The Best New Prescription Skin Treatments

If you haven't visited a dermatologist lately (or ever!), you're missing out on the highest grade of skin treatments available. Though many women are reluctant to visit a doctor for cosmetic reasons, San Antonio dermatologist Vivian Bucay (www.drvivianbucay.com) says vanity isn't the reason patients come in: "Acne - regardless of severity - has a significant impact on one's self-esteem and, therefore, it affects an individual's performance whether in school or in the workforce."

Since one third of women over 30 suffer from some degree of acne, pharmaceutical companies have developed many products you may have never heard of. And not only can doctors write a prescription for the most effective treatment, their expertise allows them to choose the specific medicine that will work in harmony with your skin type. "I take many things into consideration," Dr. Bucay explains. "Any underlying medical conditions such as polycystic ovarian syndrome or another hormonal problem, skin type, fair vs. darker skin tones, oily vs. dry, sensitive vs. normal, and lifestyle habits including exercise, sun exposure, and the amount of time a woman can dedicate to a skin care regimen."

Most insurance providers cover the cost of a yearly or biannual dermatologist appointment to check skin as part of an overall preventive health program. Maximize this visit by asking your doctor about the latest and greatest products below. Many are covered by health plans, and the ones that aren't are worth every out-of-pocket penny. Ask your doctor for samples and discounts if your insurance isn't willing to foot the bill.

For a physician search, google your state's directory of board-certified dermatologists and find out if they accept your insurance provider or ask your family doctor to recommend someone she knows.

Here are some products you may want to inquire about during an office visit:

For Rosacea

Noritate (metronidazole) - Topical cream used to treat both acne and rosacea, believed to work by killing bacteria beneath the skin's surface. "Patients with rosacea - chronic redness with or without pimples - must be approached with caution because their skin can be very irritated by these kinds of products," explains Dr. Bucay. "I either recommend a metronidazole cream, such as Noritate, which works well for dry skin, or something like Finacea gel, which contains azelaic acid, which is tolerated by rosacea patients with oily skin." About $50 after coverage (tube lasts about 6 months). For Acne

Tazorac (tazarotene) - Topical cream used to treat acne. It appears to help acne partly by keeping pores clear. Dr. Bucay weighs in: "Retinoids like Retin A and Tazorac increase cell renewal to make skin appear fresher. Another benefit is that these products treat both acne and photodamage." At $125 per tube (tube lasts 3-6 months), Tazorac is the most expensive of the bunch. Less costly alternatives like ROC or Neutrogena Anti-Wrinkle cream contain smaller doses of retinol and are available without a prescription.

Pandel (hydrocortisone probutate) - Steroid cream that dries up zits while it soothes inflammation. $35 per tube (tube lasts up to one year)

Duac - Topical spot treatment that contains an antibiotic (clindamycin) and 5% benzoyl peroxide. Can be very drying (use in combination with Mimyx - see above) but skin does adapt after a month or so. $10 after insurance

Minocycline - This oral antibiotic taken once daily (gradually decrease to once every other day) controls breakouts and acne by killing bacteria in your system. Acne sufferer Jenna Britt of San Antonio says this course proved the most effective. "I was breaking out even with topicals," she remembers, "until we added a oral antibiotic. Now my skin looks great." Ask you doctor about possible side effects. Generic - $10

MimyX - recently FDA approved to treat eczema, this nonsteroidal cream contains no emulsifiers, perfumes or dyes. Layer it over acne creams to combat drying; it works by mimicking the skin's barrier and hydrates without causing zits. $40 after coverage (tube lasts up to one year)

It's worth remembering that acne responds best to a combination of products; one cream alone may not be the miracle you've been waiting for. But used together, these products are a godsend for acne sufferers. You can even prevent a big day from being ruined by an unexpected eruption. "For emergency treatment of a pimple," says Dr. Bucay, "I instruct patients to mix a bit of Duac, Tazorac, and a mild hydrocortisone cream (Pandel) and apply a dab of the mixture to the trouble spot. It works quickly!" Hyperpigmentation

If your skin is discolored from healed acne lesions, called "postinflammatory hyperpigmentation", try some of the new prescription skin lighteners to even out your complexion.

Aclaro (hydroquinone USP 4%) - Use this melanin blocking cream twice daily to fade scars or sunspots. Epiquin, Micro, or Lustra are also recommended. OTC Products

Neutrogena Ultra Sheer Sunblock SPF 30 - Use as a moisturizer/sun protector for combination skin.

Cetaphil - The mild cleanser recommended for all skin types and ages is a classic.

Aveeno Positively Radiant Daily Moisturizer - An oil free soy complex that hydrates with SPF 15

Elta - The gold standard in sun protection, this thick cream is a broad-spectrum sun blocker. "My favorite sunblock is Elta because it contains high levels of micronized zinc oxide, which blocks both UVA and UVB rays. It also happens to be oil-free, and wears very well under make-up," raves Dr. Bucay. Available online or at your derm's office.

OC8 - This clear gel mattifier lasts 8 hours, like wearing invisible foundation. Buy it without a prescription at your derm's office or visit www.oc8.com Won't dry you out yet controls shine.

For the best absorption of these products and enhanced results, exfoliate twice a week. L'Oreal, Olay, and Neutrogena all offer affordable microdermabrasion/peel kits for home use.

But what about the latest advertising blitz, peptides? Do drugstore brands really deliver? "The skin care market has been flooded by products containing peptides," responds Dr. Bucay. "As we age, our ability to produce collagen declines, and this is where peptides and growth factors can help. The Olay Regenerist line of products and the StriVectin family of products contain the same active peptide, although each brand has its own 'secret mix'."

Not all of us can drop a few hundred dollars on the right mix of prescription medicines, though. What one product would you recommend for someone on a limited budget? "That's a tough one," admits Dr., Bucay, "But it would have to be something like Neutrogena Healthy Skin because it contains sun protection, antioxidants, and alphahydroxyacids. Everyone can benefit from a great sunblock to prevent the production of free radicals (unstable oxygen singlets triggered by UV exposure), which set off a chain of events that ultimately causes premature aging and may also lead to skin cancer."

With aisles and aisles of skin care products available at drugstores, supermarkets and discount retailers like Wal-Mart, it may seem like everything invented is already out there. But a whole tier of tested, regulated prescription medicines designed to fight the bacteria that clogs pores and creates acne does exist. It's no longer acceptable to let your self-esteem be plagued by problem skin. Make an appointment to see a dermatologist today, and put your best face forward.