Adult Acne: Best treatments for adult acne

What are the best acne treatments for women over 35?

Acne is caused by heredity, hormones and stress. Years ago diet and cosmetics were blamed for acne, but current thinking downplays these factors. Often women who escaped teenage acne get adult acne, and it's often stress related. It's hard to eliminate stress these days, but fortunately there are many treatments to control adult acne.

Acne control begins with gentle skin care…harsh cleansers and abrasive/gritty scrubs dry and irritate the skin but don't unplug the clogged pores. Use a gentle cleanser such as Cetaphil cleanser, a cosmetic product such as SkinCeuticals Foaming Cleanser, or even Dove soap. Your cleanser is correct when your skin feels clean but soft 15 minutes after cleansing. Toners and astringent add little and can dry the skin. Heavy moisturizers can clog pores, so stick to a light lotion, perhaps one with sunscreen for morning use, such as Neutrogena Oil Free Moisture SPF 15.

Over-the-counter acne medicines can be helpful for mild blemishes. The best ones contain benzoyl peroxide such as Clearasil Ultra and additional glycolic acid such as ProActive. These can be drying.

For more severe outbreaks, dermatologists prescribe antibiotics for inflamed pustular acne. Topicals such as clindamycin can "kill the germs that cause the pimples." Oral antibiotics such as minocycline can work faster and more effectively than topicals. These medicines have a good safety record, but we hope to taper off the pills and use just topicals as the acne subsides.

Retinoids such as Retin A are topicals that unplug pores and prevent acne….and are popular for anti-aging skin renewal effects. The newest one is Tazorac, and a less irritating one is Differin. These work over weeks to months, can be drying/irritating, but can help skin wrinkling and discoloration in addition to acne. For the most severe cases Accutane, is a retinoid pill which "cures" acne, but there are major side-effects and limitations to its use.

Facial esthetician treatments can be helpful. Laser treatments for acne are being investigated. Novel/unconventional treatments should be viewed with healthy skepticism.

Rosacea is an adult form of acne characterized by blushing and facial redness with red pimple-like bumps on the central face. Many of the treatments noted above are not useful for rosacea. Other allergies and eruptions can be confused with acne, and it's important to make the correct diagnosis.