How to Treat Adult Acne and Wrinkles

It seems like some cruel karmic joke: You’re old enough for anti-aging products, but you’ve got the spotty blemishes of a teen. Here’s how to help doubly stressed skin stay centered.

  • Gina Way

Really? Acne and wrinkles at the same time? Really? Alas, some of the changes that occur as skin ages can actually make it more prone to breakouts. As cell turnover slows, dead skin cells build up and can get trapped in pores. And “once women see their first lines, they often turn to thick creams with moisturizers that can further clog pores, like shea butter or coconut oil,” says Noëlle Sherber, a dermatologist in Washington, D.C.

“They also tend to use cream-based makeup because they find that it doesn’t accentuate the look of wrinkles the way that powder makeup can. But the heavier silicones in creamy cosmetics can end up blocking pores, too,” says Sherber. The result? A vicious circle. Subsequent attempts to “fix” the acne only exacerbate the situation. “Over-scrubbing the skin, picking at it, or drying it out with acne-fighting products can impair its barrier function and make it more susceptible to irritation and breakouts,” says Ellen Marmur, a dermatologist in New York City. “That inflammation may also break down collagen and eventually lead to more wrinkles.” Hormonal shifts play a role as well. Age-related fluctuations in both estrogen and testosterone can activate the sebaceous glands to produce more oil. And spikes in cortisol (a.k.a. the stress hormone) can lead to not only excess sebum but also collagen degradation.

The Simplest Strategy

A mild cleanser and a moisturizer provide the foundation for any smart adult-acne and anti-aging regimen. The daily use of an acne wash may overdry skin, which could trigger more oil secretion and pimples, as well as leaving skin feeling tight. Instead, supplement a mild cleanser with a 2 percent salicylic acid spot treatment where needed to treat flare-ups without irritation, says Jessica Wu, a Los Angeles—based dermatologist. (Try Clean & Clear Advantage Acne Spot Treatment; $6.50 at drugstore.) As for moisturizers, “most complexions, even those with blemishes, tend to become drier and more sensitive with age,” says Leslie Baumann, a dermatologist in Miami. “So choose creams labeled ‘noncomedogenic,’ which soothe skin without clogging pores.” Look for ingredients such as ceramides to restore the lipid barrier, which holds moisture in skin, or anti-inflammatories, like niacinamide, to calm skin. (A couple to try: Olay Total Effects Revitalizing Foaming Cleanser, $9 at drugstores; and Elizabeth Arden Ceramide Lift and Firm Day Lotion SPF 30, $72, elizabetharden.com. If you like the feel of something richer at night, try CeraVe Facial Moisturizing Lotion PM; $14 at drugstores.)

In addition, you may want to try a retinoid, such as tretinoin, a vitamin A derivative that’s also known as all-trans-retinoic acid. It was discovered about 50 years ago for use as an acne treatment because of its exfoliating properties and ability to unclog pores. Decades later, scientists discovered that it also stimulates the production of collagen, which can firm skin. Because this prescription-strength retinoid can sting, Baumann recommends starting with a gentler over-the-counter retinoid (like SkinCeuticals Retinol 1.0; $63, skinceuticals.com). Apply in the evening only, in place of your regular moisturizer. For those with super-sensitive complexions, glycolic acid can be a less drying and less irritating alternative to retinoids, says Sherber. She suggests using a glycolic acid cleanser several times a week, leaving it on for at least a minute, and then removing it by buffing gently with a damp washcloth. (Try MD Formulations Facial Cleanser; $32, bareescentuals.com.)

For Extra Help

These at-home strategies should leave you with a clearer and smoother complexion in four to six weeks. But if your acne hasn’t diminished, visit your dermatologist, who may step up treatment with topical or oral prescription medications, such as antibiotics (which help reduce inflammation), contraceptives (which regulate hormones), or spironolactone (a pill that can help diminish oil production). For stubborn fine lines, she may bump you up to a prescription-strength retinoid.

And if you’re in desperate need of a better complexion fast, “an in-office chemical peel [about $300] improves both acne and wrinkles for up to a month or more,” says Wu. For results that last several months, you might try a series of IPL (intense pulsed light) treatments (about $500 a session; you may need three or more). These treatments even out skin tone, lessen fine lines, shrink pores, and reduce oil.