzoyl peroxide, we have one of the few times when free radicals can help you,” Mariwalla says. “In the skin, the peroxide part dissociates and kills the bacteria that are causing the acne, stopping the inflammation.”

Marmur notes that “Although it takes only two days for a pimple to crop up, you need to give any topical preventive measure 42 days to kick in. The lifespan of a pimple is about six weeks, so that’s the magic number for how long you should give a product before you give up, she says. The biggest mistake people make, besides picking at a pimple, is giving up on products too early”.

As far as pulling your face apart, it’s hard to resist the lure of the mirror, that evil contraption that turns every pore into a crater. But while it may appear that your clogged pores number in the thousands, many of those little dots, particularly on the nose, are entirely normal hair follicles. Fight the urge to squeeze; leave extractions to the professionals.

Neil Sadick, MD, who shares his Park Avenue office space in New York with facialist Luzinete Ripardo states that “If you have a well-trained medical aesthetician working under the sign of a dermatologist, they can use acne extractors or microneedles to actually get in there for the more difficult whiteheads, and for emergency spot reduction, the best cure is a shot of cortisone from the doctor.

But the most major advancement may come thanks to gene research, such as that done at P&G’s Miami Valley laboratory in Ohio. A team of researchers led by Rosemarie Osborne, PhD, recently developed an innovative blend of a topical antimicrobial (sodium dehydroacetate) and vitamin B (niacinamide) that was shown, in independent clinical studies, to reduce sebum production significantly (both can be found in the new Olay Pro-X Clear line). Osborne articulates that “The biggest genomics breakthrough relative to acne is the understanding of why some people get acne and others don’t. This type of research will lead to more customized solutions for acne-prone skin in the near future. For longtime acne sufferers it is one that just may help ensure that we never have to turn to remedies again.

Popular Off-Label Options

Advil:

“An [oral] ibuprofen can help with red, inflamed pimples but not whiteheads or blackheads,” Fusco says.

Aspirin:

“It’s a salicylate,” Mariwalla says, “so you can make a little paste of it and apply to a pimple.”

Benadryl: According to Fusco, “Benadryl can be beneficial for only one subset of acne: acne rosacea.”

Hibiclens: This antibacterial all-purpose cleanser is “good for folliculitis­—infection of the follicles that looks like acne,” Mariwalla says. “But it’s too drying for the face.”

Monistat:

“For people who have little tiny pimples that are often a form of yeast, not typical bacterial acne, Monistat is actually good,” Marmur says. “No matter what, it won’t hurt you—it will just function as a moisturizer.”

Pepto-Bismol:

“The main active ingredient in Pepto is bismuth subsalicylate,” Mariwalla says. “While some people think that the benzoic acid, an inactive ingredient, will make red marks fade away, the results are chancy.”

Tough on stubborn blackheads

Kiehl’s Blue Herbal Spot Treatment is still “sheer enough to wear under makeup.

Gentle enough to use daily

Burt’s Bees Natural Acne Solutions Targeted Spot Treatment won’t irritate surrounding skin.

The life-changing

Zeno Hot Spot zaps zits’ redness” and keeps you “from picking.

Non-drying

Neutrogena On-the-Spot Acne Treatment works on even the deep ones.

Great as a mask but better as a spot treatment

A dab of Proactiv Refining Mask dries out pimples overnight.

Top Blemish Blasters

An AHA-glycolic complex in “La Roche-Posay Effaclar Serum” that tightens pores; “Sampar Pure Perfection Prodigal Pen” for pimple-fighting essential oils, “Olay Pro-X Clear Sulfur Mask” that absorbs oil and banishes blemishes around the clock with the a.m./p.m. formulas in “Kate Somerville 24 Hour Pimple Punisher”, “blue LED therapy” plus gentle vibration makes Tända Clear, an at-home light device and a non-irritating acne solution, “Malin + Goetz Acne Treatment” gets rid of pimples with 10 percent sulfur; lycopene found in “Yes to Tomatoes Acne Roller Ball Spot Stick” which controls oil production.

Via: Elle

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