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May 31, 2011 2:47 PM   Subscribe

How long should I give my new acne treatment?

I have always had slightly oily, acne-prone skin; I was on oral antibiotics for several years as a teenager, but not since I was 18 or so (I'm now 24). Since going off, I get the occasional zit, but nothing that has bothered me enough to seek treatment.

I'm living in a humid, hot climate, and seem to be breaking out a bit more. I went to the dermatologist for a breakout along my cheek, which I thought had left a scar (the derm said she thinks it's just a red mark). She prescribed me 10 days of doxycycline, a pH balanced face wash that is supposed to control the oil on my face, and what I assume is an oil-free moisturizer. She told me to wash 2x daily.

I've only been doing this for five days, but I seem to be breaking out more! I'm getting deep, painful pimples where I rarely or never do-- like my forehead and chin. I'm not terribly broken out, but it's definitely not any better.

My question is: How long should I keep trying this for before throwing in the towel? I have heard that sometimes a new treatment 'purges' your skin by bringing all the acne to the surface, but I'm not sure if that's a myth and sounds rather improbable to me. I've also heard that if you over-dry your skin, it will produce even more oil. My skin doesn't feel oily during the day.

Bonus: How do I get rid of all these annoying red marks?

Thanks in advance!
posted by queens86 to Health & Fitness (22 answers total) 4 users marked this as a favorite
 
I've also been breaking out much more than usual lately. To control the redness, I'm planning on trying an aspirin/honey mask tonight. The aspirin apparently reduces swelling/redness and the honey moisturizes. It's something I first heard of at MeFi.

As far as the medication, I started using an over the counter system and didn't see great results until probably 30 days after initial use. It didn't work after a week, but I also don't remember getting more/painful zits in the interim.

I've also been wondering if my face wash is still effective, since my face is so broken out right now. I don't know if your skin "gets used" to things or whatever...
posted by amodelcitizen at 2:56 PM on May 31, 2011


Call the doctor and ask her if you should continue the treatment.
posted by bq at 2:57 PM on May 31, 2011 [1 favorite]


You should try any acne treatment for two months, unless you've been told that it will take longer. If you're not seeing any improvement after that, it's probably not going to help you.

Having said that, you must always always finish every course of antibiotics right to the end, regardless.

BCP is a more interesting case - you'll be told that it "can" take "up to" three months before you see an improvement, but what no-one will tell you is that actually it can take up to nine months. Which it can and did, in my case. But I did see a dramatic improvement in oiliness within literally hours, so even then there was some measure of improvement within the two-month period.

You also have to think carefully about what "improvement" means. In my case, the vast majority of treatments didn't have any effect at all, so if I saw a 5% improvement, that was really dramatic and a sign that the treatment was worth continuing until I found something better. It was a matter of finding the right combination of treatments.

The idea that any new treatment "brings the impurities to the surface" is complete rubbish. If your acne appears to be getting worse, it's because it's getting worse. This wasn't necessarily caused by the treatment, though.
posted by tel3path at 3:00 PM on May 31, 2011


Please don't apply aspirin to your skin, you will burn it.

Aspirin contains salicylic acid, and any wash that contains 2% salicylic acid will be therapeutic. The most readily available brands are Neutrogena and Garnier. I use Garnier because Neutrogena still leaves me with breakouts whereas Garnier doesn't. Response to skincare products is idiosyncratic so YMMV.

Splash it on your face, wait two minutes, then fill a basin with lukewarm water (not hot or cold) and rinse with at least 20 splashes. Pat (don't rub) dry with a towel. Do this morning and evening.

But if you aren't already using a salicylic acid wash I'd hold off until you've given your present regime a go. You don't want to get confused about which parts are working and which are not.
posted by tel3path at 3:03 PM on May 31, 2011


And honey will clog your pores. No honey on acne skin please.
posted by tel3path at 3:04 PM on May 31, 2011


Every acne treatment I've ever tried over the years, from stuff recommended by dermatologists to regimens from facialists to stuff I've tried from magazines or other articles has always, always, always made my skin slightly worse before it got better. I think it's pretty normal.

If you are concerned, certainly ask your doctor.
posted by pupstocks at 3:07 PM on May 31, 2011


I have acne prone skin. I'm 38 and have been dealing with my acne for 25 years. I have read about the "purging" theory and I have heard the, "it's going to get worse before it gets better" theory. These may be somewhat true but I would only expect to see the "purging" last for a few days. The antibiotics should not cause "purging" and the cleanser shouldn't either. The only products I have heard that cause "acne to come to surface" are retinoids and AHA. If you are noticing new lesions, I wouldn't blame that on purging. The antibiotic should not cause new pimples or purging and the cleanser is probably fine. I'm not an expert but the your new deep and painful lesions sound hormonal.

What is your oil-free moisturizer that she prescribed? What does it say on the bottle?

I expect products to improve my acne quickly, or at least see some noticeable improvement. I know there is stuff out there that that works almost overnight. You shouldn't have to wait long to see results. Here are some that I swear by and you might want to try in the future:

Pan Oxyl Bar 5% or 10% You can find this bar in most drugstores like CVS, Walgreens, and most Walmart stores carry it. Look on the bottom shelf in the skincare section.

If you want to use a moisturizer/sunblock look into Purpose moisturizer by Johnson and Johnson. I use the redness reducing one. The combination of the PanOxyl bar with the Purpose moisturizer was recommended in the book, The Skin Type Solution. The author of this book also recommends putting a thin layer of salicylic acid acne gel over the affected areas after cleansing with PanOxyl and before applying the Purpose.

I think Proactiv works great. I especially love the cleanser and the skin clearing lotion. The stuff works.

Another product I would not be without is Wrinkle Revenge 1 and Wrinkle Revenge 2 by DERMAdoctor. Both are exfoliating cleansers. They do not foam and they do not contain granules. It's not a "scrub" in the traditional sense. The exfoliator is the glycolic acid. I put this cleanser on and let it sit for 5 minutes or so and rinse off. It makes my skin clear, even, glowy, and prevents breakouts. I cannot recommend this stuff enough. If you're interested in trying this product, begin with the Wrinkle Revenge 1. The bottle lasts forever. When you are done, you can graduate to Wrinkle Revenge 2. It's just not for wrinkles. I use it for acne management, fade sun damage, and to improve tone.
posted by Fairchild at 3:41 PM on May 31, 2011 [8 favorites]


I'm not understanding why I shouldn't use aspirin. If it's because it has salicylic acid, why would I use a salicylic acid wash instead? Is there more salicylic acid in aspirin?
posted by amodelcitizen at 3:44 PM on May 31, 2011


If you were to follow the popular advice to crush an aspirin tablet and use it as a poultice on a pimple, you could easily burn a hole in your skin.

Maybe you'd dilute the aspirin a lot more, in which case, it would be difficult getting the 2% mix exactly right within the exact right quality of suspension to be of any use to you. It makes more sense to wash your face in a facewash formulated for the purpose.
posted by tel3path at 3:48 PM on May 31, 2011


Oh and "is there more salicylic acid in aspirin" - yes, aspirin is salicylic acid.
posted by tel3path at 3:50 PM on May 31, 2011


This may be a little off because the ingredients are in Spanish, but the moisturizer lists water, honey, phospholipids, sphingolipids (?), hyaluronic acid and a couple other ingredients. The cleanser is 2% salicylic acid, sodium laureth sulfate, and a bunch of other stuff.

Prior to this I just washed off my makeup every night with Pond's, which the derm said was probably making my acne worse. I have never in my life used a cleanser for acne-prone skin, since it cleared up completely with antibiotics before. Maybe my skin just isn't used to all these new ingredients being slathered all over it...?

Thanks for the advice so far, I think I'll keep going with it for at least another week or two since it was expensive... and call my derm and ask. What's good for red marks? Vit E?

Thanks again for the help :)
posted by queens86 at 4:04 PM on May 31, 2011


Please don't apply aspirin to your skin, you will burn it.

Um, there are thousands of proponents of the Aspirin Mask. I am one of them. Never burned my skin. Ever.
posted by notjustfoxybrown at 4:24 PM on May 31, 2011 [1 favorite]


I, too, have never burned my skin using the Aspirin Mask.
posted by ThePinkSuperhero at 4:30 PM on May 31, 2011 [2 favorites]


I find red marks fade with time. Use a moisturizer or makeup with SPF, that doesn't clog pores, to prevent marks from darkening.
posted by Fairchild at 4:49 PM on May 31, 2011


It took six months for my acne medication to work. My skin slowly slowly slowly improved, but now I have no spots at all.
posted by elsietheeel at 5:41 PM on May 31, 2011


Aspirin is acetylsalicylic acid. Some similar properties but not the same.
posted by needs more cowbell at 5:52 PM on May 31, 2011


Definitely finish the full regimen prescribed by your dermatologist (though I do think it may be worth a call to let the derm know what's going on and make sure she agrees you should complete the regimen). It was only for ten days, right? But what is the plan after that, or does the dermatologist think the acne will go away after using this product? In my experience it generally takes a couple of months for treatments to clear up the acne, and then you have to continue the regimen after that or else the acne will return (this is in regards to topical treatments; I have had luck with Rodan&Fields Unblemish -- this is the same company that makes Proactiv). At any rate, check with your dermatologist for ongoing product/ingredient recommendations for after you are done with the current treatment.

Also, just a note, some people are sensitive to sodium laureth sulfate, and it actually makes them break out.
posted by JenMarie at 6:10 PM on May 31, 2011 [1 favorite]


My son has had really remarkable results from cutting milk out of his diet. He was on an antibiotic for several months, finished the last course of it and just didn't want to be on medication anymore. Over time, his acne worsened and mostly on a lark, we decided to try eliminating dairy products from his diet. At first it was only milk (and he was a HUGE milk drinker), his skin responded so quickly that after a month, he decided to go whole hog and cut out cheese and yogurt too. He still has outbreaks of what I think of as topical acne, but his deep cystic stuff is almost entirely gone.
posted by jvilter at 7:04 PM on May 31, 2011


About the deep, painful pimples: my doctor has always told me those ones are likely to be triggered hormonally, and unlikely to be caused by a topical application like makeup, a cleanser, or a moisturizer. The message I got was deep, painful lesions are caused "from the inside out," and not from some exterior irritant.

I can't shed any light on whether the antibiotic is playing a role, though. On the one hand, you are taking it internally, making it systemic (ie on the "inside"), and yet (as a layperson/not a doctor) I've never heard of antibiotics making acne *worse.*

I can offer, however, that sometimes a dermatologist will agree on short notice to see a patient with an occasional and particularly offensive "deep acne" lesion, and inject it with a little cortisone, which will make it go away very quickly (around 12-24 hours later). (Guess how I know?)
posted by celilo at 9:45 PM on May 31, 2011


You know... you have fairly mild acne.

Keep hydrated, get enough sleep, de-stress.

You're young and have "typical" acne, not "omg FML half my face is exploding in a half-litre of ichor" acne. I know lots of people from 20-to-30 who have mild red spots (which go away) and maybe some whiteheads and some people with "zits". I have horrible acne and I'm starting my bloody 30's.

I bet you my skin for yours if this doesn't improve your complexion - take a week off, lower your stress to ZERO, stay hydrated, don't get drunk (too much), and just be happy. (and don't smoke)

Your face will clear up.

(The Science! is Th1 vs Th2 adaptive immune response; stress and cortisols really really encourage Th1 - pro-inflammatory. Th2 is more modulatory and mobilizes phagocytes that physically remove microbes.)
posted by porpoise at 9:57 PM on May 31, 2011


You can get rid of the red marks with Retin-A (tretinoin cream) and glycolic acid products. Ask your derm about Retin-A. I went to an aesthetician who recently evaluted oily, mildly acne prone (all my life, like you) skin. The Glytone (cream wash and lotion) has really improved the effectiveness of the Retin-A for me, and the products are working to slough off the layers of skin with residual acne red marks. If your current regimen doesn't work for you, I encourage you to look into what I'm doing. I've struggled with acne my whole life, and my skin is finally looking clear and even "glowy." You should see improve within 3 weeks in my experience. 2nd whoever said the purging should only last a week or so.
posted by sunnychef88 at 10:30 PM on May 31, 2011 [2 favorites]


Thanks guys! This has given me lots of stuff to try if my current stuff doesn't work out.

You're right, my acne is fairly mild, but it was more the possibility of scarring which freaked me out... especially since I remember a derm telling me as a teen that even though my acne wasn't severe, it was the 'scarring type.' I'd like to avoid that if I can.
posted by queens86 at 3:45 AM on June 1, 2011


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