Dear Paula,
I would love to see an article or suggestions on problem-solving for people dealing with wrinkles and acne. I know you have written about them separately, but what about those of us who have adult breakouts plus worries about wrinkles? What do we do? Help!

Carmen, via email

Dear Carmen,
Many forty- and fifty-something women, including those with minimal to no history of acne, find themselves dealing with wrinkles and breakouts at the same time. We know that wrinkles are the cumulative result of unprotected sun exposure (extrinsic) and internal factors tied to aging (intrinsic), but what kind of cruel joke is Mother Nature playing when she deals our skin the double-whammy of wrinkles and acne?

Adult breakouts, particularly for women, are generally tied to one of two sources: hormones or the overuse of products that are too emollient for their skin type. If you have fallen for the wide-spread claim that an aging face is a “mature” skin type and therefore needs a range of rich, ultra-moisturizing products, you may have set your skin up for the breakouts you're experiencing now. If that is not the case and your skin-care routine remains suitable for your overall skin type, you may want to visit your physician to have your hormone levels checked. The role of androgens (male hormones) should be carefully considered, especially if you are entering or have just finished menopause. A surge in androgens can cause acne flares, particularly as estrogen levels drop. Your physician will discuss treatment options to help balance hormones, which should reduce (if not eliminate) breakouts.

As for how to treat blemishes and wrinkles, my previous advice for both still applies. Blemishes must be treated with a gentle, water-soluble cleanser, a topical disinfectant (a gentle benzoyl peroxide product), a beta hydroxy acid exfoliant (BHA/salicylic acid), and by avoiding products that are thick, greasy, or occlusive. For fighting wrinkling, I recommend lightweight toners, serums, or very thin lotions loaded with antioxidants, cell-communicating ingredients, and ingredients that mimic the structure of healthy skin to help improve the skin's condition and reduce the appearance of wrinkles.

Don't forget that your greatest anti-wrinkle ally remains an effective sunscreen rated SPF 15 or higher, and that it must be applied every day, rain or shine. Use a lightweight sunscreen to avoid exacerbating blemish-prone areas; you'll get the best results using a matte-finish foundation with an effective sunscreen.

Another option to address wrinkles and blemishes is the active ingredient tretinoin, found in prescription products such as Renova, Tazorac, and Retin-A. Tretinoin not only has the ability to stimulate collagen production (which reduces wrinkles), but also affects the way new skin cells are formed, travel through the pore's follicle lining, and are shed. Reconfiguring this process so it functions in a more normal manner unclogs pores and often has a significant impact on preventing new breakouts from occurring (Source: Journal of the European Academy of Dermatology, December 2001, page 43). Note that if you decide to use a tretinoin product, it cannot be applied with benzoyl peroxide because the latter inactivates tretinoin. Use the benzoyl peroxide over blemishes in the morning, and apply the tretinoin product at night. For detailed battle plans that address wrinkles and blemishes, please visit

Source: Paula Begoun