Clinique last fall launched its Acne Solutions line, a three-step system similar to its classic skin-care sets, but containing anti-acne ingredients.

“In talking to our own consultants at the (retail) counter, mature customers complain of acne … and that led us to one of our major endeavors of the last five years,” says Tom Mammone, executive director of research and development at Clinique, who says several studies backed the concept that more adults say they have acne.

Peter Scocimara, CEO of Therative, the company that makes the ThermaClear heat-based, anti-acne device, says he initially thought the product would be marketed primarily to teenage boys, but that adult women have turned out to be the primary consumer. “The teen market is huge but the more sensitive market to the individual pimple is the adult woman.”

Adult acne is more common on the jawline, neck, chest and back, while teen acne tends to cluster on the forehead and cheeks, says Dr. Katie Rodan, one of the two dermatologists behind the skin-care brand Rodan + Fields.

“Pimples move south with age,” Rodan says. “They’ll be fewer in number but bigger in size.”

Teen acne is typically blamed on hormonal changes, while stress can be a more likely factor for adults, she says.

But bacteria can be the real culprit, and adults can allow heated bacteria to fester on their skin anytime they do an activity such as bikram yoga or 30 minutes on the stationary bike at the gym and enjoy their smoothie before showering.

“You stew in your own sweat,” Rodan says. “That heat you generate helps the bacteria and adults tend to do more heavy, sweaty, gym-intense exercise.”

“Showering after exercise is the easy part of curbing adult acne; living stress-free is much harder,” she adds.

Dr. Mary Lupo, clinical professor of dermatology at Tulane University, who also consults for beauty brand Philosophy, says occasional acne can be treated with over-the-counter products that include benzoyl peroxide to kill bacteria or salicylic acid to unclog pores.

But for anything consistent, she recommends prescriptive treatments that will treat an existing outbreak and could help prevent future ones.

The estrogen and progestin in the Yaz birth control pill – an option only for women – and the anti-androgen action of the hormone-therapy drug Spironolactone, which suppresses oil output, are effective, says Lupo, as is Accutane. All of those, however, should be taken while under a doctor’s care because there are potential side effects.

Laser treatments also can help active acne and acne scarring by stimulating collagen – a bonus is that they also can help with fine lines and wrinkles, she adds. But treatments average $250-$500 and patients typically need three.

The best treatment might be to accept that adult acne happens – and to know you’re not alone, says self-esteem adviser and blogger Jess Weiner, who is featured in Seventeen magazine among other media outlets.

She is no stranger to an outbreak, she says, and she used to do her best to cover it up with topical treatments and makeup.

“The blemish becomes magnified, at least in your own mind,” Weiner says. “It impedes you from feeling sexy, or fresh, or clean. … Just like when you were in junior high, a bad case of acne can completely level your confidence for the day.”

Recently she decided to change her approach and she has seen an improvement. She goes out without concealer – and no one else seemed to notice, Weiner reports.

“I also figured out how to dress around my zits. I wear hats! Hats became the great distractor. I also wear my glasses a lot, scarves or cleavage-baring shirts because then people weren’t looking at my face.”

What Causes Acne?

Acne origins are not very well known, but doctors believe acne results from several related factors. One important factor is an increase in hormones called androgens (male sex hormones). These increase in both boys and girls during puberty and cause the sebaceous glands to enlarge and make more sebum. Hormonal changes related to pregnancy or starting or stopping birth control pills can also cause acne.

Another cause of acne is heredity or genetics. Researchers believe that the tendency to develop acne can be inherited from parents. For example, studies have shown that many school-age boys with acne have a family history of the disorder. Certain drugs, including androgens and lithium, are known to cause acne. Greasy cosmetics may alter the cells of the follicles and make them stick together, producing a plug. Although you may hear that acne is not caused by greasy skin, greasy sking can still cause a problem.

What makes acne flare up?

* Changing hormone levels in adolescent girls and adult women 2 to 7 days before their menstrual period starts
* Oil from skin products (moisturizers or cosmetics) or grease encountered in the work environment (for example, a kitchen with fry vats)
* Pressure from sports helmets or equipment, backpacks, tight collars, or tight sports uniforms
* Environmental irritants, such as pollution and high humidity
* Squeezing or picking at blemishes
* Hard scrubbing of the skin
* Stress.

Lies about acne

There are many myths about what causes acne. Chocolate and greasy foods are often blamed, but there is little evidence that foods have much effect on the development and course of acne in most people. Another common myth is that dirty skin causes acne; however, blackheads and other acne lesions are not caused by dirt. Stress doesn’t cause acne, but research suggests that for people who have acne, stress can make it worse and sometimes can make it worse within just a few hours.

What are acne treatments?

Acne is often treated by dermatologists (doctors who specialize in skin problems). These doctors treat all kinds of acne, particularly severe cases. Doctors who are general or family practitioners, pediatricians, or internists may treat patients with milder cases of acne.

The goals of treatment are to heal existing lesions, stop new lesions from forming, prevent scarring, and minimize the psychological stress and embarrassment caused by this disease. Drug treatment1 is aimed at reducing several problems that play a part in causing acne:

* abnormal clumping of cells in the follicles
* increased oil production
* bacteria
* inflammation.

All medicines can have side effects. Some side effects may be more severe than others. You should review the package insert that comes with your medicine and ask your health care provider or pharmacist if you have any questions about the possible side effects.

Depending on the extent of the problem, the doctor may recommend one of several over-the-counter medicines and/or prescription medicines. Some of these medicines may be topical (applied to the skin), and others may be oral (taken by mouth). The doctor may suggest using more than one topical medicine or combining oral and topical medicines.

Acne lesions occur mostly on the face, neck, back, chest, and shoulders. It is the most common skin disease. Although acne is not a serious health threat, severe acne can lead to disfiguring and permanent scarring.

Women actually have more and different issues than men with acne.

How does acne affect women?

Most young women and men will have at least a few pimples over the course of their lives. But acne seems to affect men and women in different ways. Young men are more likely to have a more serious form of acne. Acne in young women tends to be more random and linked to hormone changes, such as the menstrual cycle.

As women get older, acne often gets better. But some women have acne for many years. Some women even get acne for the first time at age 30 or 40.

For many women, acne can be an upsetting illness. Women may have feelings of depression, poor body image, or low self-esteem. But you don’t have to wait to outgrow acne or to let it run its course. Today, almost every case of acne can be resolved. Acne also can, sometimes, be prevented. Talk with your doctor or dermatologist (a doctor who specializes in treating skin problems) about how you can help prevent acne and if treatment would help you.

To find out about the the Acne No More Book read my review.

What are the different types of acne lesions?

* Comedo (whiteheads or blackheads) or papules. The comedo is the basic acne lesion, which is a plugged pore. If the plugged pore stays under the skin, it’s called a closed comedo and forms a white bump or whitehead. Blackheads are comedos that open up and appear blackish on the surface of the skin. This black color is not due to dirt, but because the air reacts with the excess oil.

* Pustules or pimples. Pustules or pimples are acne lesions that contain pus and are red at the base.
* Nodules. These are more serious acne lesions. They lodge deeper in the skin, are painful, and can cause scarring.
* Cysts. Like nodules, these lesions are deep within in the skin, are painful, and are filled with pus, and can cause scarring.

Many things can trigger acne in women:
* Hormone changes during puberty. During puberty, girls have an increase in male sex hormones called androgens. This increase causes the glands to get larger and make more sebum.
* Hormone changes as an adult. The menstrual cycle is one of the most common acne triggers.

Acne lesions tend to form a few days before the cycle begins and go away after the cycle is completed. Other hormone changes, such as pregnancy and menopause, improve acne in some women. But some women have worse acne during these times. Stopping use of birth control pills can play a role as well.

* Medicines. Certain medicines, such as those used to treat epilepsy and types of depression.
* Make-up.
* Pressure or friction on the skin. Friction caused by bike helmets or backpacks can make acne worse
* Family history. If other people in your family have acne, there is a greater chance you will have it.

Does poor hygiene cause acne?

It is a myth that women get acne because they don’t wash enough. Too much washing or scrubbing the skin harshly can make acne worse. And washing away surface oils doesn’t do much to prevent or cure acne, because it forms under the skin. The best way to clean the face is to gently wash it twice a day with a mild soap or cleanser. Be careful to remove make-up without harsh scrubbing.

Can stress cause acne?
Stress does not cause acne. But, acne may be a side effect of some medicines used to treat stress or depression. And in some cases, the social and emotional impact of acne lesions causes stress. Talk with your doctor if you have concerns.

Can eating chocolate or greasy foods cause acne?
While many women feel that eating chocolate or greasy foods causes acne, experts have not found a link between the diet and acne. Foods seem to have little effect on acne in most people. But, it’s important to eat a healthy diet for good health.

How is mild acne treated?
There are many treatments for mild acne. Mild acne can consist of whiteheads, blackheads and small pustules. At home, you can wash your face twice per day with warm water and a gentle cleanser or soap. Your doctor may suggest you also try an over-the-counter lotion or cream. These medicines may make your skin dry if you use them too much. Be sure to follow the directions.

If these medicines dont work, your doctor may prescribe a cream or lotion with benzoyl peroxide, resorcinol, salicylic acid, or sulfur.

* Benzoyl peroxide works to reduce oil made by the glands.
* Resorcinol, salicylic acid, and sulfur help breakdown whiteheads and blackheads.

If your acne does not get better after six to eight weeks, talk with your doctor about changing your treatment.

Can more serious forms of acne be treated?

Yes. Work with your doctor to find the best treatment for you.

Moderate to moderately severe acne. This type of acne consists of several whiteheads, blackheads, papules and pustules that cover the face and/or other parts of the body. It can be treated with antibiotic lotions or gels, as well as retinoic acid. Retinoic acid is an altered form of vitamin A. It helps prevent whiteheads and blackheads. Your doctor may also prescribe an antibiotic pill, such as erythromycin. If you take birth control pills to prevent pregnancy, antibiotics can affect how well they work. Be sure to use a second method of birth control with the pill, such as a condom. Retinoic acid and antibiotic pills can make the skin sensitive to the sun. So, wear sunscreen and stay in the shade while using them.

Severe acne. Severe acne consists of deep cysts, redness, swelling, extreme damage to the skin and scarring. You should see a dermatologist to care for this type of acne. Scarring can be prevented with appropriate treatments. Your dermatologist can prescribe oral antibiotics and oral contraceptives. Large inflamed cysts can be treated with an injection of a drug that lessens the redness, swelling, and irritation, and promotes healing.

Your dermatologist may prescribe Accutane, if other treatments have not worked. This is a strong medicine that can help prevent scarring and treat active disease. But, Accutane also can cause birth defects. It is important that you are not pregnant and do not plan to get pregnant while taking this medicine. You must use two methods of birth control at the same time. This is done for one month before treatment begins, during treatment, and for a full month after stopping the drug. Talk with your dermatologist about when it’s safe to get pregnant. Other side effects of this drug may include dry eyes, itching, mood changes, and changes in the blood and liver. You and your dermatologist can decide whether this medicine is right for you based on the pros and cons. Use any prescribed medicine exactly as you are advised. Taking more medicine than you are supposed to take may make acne or your general health worse. Ask your doctor what to do if you miss a dose.

Some large cysts do not respond to medication and may need to be drained or removed. Your dermatologist is the only person who should drain or remove these. You should never try to drain or remove your acne by squeezing or picking. This can lead to infection, worsen your acne, and cause scarring.

Overall, if you dont see a change in your skin in six to eight weeks, talk with your doctor about your treatment plan.

Can birth control pills help treat acne?

For women who break out mainly around their menstrual cycle, some birth control pills can help. Research shows that these pills can clear acne by slowing down overactive oil glands in the skin. Sometimes, birth control pills are used along with a drug called spironolactone to treat acne in adult females. This medication lowers levels of the hormone androgen in the body. Androgen stimulates the skins oil glands. Side effects of this drug include irregular menstruation, breast tenderness, headache and fatigue. Spironolactone is not appropriate therapy for all patients.
When is surgery used for acne scarring?

If you have scarring, your dermatologist may suggest surgery to help heal acne lesions and remove scarring. A laser can reshape scar tissue and reduce redness. Dermabrasion is a type of surgery that can remove surface scars and reduce the depth of deep scars. Another option is to transfer fat from one part of the body to the face. In some cases, a single treatment can help scarring. But for lasting results, several are often needed. There are also topical treatments for acne scarring.

Photodynamic therapy is a new acne treatment. It begins with light microdermabrasion. This is used to remove dead skin cells on the faces surface. Then, an acid is put on the skin for 30 to 60 minutes. After this period, the acid is taken off. Lastly, the skin is treated with a laser. This treatment is still being researched, but seems to give positive long-term results.
How can I help prevent acne and acne scars?

You can help prevent acne flare-ups and scars by taking good care of your skin:

1. Clean your skin gently with a mild soap or cleanser twice a day?once in the morning and once at night. You should also gently clean the skin after heavy exercise. Avoid strong soaps and rough scrub pads. Harsh scrubbing of the skin may make acne worse. Wash your entire face from under the jaw to the hairline and rinse thoroughly. Remove make-up gently with a mild soap and water. Ask your doctor before using an astringent.

2. Wash your hair on a regular basis. If your hair is oily, you may want to wash it more often.

3. Do not squeeze or pick at acne lesions. This can cause acne scars.

4. Avoid getting sunburned. Many medicines used to treat acne can make you more prone to sunburn. Many people think that the sun helps acne, because the redness from sunburn may make acne lesions less visible. But, too much sun can also increase your risk of skin cancer and early aging of the skin. When you’re going to be outside, use sunscreen of at least SPF 15. Also, try to stay in the shade as much as you can.

5. Choose make-up and hair care products that are non-comedogenic or non-acnegenic. These products have been made in a way that they don’t cause acne. You may also want to use products that are oil-free.

6. Avoid things that rub the skin as much as you can, such as backpacks and sports equipment.

7. Talk with your doctor about what treatment methods can help your acne. Take your medicines as prescribed. Be sure to tell your doctor if you think medicines you take for other health problems make your acne worse.

Is rosacea the same as acne?

Rosacea (ro-ZAY-she-ah) is a common skin problem often called adult acne. Faired skinned and menopausal women are more likely to have rosacea. Rosacea also seems to run in families. It causes redness in the center parts of the face and pimples. Blood vessels under the skin of the face may enlarge and show through the skin as small red lines. The skin may be swollen and feel warm.

Women with rosacea don’t have the same lesions as seen with common acne. They may have flushing of the face, when they are hot, drink alcohol or hot drinks, or eat spicy foods. This flushing causes the face to appear red. In the most severe form, this redness does not go away. The eyes may become swollen and nodules in the skin may be painful.

You can help keep rosacea under control by keeping a record of things that cause it to flare up. Try to avoid or limit these triggers as much as you can. Antibiotic lotions or gels can also help. Sometimes, you may need to take antibiotic pills. Your dermatologist may treat you with laser surgery. If you think you have rosacea, talk with your doctor about these treatments.

You can use an acne journal to keep track of different variables that may be contributing to your flare-ups. This may include anything from the severity of your acne, the food you eat, stress levels, medications, physical activities, how much water you drink, and even the clothing you wear (certain types of clothing can promote and/or irritate pimples on different parts of your body).

Since a woman’s hormones will fluctuate from month to month, she may wish to keep track of her monthly cycle. Some women find that they have more breakouts right before their period.

Keeping track all these variables may seem like too much work. You may be tempted to blow off the acne journal and keep experimenting with different remedies in the hopes that something works out. But you’ll be groping in the dark, and you’ll likely waste your time with remedies that are designed to solve problems you don’t have. Or you may find something that works for a while, but fails whenever your worst acne trigger kicks in. You’ll save yourself a lot of time, misery, and money in the long run by keeping a journal.

After you’ve been writing all this down for a while, you’ll probably notice a trend: Maybe a certain food seems to trigger a breakout. You can test this theory by eliminating the food from your diet for a while. If your complexion improves, you now know to avoid eating that particular food.

What if the trigger is something beyond your control, such as job stress or a menstrual cycle? Your best option is to ramp up your acne regimen whenever this comes up. However, don’t automatically assume that you can’t do anything about these patterns. For example, birth control pills can sometimes help with acne caused by menstruation. Job stress can be remedied by quitting and getting another job, or by finding ways to improve work conditions.

If you’re at your wits’ end when it comes to figuring out what’s causing your face to break out, you should seriously consider starting an acne journal. The little time you spend on your journal each day will help you understand your acne better and arm you with the knowledge you need to control it.

To assess the efficacy of the combined oral contraceptive containing 3-mg drospirenone/20-microgram ethinyl estradiol (3-mg drospirenone/20-microgram ethinyl estradiol) administered as 24 consecutive days of active treatment after a 4-day hormone-free interval (24/4 regimen) compared with placebo for the treatment of moderate acne.

METHODS: Healthy females aged 14–45 years with moderate acne were randomized in this double-blind study to 3-mg drospirenone/20-microgram ethinyl estradiol or placebo for six cycles of 28 days. The primary outcome measures of acne lesion counts and Investigator Static Global Assessment scale ratings were assessed at baseline and during cycles 1, 3, and 6.

RESULTS: The percentage reduction from baseline to endpoint for total lesions is 46.3% for 3-mg drospirenone/20-microgram ethinyl estradiol 24/4 combination oral contraceptive group and 30.6% for placebo group. The likelihood of participants in the 3-mg drospirenone/20-microgram ethinyl estradiol 24/4 regimen group having “clear” or “almost clear” skin as rated by the investigators at endpoint was about threefold ) greater than in the placebo group. The 3-mg drospirenone/20-microgram ethinyl estradiol 24/4 regimen was well tolerated.

CONCLUSION: The low-dose combined oral contraceptive containing 3-mg drospirenone/20-microgram ethinyl estradiol administered in a 24/4 regimen significantly reduced acne lesion counts more effectively than placebo and demonstrated greater improvement in the Investigator Static Global Assessment rating of acne. The safety profile was consistent with low-dose combined oral contraceptive use.

So after deciphering the doctor geek speak it seems yes, birth control pills are an effective treatment for acne.

If over-the-counter products have been ineffective however, it is time for you to make an appointment with your family physician or dermatologist. Your doctor can prescribe topical treatments that are stronger and more effective than the ones available without a prescription.

Your specialist may begin with simple external applications such as benzoil peroxide. Formulations containing benzoil peroxide work by killing bacteria that are trapped in your pores by excess oil. Unfortunately, superficial skin medications do not address deep infections that cannot be reached from the skin’s surface.

Deeper body surface infections may respond to management with an antibiotic. Two of the most common antibiotics used for curing body surface infections are tetracycline and erythromycin. These medications eliminate the bacteria causing infection in the deepest layers of the skin.

Your physician may prescribe a chemical peel as well as medication. A chemical such as glycolic acid is used to cause the uppermost layer of your skin to peel off. Other, less extreme ways of removing the top layer of your skin comprise scrubbing your face with slightly abrasive pads or employing skin washes that contain beads or microscopic particles.

It has long been recognized that exposure to sunshine can be used as a body surface treatment. Special lighting is now available that can reduce the number of inflamed skin lesions by about 70% or so within about a month. One advantage of this technique is that it has no known side effects, although it is not as efficacious if the infection is severe.

Birth control pills are sometimes prescribed to manage body surface breakout, but the pill has arguably serious side effects. The Diane-35, which was specifically developed to treat severe cases of zits (and not for birth control), has been linked to a small but elevated risk of blood clots compared to other birth control pills. You should also know that if you are taking tetracycline, it negates the contraceptive effectiveness of the pill.

Finding a cure for the breakout is the objective, but the approach should be chosen based on the severity of your skin breakout and the risks linked with potential treatments. Whether the treatments you choose are topical or internal, your doctor can explain what you need to take into consideration prior to making a decision. Body surface medications may be more effective than topical treatments, but they have potentially more serious side effects. You need professional advice and realistic expectations for any method of curing acne you try.

Drainage and Surgical Excision

Some large cysts do not respond to medication and may require drainage and extraction. Drainage and extraction, or acne surgery as it is also called, should not be performed by patients. Dermatologists are trained in the proper technique and perform acne surgery under sterile conditions. Patient attempts to drain and extract comedones by squeezing or picking, can lead to infection, worsening of the acne and scarring.

Severe acne requires an aggressive treatment regimen and should be treated by a dermatologist.

Acne Injections

When an acne cyst becomes severely inflamed, there is a good chance it will rupture and scarring may result. To treat these severely inflamed cysts and prevent scarring, dermatologists may inject such cysts with a much-diluted corticosteroid. This lessens the inflammation
and promotes healing. An interlesional corticosteroid injection works by “melting” the cyst over a period of 3 to 5 days. As painful as this may sound I never found it to be bad at all, the needle is this and it is really good to get rid of the lumpy red zits.

Accutane

Accutane is a potent drug reserved for treating severe cystic acne and acne that has proven itself resistant to other medications. Accutane is a synthetic (man-made) retinoid (form of vitamin A) that comes in pill form. It is usually taken once or twice a day for 16 to 20 weeks.

Today, it is the most effective acne treatment available because it is the only acne treatment that works on all four factors that predispose a person to acne – excess oil production, clogged skin pores, P. acnes and inflammation. The remissions achieved with Accutane usually last for many months to many years. For many patients, only one course of Accutane therapy is needed.

While Accutane is the most effective acne treatment available, it cannot be prescribed to everyone due to a number of potential side effects, some serious. One of the most serious side effects is the potential to cause severe birth defects in a developing fetus. For this reason, the U.S. Food and Drug Administration (FDA) requires that women not be (or become) pregnant while taking Accutane. FDA regulations require women of childbearing age to take 2 pregnancy tests prior to beginning Accutane therapy and use 2 forms of birth control for 1 month before therapy begins, while taking the drug and for 1 full month after therapy. It is also important that women not breast feed during this time. Women who wish to become pregnant after taking Accutane should talk to their dermatologist and gynecologist about when it is safe to get pregnant after receiving Accutane therapy.

Other possible severe side effects that may occur while taking Accutane include:

* Severe pain in the chest or abdomen
* Trouble swallowing or painful swallowing
* Severe headache, blurred vision or dizziness
* Bone and joint pain
* Nausea or vomiting
* Diarrhea or rectal bleeding
* Depresion
* Dryness of the skin, eyes and nose
* Thinning hair

If any side effect occurs, the patient’s dermatologist or other healthcare practitioner should be contacted immediately because some of these side effects can lead to serious health problems.

While taking Accutane, patients are regularly monitored for side effects through follow-up visits. For most people, these side effects are tolerable and not a reason to discontinue therapy before remission is achieved. However, it is important to keep appointments for follow-up visits because monitoring can reveal conditions that a patient might not notice. For example, a patient may not realize a rapid increase in bad cholesterol that is detected through a blood test.

The decision to use Accutane should be made jointly by patient and dermatologist. When used with all due caution under close medical supervision, Accutane can resolve severe acne that has not responded to other therapy. It has proven especially effective in resolving cystic acne, a severe form of acne that usually does not respond to other therapies.

For a substantial number of patients, one course of Accutane therapy is all they will ever need. A small number of patients require more than one course of Accutane therapy to control severe acne.

It is important to take Accutane as prescribed even if the skin clears before all of the pills have been taken to prevent relapse. At the end of an effective course of Accutane therapy, all or most of the acne lesion will have cleared. Patients may notice residual erythematous (reddish) macules (flat spots) where acne lesions were present. These macules are not scars, and they will fade in 6 to 8 weeks.

After therapy, patients should continue to follow the Skin Care Guidelines for People with Acne.

Antibiotic pills
Oral antibiotics have been a mainstay of therapy for severe acne for many years. Like topical antibiotics, oral antibiotics work to reduce the P. acnes population (a contributing factor in acne), which, in turn, decreases inflammation. Treatment with oral antibiotics usually begins with a high dosage, which is reduced as the acne resolves. Over time, the P. acnes bacteria can become resistant to the antibiotic being used to treat it. When this happens, another antibiotic can be prescribed. Numerous studies support the effectiveness of the following broad-spectrum oral antibiotics that are used to treat acne in the United States: doxycline, erythromycin, minocycline and tetracycline. For information about each of these oral antibiotics, see Prescription Acne Medications.

Birth Control pills
Birth Control pills have been shown to effectively clear acne in women by suppressing the overactive sebaceous glands. Oral contraceptives can be used as long-term acne therapy; however, this medication should not be prescribed to women who smoke, have a blood-clotting disorder, are older than 35 or have a history of migraine headaches without the advice of a gynecologist.

Spironolactone, a synthetic steroid, may be used in combination with birth control pills to treat acne in adult females. Spironolactone inhibits androgen production. Side effects include irregular menstruation, breast tenderness, headache and fatigue

Are these tips all you need to prevent acne? If not you should be interested in a proven method to rid you of your acne. Then read my review of the book Acne No More. Another great product I have reviewed is Acnezine.