A New Wrinkle for DMAE DMAE (2-dimethylaminoethanol) is an ingredient found in skin-care products or that can be taken as an oral supplement. Manufacturers claim it has an anti-aging benefit, yet the research about this benefit is at best sketchy and inconclusive. In essence the only definitive information that assesses DMAE’s potential comes from companies that are selling products containing it. A recent study published in the May 2007 issue of The British Journal of Dermatology has shown contrary evidence that it may actually pose risks for the skin. In vitro tests of the pure substance, as well as creams that contained DMAE, demonstrated a fairly fast and significant increase in protective elements around the skin cell. However, a short time later the researchers observed an important reduction in cell growth and, in some cases, they found it halted cell growth altogether. So while you may initially experience a kind of swelling of the skin because of the expanding effect caused by topical application of DMAE, the long-term results appear to be far from desirable. 
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I have a problem with cystic acne. I only get it monthly right before my period. I am 40 years old. My dermatologist has me using Cetaphil Daily Facial Cleanser for Normal to Oily Skin, Cleocin T Lotion (which is a prescription antibiotic) in the morning and Differin Cream at night (which I use every other night). Can you tell me if there is anything else I should be using or doing? I am getting frustrated. Mary, via e-mail Dear Mary, Cystic acne, whether chronic or intermittent, is one of the most frustrating types of acne lesions to deal with. Not only are cystic acne breakouts painful, but the extent of damage they’re capable of inflicting often goes beyond the reach of topically applied products. What happens in cystic acne is not a pretty picture. It is typically triggered by a surge in hormones, such as occurs during a woman’s menstrual cycle. For some unknown reason, the skin’s oil glands become hypersensitive to this cascade of hormones, and react by overproducing sebum--so much, in fact, that the oil gland itself becomes engorged, swollen, and hardened with the excess. Unable to push the extra oil into the lining of the hair follicle (which leads to the surface of the skin via pores), the gland bursts underneath the skin. This causes acute inflammation and irritation, and leads to the redness and soreness of cystic acne. Because these lesions start so deep in the skin, scarring is an all-too-common side effect. Although I think the products your dermatologist has you using are worthwhile for many degrees of acne, they are probably an unsuitable solution for combating cystic acne, even though yours is a not a daily occurrence. As acne becomes more severe, the options one has for treatment gradually diminish. Many dermatologists regard cystic acne as the most severe type of acne lesion, and, when pressed, admit that treatment options are limited to oral drugs such as Accutane and sulfa-based antibiotics--both bona fide options, but not without some risk. Neither would likely be recommended in a case like yours, where cystic acne ebbs and flows with the monthly cycle. A potential option you may want to pursue with your dermatologist is oral hormone therapy. It’s possible that your cystic acne is tied to an increase in testosterone production during your menstrual cycle. Drugs known as anti-androgens (an example is Cimetidine) are able to block the effects of androgenic hormones. The downside is that these prescription drugs are not without side effects, and as such are generally prescribed in low dosages. The hypertension-taming drug spironolactone (brand name: Aldactone) also has anti-androgen effects and is yet another hormone-balancing possibility to discuss with your dermatologist. However, the trade-off of long-term use (required with hormone blockers) may not be worth the relief from intermittent cystic acne. Conversely, you could also consider estrogen therapy if tests determine that there is an imbalance in your body’s levels of testosterone and estrogen. In the meantime, I advise you to keep your skin-care routine as simple as possible, and avoid the use of overly heavy, thick moisturizers in the areas where cystic acne occurs. The cleanser you’re using is a fine option; but make sure you are using an effective sunscreen during the day (possibly a foundation with an effective SPF and moisturizing only those areas of your face that are dry). It is difficult to suggest the use of standard topical anti-blemish treatments if cystic acne is exclusively what you’re dealing with. However, regular exfoliation with a salicylic acid (BHA)–based product will keep debris from building up in the hair follicle (pore) lining, which will provide a clear pathway that gives swollen oil glands a better chance of expelling excess oil into the pore lining rather than beneath the surface of the skin.
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