Zits and wrinkles?!

Just as the Botox starts wearing off on your forehead and the wrinkles return, you also notice you've broken out in three huge zits on your face.  Wrinkles and acne?  Weren't you supposed to outgrow those pimples?  What gives?

The fact remains that age has little to do with it.  A lot of factors are involved in acne.  One of the key players in women is hormones.  Maybe you've noticed you tend to flare right before your menstual cycle starts, and then pimples clear once it's over.  Levels of androgens, a type of hormone, fluctuate during the month.  They stimulate the sebaceous glands in our skin to produce excess oil and sebum, which contribute to the formation of blocked pores and pimples.  Some women also experience irregular menstrual cycles, hirsutism (excess hair growth), and weight gain in addition to acne.  Such symptoms may be due to a condition called PCOS, or polycystic ovarian syndrome.  This diagnosis can be made by your dermatologist or ob/gyn by checking blood tests, and sometimes an ultrasound.

There are treatments available to help decrease levels of androgens and regulate menstrual cycles, which can often help improve acne.  Oral contraceptive pills (birth control) and an anti-androgen medication called spironolactone are often used.  Oral antibiotics, and prescription topical medications: antibiotics, benzoyl peroxide, and retinoids can dramatically improve skin.  Finally, accutane is a very effective medication for severe acne that does not respond to other treatments.

What about diet and acne?  There's been a lot of discussion about dairy, sugar, and chocolate, and their effects on acne.  Although there is nothing conclusive, and more studies are needed, it makes sense that certain foods that can increase inflammation in the body.  The "white" foods: white sugar, white rice, white bread, potatos, etc are nutritionally empty foods and raise sugar and insulin levels, leading to increased inflammation, which may be harmful to cell health.  Eating a balanced diet rich in whole grains, vegetables, and fruit, with a limited amount of animal fats and sugary foods, is a good idea in general.  Foods rich in antioxidants, like berries, oranges, pomegranates, salmon, dark chocolate, red grapes, and greens help keep the skin looking healthy.  So while dairy is an important source of vitamin D and calcium for women, lowfat greek yogurt is a better choice an a vanilla milkshake (sorry!).

Makeup and products can often be the culprit in breakouts, as well.  Look for makeup that is labeled "noncomedogenic," meaning it won't clog pores.  Oily sheens for hair can often add to breakout along the forehead.  Use mild, gentle cleansers and avoid harsh, abraisive scrubs.

So, there are lots of factors to blame acne on.  Thankfully, there are lot of solutions, too.