April 24, 2009

If you're still battling pimples long past your high-school years, here's some good news. By targeting the source of the problem, you can finally start to rely on clear skin every day. What that means is you need to get a handle on your stress first. It's the number-one trigger of adult acne, says David E. Bank, M.D., a dermatologist in Mt. Kisco, N.Y. "Stress boosts cortisol and other hormones that increase oil production," he explains. (Oil plus dirt and bacteria equals breakouts.) So make time for exercise or other relaxation every day. Then try these measures to put a stop to your breakouts:

Rethink Your Cleanser.

You know to suds up morning and night, but when was the last time you really examined your cleanser? You need one that deep-cleans without stripping moisture. Steer clear of creamy products; they clog pores. Instead, use one of the new products made for adult acne, with antiaging/antiwrinkling and antiblemish ingredients. Be sure it has salicylic acid (the gold standard of pore decloggers) to slough off dead skin, which can clog pores. We love Olay Total Effects Anti-Aging Anti-Blemish Daily Cleanser ($7; at drugstores) and Mario Badescu Acne Facial Cleanser ($15, mariobadescu.com). Or try one of the new acne kits that contain a blemish-fighting cleanser (plus toner and moisturizer), like Rodan + Fields Unblemish Regimen ($85; rodanandfields.com). For body acne, try Murad Acne Body Wash ($35; murad.com).

Stash toner in your desk drawer.

Give problem areas (or oily spots) a midday deep cleansing with a swipe of alcohol-free toner (alcohol can be too drying for grown-up skin). We like L'Oreal Paris AcneResponse Skin Clarifying Toner ($25 for a three-product kit) and Neutrogena handy pre-moistened Rapid Clear Pads ($7; both at drugstores, shown at left). Or opt for a shine-control serum that controls oiliness while also treating skin with salicylic acid. Our favorite: Chanel Precision Purete Ideale T-Mat Shine Control Serum ($35; chanel.com).

Get Peeled.

Monthly glycolic peels, done either in your dermatologist's office or at home with an over-the-counter kit, can help prevent breakouts by speeding the turnover of dead skin cells (which combine with the skin's natural oil, or sebum, to clog pores), says Patricia Wexler, M.D., a dermatologist in New York City. At your doctor's office, peels with a concentration of up to 20% glycolic acid can cost $150 or more a visit. You can get similar results by using lesser percentages of exfoliating acids (hydroxy acids) more frequently at home, like Wexler's own Exfoliating Glyco Peel System ($65; bathandbodyworks.com) with 10 percent glycolic acid peel pads or MD Skincare Alpha Beta Daily Face Peel ($72; mdskincare.com), a tried-and-true formula with a mix of dead-skin-sloughing acids.

Keep Your Skin Hydrated.

Most of us ditch our moisturizers at first sight of a pimple, thinking that any extra oil will make the breakout worse. That's definitely the wrong tactic, says Wexler, adding that "dryness itself can cause a rebound of oil secretions and secondary acne breakouts." Experts recommend oil-free hydrators that are noncomedogenic (non-pore-clogging), such as the lightweight, fast-absorbing Estee Lauder Hydra Complete Multi-Level Moisture Gel Creme ($40; esteelauder.com, shown at left). Oil-free moisturizers with salicylic acid work double duty; try Dr. Brandt Poreless Gel ($55; sephora.com), which contains salicylic acid and antibacterial tea-tree oil.

Clean your cell phone or Blackberry regularly.

Whatever you're cradling to your ear (and, consequently, to your face) is transferring bacteria, dirt and oil directly to your pores. Wash off your phone or BlackBerry several times a week by wiping it down with a tiny bit of alcohol or a disinfecting wipe; this will go a long way toward keeping the area on your chin and cheeks free of breakouts.

Get a handle on your monthly cycle. "Nearly half of women experience increased oiliness and breakouts the week before their period," says Diane Berson, M.D., an assistant attending physician at the New York-Presbyterian Hospital in New York City. What can you do to decrease your chances? Each month, mark on your calendar the two weeks before the beginning of your period. Then make sure every single one of those 14 days you spot-treat the areas most prone to breakouts (for most women, this is around the mouth and chin). Best bet: Clean & Clear Advantage Invisible Acne Patch ($10; at drugstores), a clear gel with salicylic acid in a dab-on applicator tube; it dries matte and cannot be detected either on bare skin or under makeup. You can also try Aveda Outer Peace Spot Relief ($38; aveda.com), with the oil-absorbing botanical saw palmetto. Go high-tech.

When you get a pimple, how you treat it will make all the difference in how quickly it clears up. If you're a technology buff, consider the handheld gadget Zeno ($275; myzeno.com). You press the tip directly against breakouts to send bacteria-busting heat into pores. We tested it and found that it really did seem to clear up pimples faster.

Squeeze the right way.

Every single expert we talked to warns against squeezing at all, but we know it's really hard to resist. If done incorrectly, you can cause bacteria to spread to other pores and trigger more acne. To do it right, only pop a whitehead or blackhead (squeezing painful cysts will only make them worse). Start with clean skin and a blemish extractor like Sephora Double-Ended Blemish Extractor ($16; sephora.com), which applies even pressure to the pore, helping to extract what's trapped inside. Apply a warm, moist washcloth to the area for several minutes to help "open" the pores, then press the blemish extractor directly over the pimple (be sure to sterilize the extractor in rubbing alcohol first). If you must reapply the extractor, swipe it again with alcohol so you don't spread bacteria. Once you've removed any fluid, follow with a deep-cleansing clay mask to help dry out the remaining blemish. What works for us: Biore Shine Control Clay Mask ($6; at drugstores) with cooling peppermint extract, and Peter Thomas Roth Therapeutic Sulfur Masque ($40; peterthomasroth.com) -- sulfur is a natural calming mineral.

Talk to your doctor.

If your acne is stubborn, talk with your dermatologist about prescriptions like topical Tazorac to speed up skin exfoliation, topical antibiotics to control bacteria, or birth-control pills to help regulate your hormones. The powerful oral drug Accutane, which essentially shuts down oil production, is an alternative for more serious acne, but if you're pregnant or planning to be soon, steer clear of it because it can cause birth defects. For drug-free options, ask your doctor about the Laserscope Gemini and V-Beam lasers, which heat sebaceous glands to slow oil production; others like the Smoothbeam kill bacteria in pores (cost: $1,200 for 10 sessions). For an immediate fix, painful cysts can be treated with cortisone injections (about $50 to $150 per cyst).