Ask The Doctor

ASK THE DOCTOR: TREATING ADULT ACNE

Though you may have left your angst back in high school, there are some teenage problems that can follow you into
adulthood. Yes, even as an adult you may still be hanging onto some of your adolescent skin problems. If the
persistence of your blemishes is making you see red, you’re not alone. “Many adults experience moderate to serious
acne,” says Fran E. Cook-Bolden, a dermatologist in New York City. Below, find her step-by-step plan for how to clear
up your skin for good:

1. Determine your skin type
Believe it or not, all acne-prone skin is not oily. Dry, sensitive and even normal skin can break out. To determine your
skin type, Dr. Cook-Bolden recommends considering how your face feels in the middle of the day and not after washing
your face. “Ideally, this is best done on a day when you are able to stay home or on a day that you don’t have to apply
any make-up, moisturizers or sunscreen, as this will change the level of hydration of the skin,” she says—so try doing so on a weekend day. If your skin feels oily in the middle of the day, you have oily skin, if it feels dry at midday, you have dry skin and if you really don’t notice anything abnormal, your skin— not surprisingly—is probably normal. Note that your skin type may change with the season, so you may need to repeat this analysis each season. Regardless, this step is extremely important, says Dr. Cook-Bolden: “Determining your skin type will provide you with the information you need about how you will tolerate the available treatments, and if you don’t use the correct treatment, it won’t work.”

2. Use products made for your skin type
Once you’ve determined your skin type, choose your products accordingly. “Don’t just stop at skincare—use makeup that is made for your skin type and that you feel comfortable with so as not to exacerbate your acne,” says Dr. Cook-Bolden. If you’re oily, choose oil-free skincare and makeup. If you’re dry, use products that hydrate skin, and if you’re normal, keep things oil-free, but not too religiously. Don’t forget to check out you hair care and grooming tools, as they can often clog pores as well. Dr. Cook-Bolden recommends using silicone-based preparations for hair care to minimize breakouts.

3. Observe the types of breakouts you have
As you may well know, breakouts come in all shapes and sizes. Determining which you most frequently get can help you choose the best treatment option. If you have mostly clogged pores, blackheads or whiteheads, Dr. Cook-Bolden recommends choosing products with salicylic acid to use in the morning and a retinol, which will also provide anti-aging benefits, to use at night. If you have mostly pimples or pus bumps, use a benzoyl peroxide treatment in the morning and a retinol in the evening. If your breakouts include a number of cysts or larger and deeper breakouts, an over-the-counter treatment just might not cut it, says Dr. Cook-Bolden: “If you fall into this category, head to your dermatologists for some professional help.”

Because topical acne treatments can cause skin irritation, make sure you choose the formula, and begin using sparingly, building up your skin’s tolerance. “Applying an excessive amount won’t make treatments work any quicker and will cause irritation,” Dr. Cook-Bolden says. “Topical treatments are available in many different formulations like creams, lotions and gels, so choose a formula that matches your skin type, feels good on your face and is synergistic with your make-up. And remember, if you don’t use it, it won’t work.”

4. Consider your menstrual cycle
If you notice a relationship between your breakouts and your menstrual cycle—whether preceding, during or coinciding with ovulation—and are not seeing a response to topical therapies after two months, there may be a very strong hormonal component to your acne, says Dr. Cook-Bolden. “If this is the case, you may again need to seek help from your dermatologist, who may also partner with your gynecologist to get those hormones under control.”

5. Be patient
It can take two months or more to see a significant response from treatment, says Dr. Cook-Bolden, so if you don’t notice immediate results, don’t despair. No matter what you do, avoid the temptation to squeeze and pick, as doing so can leave scars far worse—and permanent—than a pimple. If you have a terribly troubling blemish, make an appointment to see a dermatologist to have it injected with a pimple-shrinking steroid.

NEED TO SAVE FACE?
TRY THESE POWERFUL BLEMISH BLASTERS

	Cleanse with Skinceuticals Clarifying Cleanser to clear up blackheads and whiteheads. It contains acne-fighting alpha and beta hydroxy acids and salicylic acid to unclogs pores and remove dirt, oil and other debris from the skin. ($24, www.dermstore.com)
		Kiss pimples goodbye with Peter Thomas Roth’s Medicated BPO 5% Acne Wash, which contains benzoyl peroxide to kill bacteria on contact and help prevent the appearance of new blemishes. If you need something stronger—perhaps for your chest or back, try the 10% version. ($32, www.sephora.com)
	Purify pores by using Biore’s Self-Heating mask once a week. It instantly heats up on contact with water to help open up and intensively cleanse pores by absorbing excess oils and getting rid of pore-clogging dirt and dull, dead skin cells. ($6.99, www.drugstore.com)
		Try the Rodan and Fields Unblemish Regimen, which uses sulfur to banish breakouts, if you are having trouble tolerating a benzoyl peroxide-based regimen. Its three-step cleanser, toner and treatment system will clear your skin—minus the irritation—in no time. ($85, www.skinstore.com)
	Use SkinCeuticals Retinol 1.0 at night to help stimulate cell regeneration and minimize the appearance of pore size and fight blemishes. Limit initial use to once or twice a week, gradually increase frequency to every other nigh and finally each evening as tolerated. ($48, www.amazon.com)
		Dab DDF’s 5% Benzoyl Peroxide Gel with Tea Tree Oil onto problem areas. Its tea tree oil will serve as a natural antiseptic and healer. ($24, www.sephora.com)
	Conceal spots with Benefit’s Galactic Shield, a precise cover-up packed with zit-fighting salicylic acid. ($20, www.benefitcosmetics.com)
		Moisturize oily skin with Cellex-C’s Sea Silk Oil-Free Moisturizer, which will leave skin soft but not shiny. ($49, www.sephora.com)
	Soothe skin irritated by topical treatments with Dr. Paul Lorenc’s Cucumber Chamomile Calming Serum, which contains an anti-oxidant rich and anti-inflammatory skin-cocktail with a hyaluronic acid base. ($62, www.lorenc.com) Call 212.472.2900 to order
		Avoid attacking blemishes with your nails. Prevent scarring by using Tweezerman’s Skin Care Tool to gently extract blackheads and whiteheads. ($8.99, www.drugstore.com)