As you wipe the steam off your bathroom mirror, you find yourself face-to-face with a huge pink dot on the end of your nose. This is not a good way to begin the week.
You give the mirror another wipe with your hand, then get up on your toes and lean over the sink to get a better look. It's there all right. But what's this? When you move your chin up to get a better view, you happen to glimpse a couple of whiteheads sprouting under your bottom lip.
You don't like this at all. You place one knee up on the sink and press your face close to the mirror, and there, in the gully between your nose and cheek, you find a lone blackhead staring back at you.
Stunned, you stumble back from the mirror. Sitting on the edge of the bathtub, you place your newly blemished face in your hands. Your thoughts drift back eons to a time of pimples and proms. Rocking back and forth, you wonder: What's going on here?
The answer is simple enough: You have acne. Acne may be the scourge of the adolescent years, but it can follow some people into middle age and beyond. "Women can have flare-ups at 25 or 35 years old and even older. In fact, my mother was still breaking out when she was 62," says dermatologist James E. Fulton, Jr., M.D., Ph.D., founder of the Acne Research Institute in Newport Beach, California.
Acne is really a catchall term for a variety of symptoms such as pimples, whiteheads, and blackheads, says Peter E. Pochi, M.D., professor of dermatology at Boston University School of Medicine. "It's a condition where the pores of the skin become clogged and the person gets inflamed and noninflamed lesions."
So what's the cause of all the clogging?
"Chocolate doesn't cause acne," says Dr. Fulton. "Dirty hair or skin doesn't cause it. Sex, either too much of it or a lack of it, doesn't cause it either."
So what does? Heredity—at least for the most part.
"Acne is genetic; it tends to run in families," says Dr. Fulton. "It is an inherited defect of your pores."
|
If both of your parents had acne, three out of four of your brothers and sisters will get it, too. But if your sister is pimple-free while your face is a war zone, be aware that other factors can aggravate an acne outbreak. "Stress, sun exposure, seasonal changes, and climate can precipitate an acne attack," says Dr. Fulton. Certain types of makeup and taking birth control pills can also cause a breakout.
"Working women are especially vulnerable," adds Dr. Fulton. "They're prone to lots of stress, plus they tend to wear makeup a lot."
So here's some blemish-free advice, keeping in mind those who need it the most.
Change your makeup. In adult women, makeup is the major factor in acne outbreaks. "Oil-based makeup is the problem," says Dr. Fulton. "The pigments in foundation makeups, rouges, cleansing creams, or night moisturizers aren't the problem, and neither is the water in the products. It's just the oil. The oil is usually a derivative of fatty acids that are more potent than your own fatty acids. Use a non-oil-based makeup if you are prone to acne."
|
Read the labels. Cosmetic products that contain lanolins, isopropyl myristate, sodium lauryl sulfate, laureth-4, and D & C red dyes should also be avoided. Like oil, these ingredients are too rich for the skin.
Rinse that rouge. "Wash your makeup off thoroughly every night," says Dr. Fulton. "Use a mild soap twice a day and make sure you rinse the soap entirely off your face. Rinsing six or seven times with fresh water should do it."
|
|
Go for the natural look. "Whatever makeup you use, the less you use of it, the better," says Dr. Fulton.
Blame it on the Pill. Research conducted by Dr. Fulton indicates that certain birth control pills such as Ovral, Loestrin, Norlestrin, and Norinyl can aggravate acne. If you're on the Pill and have acne problem, discuss it with your doctor. He may be able to switch you to another pill or prescribe another birth control method.
Leave well enough alone. "You shouldn't squeeze pimples or whiteheads," says Dr. Pochi. "A pimple is an inflammation, and you could add to the inflammation by squeezing it. You may cause an infection." You can't do anything to a pimple to make it go away faster, he notes. "Normally a pimple will last from one to four weeks, but it will always go away."
A whitehead is a noninflamed plugged pore, notes Dr. Pochi. "The core of a whitehead is much smaller than the core of a blackhead. When you squeeze the whitehead, the wall of the pore could break and the contents could leak out into the skin and cause a pimple. A pimple naturally forms from the rupture of a whitehead pore wall."
Know when to squeeze. Although most pimples are best left alone, there is one kind that you can squeeze to help get rid of it. "Sometimes a pimple will have a little central yellow pus head in it," explains Dr. Pochi. "Gentle squeezing usually pops these open very nicely. Once the pus is out, the pimple will heal more quickly."
Attack blackheads. You can also get rid of a blackhead by squeezing it. "A blackhead is a very blocked pore. The material inside the blocked pore is solid, and the surface of the pore is widened," explains Dr. Pochi. The black part of a blackhead is not dirt. In fact, dermatologists aren't really sure what it is, but whatever it is, it will not result in a pimple.
Use OTCs to KO acne. You can fight back an acne attack with over-the-counter products. "Use OTCs with benzoyl peroxide in them," says Dr. Fulton. "The benzoyl part pulls the peroxide into the pore and releases oxygen that kills the bacteria that aggravates acne. It's like two drugs in one. The benzoyl also suppresses the fatty acid cells that irritate the pores."
OTC acne products come in various forms, such as gels, liquids, lotions, or creams. Dr. Fulton suggests using a water-based gel. It is the least likely to irritate the skin.
He also suggests using it for an hour or so in the evening, then washing it off very thoroughly at bedtime, especially in the areas around the eyes and neck.
Don't be fooled by the numbers. Acne medications contain concentrations of benzoyl peroxide ranging from 2.5 percent to around 10 percent. The percentage, however, has little to do with the product's effectiveness. "In most tests that have been conducted, the lower-strength products were as effective as the upper-strength ones," says Thomas Gossel, Ph.D., R.Ph., a professor of pharmacology and toxicology at Ohio Northern University. "Five percent works as well as 10 percent."
Give dry skin extra care. Dry skin can be sensitive to benzoyl peroxide, so Dr. Gossel recommends you start with a lower-strength product first, then increase the concentration slowly. "You're going to get reddening of the skin when you put it on, but that is a normal reaction," he says.
Stay out of the sun. Acne medications may cause adverse reactions to the sun. "Minimize exposure to sunlight, infrared heat lamps, and sunscreens until you know how you will react," cautions Dr. Gossel, who advises a patch test for sunscreen sensitivity.
Scrub that skin. "Cleanse your skin thoroughly every time before applying any over-the-counter acne medication," says Dr. Gossel. A clean face is a happy face.
Use one treatment at a time. Don't mix treatments. If you are using an OTC acne product, you should stop using it if you are given prescription medication for your acne. "Benzoyl peroxide is a close cousin to Retin-A and other products containing vitamin A derivatives, such as Accutane," says Dr. Gossel. A person shouldn't use both of them together.
Stop the spread of acne. Apply acne medication about a half inch around the affected area, says Dr. Fulton, to help keep the acne from spreading. "The medication really doesn't fight the pimple you already have," he explains. "It acts more like a pimple preventive." Acne moves across the face from the nose out to the ear. You need to treat beyond the red inflammatory area. "When you buy an OTC product, it says to apply it to the affected area. To most people the affected area is where they see the pimples. But that's not the case at all."
James E. Fulton, Jr., M.D., Ph.D., is a dermatologist and founder of the Acne Research Institute in Newport Beach, California. He is also coauthor of Dr. Fulton's Step-by-Step Program for Clearing Acne and codiscoverer of Retin-A (synthetic vitamin A), a prescription drug used to treat a variety of skin problems.
Thomas Gossel, Ph.D., R.Ph., is a professor of pharmacology and toxicology at Ohio Northern University in Ada and chairman of the university's Department of Pharmacology and Biomedical Sciences. He is an expert on over-the-counter products.
Peter E. Pochi, M.D., is a professor of dermatology at Boston University School of Medicine in Massachusetts.
Maurice Stein is a cosmetologist and Hollywood makeup artist. He is the owner of Cinema Secrets, a theatrical makeup house in Burbank, California.