Pimples at my age?

One hopes that with the passing of adolescence, we also can leave behind acne and the heartache it can cause. But this isn't the case for many women.

Anyone can get an occasional breakout, especially around menstruation time in women. But for an increasing number of people, one pimple turns into 10, then 20 - and soon there's a full outbreak, which may also be appearing on the back and chest.

"Adult acne seems to be on the increase," says Yardley, Pa.-based dermatologist/clinical psychologist Richard Fried, M.D., Ph.D. "It's not quite clear what is causing it, but certainly stress and hormones are playing a large part.

Acne is caused by bacteria called P. acnes. If conditions in the pores are right, these bacteria can cause infection and inflammation, resulting in acne.

For those who do have acne, Dr. Fried cautions that adult skin may be less forgiving than it was during the teen years.

"If you're seeing scarring and pitting as a result of your bouts with acne, don't wait. See a dermatologist to help you get it under control before it can cause lasting damage to your skin," he says.

Those experiencing mild outbreaks may want to try some over-the-counter preparations. Dr. Fried recommends washing twice daily with a skin cleanser that contains benzoyl peroxide or glycolic acid.

Spot treatment of mild acne breakouts with acne-fighting gels from companies such as Neutrogena and Clearasil can be beneficial.

Pay attention to the areas where breakouts typically occur, Dr. Fried cautions. Headbands worn while exercising will trap sweat and bacteria and may lead to acne on the forehead. He also recommends examining the back for evidence of acne triggered by lying on a workout bench at the gym.

TIME TO SEEK HELP If acne is moderate to severe, it's time to see a dermatologist.

Much can be done to treat outbreaks and diminish their severity. Dermatologists routinely use an arsenal of topical prescription creams such as Differin, Retin-A, Tazorac, Duac and Benzyclin, often in conjunction with oral antibiotics such as doxycycline and clindamycin, to help calm acne flares.

Hormone therapies are also available, but are not as exciting as a relative newcomer to the acne treatment scene - photodynamic therapy.

Photodynamic therapy involves activating a topical photosensitizing agent, called Levulan, with a "BLU-U Light" or an intense pulsed light that helps the topical penetrate into pores, eradicating the bacteria responsible for the acne.

Many dermatologists are excited about the results obtained with photodynamic therapy, as they don't have to worry about antibiotic resistance producing unwanted hormonal changes, Dr. Fried says. This therapy also helps to retexturize the skin, reduce oiliness and eliminate fine lines.

"There is a lot to commend (with) this form of acne treatment," Dr. Fried says.

Sometimes acne does persist, even into one's 50s, but the medical field is keeping up. And be sure that it is acne. Check in with your dermatologist.

"You need to ascertain that what you're looking at is really acne," Dr. Fried explains.

"It can also be rosacea, which looks almost identical, but its cause is completely different, and so is its treatment."

If it turns out that your red bumps and pimples are, indeed, rosacea, the Food and Drug Administration recently approved a new oral medication called oracea to address that. It specifically targets pimples that resemble acne.

Other products include the Sothys basic care for oily skin product line; Biologique Recherche's P50 Lotion and Masque Vivant, to clean out pores; Valeant Kinerase Clear Skin Collection; Luzern Laboratories Serum Control Absolut; low irritation benzoyl peroxide NeoBenz Micro by SkinMedica; and Trienelle Skincare's AcneRecovery System, with treatment individualized to the patient.