The red menace

October 31, 2005 1:34 PM

I'm 23 and I have more acne than I ever did in high school. This is a general problem, but I've also got a (first) date on Thursday--got any miracles?

I wash my face religiously every morning, and almost every night. In the morning, I follow with Cetaphil oil free moisturizer, which somtimes leaves my face feeling greasy, even though I use a very light hand. I rotate among about 3 different face washes, depending on how my skin feels (it gets quite dry in colder weather)--but maybe that's part of the problem?

I've got regular old zits and lots of blackheads, which often swell up and get red. Most of the "activity" is in my T-zone, but a lot is along my hairline, and some is on my cheeks (closer to my ears than to my nose). The blackheads in particular seem to arise and never go away--whether I pick at them or leave them alone. (I try not pick, really!) I also use a spot treatment (Neutrogena On-The-Spot benzoyl peroxide).

None of this is terribly ugly, but it's definitely gotten worse, perhaps with the stress I've been under lately. I'd love suggestions for routines, as well as miracles I can work between now and Thursday, to clear up the worst of the red. I'd prefer over the counter stuff, but I'll find a dermatologist if necessary.

posted by CiaoMela to health (53 comments total)

Get Oxytetracycline, stop drinking milk for a while. Drink lots of water, sort your sleep cycle out (if you cant sleep, get up, have a hot chocolate and write down all the problems in your head and solutions where you can).

Don't pick at them at all! You're smearing it around.

And if it all falls through at date time, don't worry about it - get on with being a charming and entertaining gentleman with a flirtatious streak. Looks matter less to women than men.

Best of luck!
posted by rc55 at 1:39 PM on October 31, 2005

I've had pretty bad Back acne fro most of my twenties. A couple of months ago I discoverd some homemade soap at the local farmers market. The main ingredient is tea tree oil.

The worst of the acne cleared up in a week. Nothing has worked as successfully as this soap. For what it's worth, I don't have particularly sensitive skin, so this may not work for you, but.... Hey, it might be worth a shot.
posted by lyam at 1:43 PM on October 31, 2005 [1 favorite]

Just see a dermatologist. You'll get it sorted that much more quickly and just be able to get on with things. The things they can get you make a massive difference compared to any over the counter stuff. It won't get anything done in time for your date, but as rc55 says just don't worry about that and use the advice of others here until you can sort out a better and more long-term solution.
posted by edd at 1:53 PM on October 31, 2005

You might want to see a dermatologist or your primary care physician to have your condition evaluated medically. Most acne medications are antibiotics, though a medication called Accutane is an amazing medication for severe acne. However, no med will work by Thursday, and Accutane causes birth defects if taken by pregnant women...
posted by jasper411 at 1:53 PM on October 31, 2005

I second the acutane.

It's rough at first but if you can put up irritation of your skin for a while, the results are more than worth it.

Highly recommended.
posted by dead_ at 1:56 PM on October 31, 2005

Like lyam I'd also really suggest something with tea tree oil or an alternative product to the big brands (noxema, clearasil, etc). My SO recently started working at an outlet that carries a lot of tea-tree oil products and has a strict policy against animal testing and various ingredients (no mineral-oils, etc). At first I thought it was all a marketing angle for hippies but it does make a large difference with my skin. A lot of the standard cleansers have various agents that make your skin "feel clean" after using them, but in reality they whipe the natural ingredients out with the dirt - kicking your skin into oil production mode to compensate.
posted by prostyle at 1:56 PM on October 31, 2005

Looks matter less to women than men.

Not so helpful when the poster is a woman.

If you can't get to a dermatologist in time for your first date, I concur with the get lots of sleep, stop picking at your face call. Actually, try not to touch your face at all (it's damn difficult, but it does keep it a lot less oily). If you have long hair, don't let it fall on your face.

tea-tree oil is great, but more many people it's a little too harsh for the face.
posted by gaspode at 1:58 PM on October 31, 2005

golden bullet ?
posted by JohnR at 2:00 PM on October 31, 2005

Accutane will destroy any and all acne you will ever have. You will never have acne again either. Depending on how bad you are, you'll probably only be on it for like 6 months. You'll get used to the chapped lips over time.
posted by geoff. at 2:02 PM on October 31, 2005

Do you work out? I get spots along my hairline when I'm being a particularly diligent gym-goer, but I can reduce them if I shower or wash my face right away. Just a thought.
posted by jamesonandwater at 2:03 PM on October 31, 2005

For a quick fix, I've had good luck using a treatment with salycilic acid, like Neutrogena's quick-fix stuff. It helps things overnight, literally. Long term, see a dermatologist.
posted by Specklet at 2:05 PM on October 31, 2005

My old treatment (which won't probably be as effective as a doctor approved medicine, obviously) was this (daily):

Step 1: Wash with soap, then dry. (Cleansing)
Step 2: Wipe affected area with isopropyl alcohol, allow to dry. (Astringent)
Step 3: Wipe affected area with 10:1 water to dettol solution, tissue dry. (Antiseptic)

My biggest problem was ending up with infected zits and doing this for even a week really helped clear me up. But my acne wasn't extremely serious, so take that as you will.

This also hurt a hell of a lot less than those horrible salycilic acid solutions, and didn't end up leaving me with horrible looking skin. Helped a couple of friends of mine too. Dettol reccomends using their product to treat acne as well, so I guess it can't be all wrong.
posted by shepd at 2:14 PM on October 31, 2005

OK, to get rid of the big crap by your date, dab the inflamed bits with the benzoyl peroxide solution and smear the rest of your face with a salicylic acid cream. But don't mix them, 'cause I think they deactivate each other, or something.

Once the big ones are "flat", use green makeup to cover up the red spots. No, I'm not kidding. Green helps cancel out the red. Dab it on very lightly, kind of spread it around with your finger to minimize the green tint. I use the Neutrogena SkinClearing Oil-Free Concealer, Correcting Green 06, and it is awesome. If it makes you feel better (it makes me feel better) it has salicylic acid in it, so you can pretend it's acne cream and not actually makeup.

Sleep, good nutrition, working out regularly (and washing up afterwards), and getting enough water are all long-term solutions for getting rid of blackheads, but I don't know of any short-term ones.
posted by schroedinger at 2:14 PM on October 31, 2005

For drying some of your zits out by Thursday, you might want to try applying a mask a couple of times. The one that really works for me is the Queen Helene Mint Julep. It usually shrinks the red spots and dries them out a bit so they're less noticeable. You can probably find it at Walgreens or CVS or someplace like that. If you can't find the Mint Julep, look for other mud masks with clay. (Bonus for using a mud mask is that it usually clears out the blackheads too.)

In the long term, do what everyone else suggested and see a dermatologist.
posted by MsMolly at 2:23 PM on October 31, 2005

For a quick fix, there are cosmetologitianist who offer "acne treatment" facials. I tried it once, my face swelled up the next day, but by the following day there was a dramatically marked improvement compared to pre-treatment. Pricey, though.

Acutane may be great but it is really quite toxic and should be a last-resort kind of treatment.

You don't have to see a dermatologist - your family doctor should be able to prescribe a topical benzoyle peroxide cream with either clindamycin or erythromycin in it. I've been on it for a month & 1/2 now (the $$ medicated stuff at night, the over-the-counter stuff in the morning) and my skins the best it has been since before I *started* getting zits (I had comodes, whiteheads, and the pizza-like nasty ones, and really complicated subdermal buildups).

Also, rotating washcloths and pillowcases frequently can help, as does resisting the urge to touch your face.
posted by PurplePorpoise at 2:37 PM on October 31, 2005

geoff.: Accutane will destroy any and all acne you will ever have. You will never have acne again either.

This (unfortunately!) is false. You can experience relapses (though never as severe as the initial condition) in the months or years following treatment. Another thing that (ro)accutate can do is greatly exacerbate your initial problem in the first months of treatment, before fixing it.

One more thing. IANAD, obviously, but your comments about religiously washing your face are setting off alarm bells for me. You may be irritating your skin. By regularly scrubbing your face like that, you risk encouraging your sebaceous glands to produce more oil than they would otherwise, and otherwise clogging up your pores with dead skin/detritus.

But yeah -- don't take all your advice from anecdotes in AskMe; see a dermatologist.
posted by Sonny Jim at 2:53 PM on October 31, 2005

I haven't tried it so I can't 'recommend' it, but I thought I would mention it in case someone tried it and can vouch for it. One of the recent Cosmo articles (yeah, I know it's not exactly a reliable reference source) suggested using Cortizone cream as an emergency solution to last minute acne problems. Has anyone tried this?
posted by tuxster at 2:54 PM on October 31, 2005

If you can get to a regular doctor right now and ask for a scrip of Erythromycin... that might help by Thursday.

Not "behold the miracle of my unblemished porcelain skin," help tho’. More "hey, my suppurating pustules have diminished to red blotches," sort of help.

Whacking some benzoyl peroxide on the whole thing is a great idea too.

Long term, glycolic products helped clear up a horrible long term case of zits on my chest. Yes... acne on my boobs. Boobne?

Anyway, Retin-A was way to strong for me -- peeling, ow -- but stuff with AHAs in it, recommended by a dermatologist, purchased from a pharmacy, worked well.

Caveat: The zits were *more* red and awful for about a fortnight after started to apply the AHA gel. The dermatologist had warned me about this, so I was expecting it and it was OK. By six weeks, they'd gone completely. Oh, and AHAs make your skin more sensitive to the sun, so I had to stock up on 30+ sunscreen.

Dietwise, drinking buckets of water, and cutting back on instant coffee (Nescafe and the like) cut my chin zits waaaay back. By buckets, I mean 2 x 2 litre jugs over the course of the day. And I swapped to green tea.

Re Accutane - don't take a course lightly. There are some full on side effects. Including, um… suicide. FWIW, the one person I know who's taken it was *seriously* knocked around by it - utterly exhausted and depressed for the entire 6 month course. She was a really high-energy kind o' gal pre-Accutane, so it was quite a dramatic change. Her skin was beautiful afterwards, but even so, she wasn't sure if it had been worth it. YMMV obviously.

Good luck!
posted by t0astie at 2:55 PM on October 31, 2005

I just read something that indicated a lot of the advice/etc dermatologists provide is bunk, and that it's mostly your eating habits that cause acne. Specifically, what you ate two days prior. I can't remember where I saw that.
posted by user92371 at 2:58 PM on October 31, 2005

I also was plagued by acne well into my 20's. As far as what you can do by Thursday, I would recommend not wearing any makeup for the next few days. That helps me a lot. Also, when I have flare ups I start taking an oral antibiotic I have on hand from my doc. I typically see a marked improvement a day or two later. You may be able to call your physician, explain your problem, and have her prescribe somthing over the phone. (One warning is that oral antibiotics can interfere with oral contraceptives - something to keep in mind if you and your date end up hitting it off!)

And not to be snide, but maybe chose a certain type of dating venue to play down the acne? A low light situation such as a movie or candlelit restaurant might make you feel less self-conscious.

But long-term I agree with seeing a dermotologist. I waited until I was 25 and having antibiotics on hand for my occassional flare ups was enough to cure me more or less. I wish I had gone sooner.
posted by peppermint22 at 3:06 PM on October 31, 2005

Nothing to add except to second t0astie's warnings re: Accutane. Some people get chapped lips and dry skin; other people (like myself) end up with noticable scarring around the mouth and a permanently depressed ability to heal small cuts and scrapes. I also experienced near-fatal levels of depression and other emotional instability.

I've heard other, similar horror stories from friends and acquaintances; this thread is the first place I've heard people unreservedly recommending the stuff.

Four years on, I do have practically flawless skin, and my fiancée thinks the split in my lower lip is "sexy." Talk to your doctor -- at length -- before deciding on Accutane.
posted by S.C. at 3:36 PM on October 31, 2005

I've used Retin-A for about seven years, and it's not a quick fix, but it's worth looking into long-term. Also, it will help repair damaged skin. You will have to wear sunblock all the time, though. Retin-A makes you really sensitive to the sun. Also, the little bit of acne that Retin-A left behind was taken care of when I went on a birth-control pill. Long-term, I would try several other solutions before trying Accutane (even if it does end up being right for you).

In the short-term, maybe try to stay off the phone as much as possible. The phone's a good way to spread oil.

And I guarantee that your skin doesn't look as bad as you think it does.
posted by Airhen at 3:52 PM on October 31, 2005

I'm really sorry for mistaking the posters gender and saying what I did (no bad intention, just out of context - couldn't get further worse).

In any case, of course I do still wish you the very best of luck with your problem.
posted by rc55 at 3:56 PM on October 31, 2005

user92371: The article you saw is here.

Commenters at the bottom make the good point that modern anti-acne treatments are, for most people, less drastic and more effective that completely altering your diet.
posted by Espy Gillespie at 4:20 PM on October 31, 2005

Thoughts for the long term:
-The concept of "spot treatment" is sort of misleading--it's best to put benzoyl peroxide or salicylic acid on the whole affected area (in this case, your t-zone) every day, to prevent pimples from forming in the first place. If you're like me, benzoyl peroxide dries your skin out a lot--I've found that 5% or 2.5% concentrations aren't as bad as 10%, and I like the 2.5% stuff they sell at clearskinregimen.com , which is connected to acne.org.

-Logic dictates that benzoyl peroxide can't do anything for blackheads, because it works by killing bacteria. Pimples become pimples because of bacteria (Propionibacterium acnes). Blackheads aren't caused by bacteria, so you need to deal with them another way--namely, some sort of exfoliation process, either chemical (Salicylic acid, glycolic acid, alpha-hydroxy acid) or mechanical (face scrubs). Do not use abrasive scrubs if you have pimples, because that can lead to scarring. I personally found that salicylic acid and other OTC products didn't do much--Retin-A worked better.

-Paula Begoun gives a good scientific overview of things on her website. (She sells her own line of products, but she was on the scene as a writer and consumer advocate before she came up with her own line, so I trust that she's being objective.)
posted by needs more cowbell at 4:27 PM on October 31, 2005

I second clearskinregimen.com.
posted by granted at 4:40 PM on October 31, 2005

I saw an expensive gizmo mentioned a few weeks ago. It takes advantage of the fact that the bacteria that cause acne have a heat shock response that kills them, below the temperature that will burn you. It looked like a device to basically heat the heck up out of an acne pimple... the bacteria inside go into shock and die, and the pimple will shrink a great deal by the next day. According to what I read, it works really well.

Interestingly, this correlates some with my real-life experience. I noticed that spending some time in the sun was a great way to wipe out pimples, even the same day. (however, the damage makes existing open pimples take forever to heal, so it's a mixed bag.) So I developed a rather unpleasant treatment that worked reasonably well.... 'cooking' my face (gently) over an electric stove. I had no idea WHY it worked, but it definitely helped.
posted by Malor at 4:54 PM on October 31, 2005

I do think diet has some effect in the long term--the more fresh, unprocessed foods you eat, the better your skin will look. Avoiding alcohol and tobacco goes along with this.

More longterm suggestions: a lot of what works on a teenager's skin is not useful for an adult. Having dealt with bad skin all my life, I find that acne-prone formulas do me more harm than good at my age. What works for me now is something low in chemicals (Aubrey Organics makes nice products), and a very simple moisturizer (I like pure jojoba oil). When my skin feels oilier, plain old witch hazel seems to be the best trick.

I use tea tree oil as a spot treatment and neosporin as a blemish begins to heal--a never-fails one-two punch.

I did see a dermatologist for many years as a teenager and in my early twenties, and kept my skin under control with erythromicin, Retin-A, and some crazy sulfur-based soap. It's easier and cheaper now to simply control it with what I use now.

My dermatologist also gave me regular glycolic acid peels--I occasionally use a commercial product (Avon's two step peel, which I buy on eBay), and it keeps blackheads at bay.
posted by padraigin at 4:57 PM on October 31, 2005

Watch out for the accutane. It can have some horrible side effects. It has been over 6 years since I've touched the stuff, but I still have dry lips, dry eyes, and an undiagnosed pain under my ribcage.

I don't know if it is causing the depression, but the timeline seems to fit.

If you need to clear some things up by Thursday, try toothpaste. Not gel, but old fashioned toothpaste. Put it on before you go to bed, wash it off in the morning. Don't forget to use a good moisturizer after you remove it.
posted by bh at 5:01 PM on October 31, 2005

I can't offer a quick fix, because when I had acne it was stubbornly unresponsive to anything (I tried the lot) until Accutane -- some people are just unlucky like that. If you're one of those people, and your skin bothers you enough, don't be scared away from the more serious options.

Accutane cleared my face up with no serious side effects, although I do think that my skin is slightly drier 2 years after finishing the course than it was before. With Neutrogena "combination skin" oil-free moisturiser, I'd say this is still a much better place to be than my pre-treatment oily, acne-covered skin.

If it doesn't bother you enough to go for the hard stuff, remember that you're probably noticing and judging your skin much more harshly than anyone else is. Best of luck!
posted by teem at 5:01 PM on October 31, 2005

Biore Perfect Pore strips are a quick fix for blackheads. They're packed with instructions for use on the nose, but obviously, will work on other facial areas. Frankly, I thought they were a gimmick when my ex-wife was first trying them, but she raved about them so much, I decided to try an experiment on my own honker. Whew! I also found that a few days after I did a second round, the pores on my nose were far less noticeable.
posted by paulsc at 5:26 PM on October 31, 2005

Since everyone is offering personal anecdotes about accutane, I'll pile on. I took it, had no problems (no depression, suicide, mood swings) beyond the dry skin and chapped lips, and now my skin is virtually flawless.
posted by dead_ at 5:39 PM on October 31, 2005

If you can't make it to a dermatologist between now and Thursday, I recommend continuing with your current regimen of Cetaphil and the Neutrogena benzoyl peroxide cream. Try to stick to using just the Cetaphil cleanser - using too many different types of cleansers can confuse your skin, and cause more irritation (and irritation = redness, which you definitely do NOT want, especially since you have a date coming up:-)

However, for a more long-term approach, I second Paula Begoun's line. She has a lot of really good, sound and practical advice that has helped me with my skin care regimen. She's also struggled with acne, and has tried Accutane with much success. If you would rather not go on Accutane, she also has a lot to say about using benzoyl peroxide and salicylic acid treatments in the right concentrations, pH levels, etc.

Here are links to some of her articles that may be of some help to you. (note: naturally, since this is her website, she will recommend her own products - however, if you subscribe to her free email newsletter, or skim through her book, "Don't Go to the Cosmetics Counter Without Me" the next time you're at a bookstore, you will notice that she is indeed a big fan of such OTC lines as Cetaphil and Neutrogena.)

Accutane
Battle Plan for Blemishes
Battle Blan for Combination Skin
Cystic Acne
How to Be Gentle to Your Skin
Should You Use a Moisturizer?
Tea Tree Oil
Understanding Your Skin Type
posted by invisible ink at 6:35 PM on October 31, 2005

Oops, I just realized you said you use the Cetaphil moisturizer, not the cleanser. My bad! But I do recommend Cetaphil cleanser for normal/oily skin - it gets the job done without being overly harsh & drying.
posted by invisible ink at 6:38 PM on October 31, 2005

I hate to recommend it JUST for the effects on acne, but being on the Pill (in my case, first Ortho Tri-Cyclen and now Ortho Tri-Cyclen Lo) did wonders for any zits that I got. I started taking it originally in college to regulate my periods and stayed on for the anti-baby effects.

Again, I don't necessarily think that people should go on the Pill just to lessen acne, but if it fits into your life in other ways, it can help with the acne too.
posted by stefnet at 7:17 PM on October 31, 2005

After you go to the restroom, every time you go to the restroom... wash your hands with soap and water and then use your hands to wash your face. Even when you're at home, wash your face only with gentle soap, water, and your clean hands -- never use a wash cloth. Don't use pimple cream -- ever. If you wear glasses, get contacts or Lasic. Never touch your face with anything.
posted by fuzzy_wuzzy at 7:29 PM on October 31, 2005

acne is a sign of imbalance. that's why it happens so badly during puberty - fundamental hormonal shifts and all that.

for some people, the imbalance is just having way too much oil on their face (but remember that your skin does need oil to be healthy, and washing too much can actually prompt it to produce too much). for some, it's more than that.

see a dermatologist, yes - but also consider a dietician and a naturopath. it may be something about your diet, your emotional health, your environment, substances or materials you come in to regular contact with and have a mild allergic reaction to... possibly a combination of those and other factors.

to call skin sensitive is an understatement. it does weird things in response to things you wouldn't think of as being related. f'rinstance, i get a wart on my index finger when i'm really stressed. no idea why. but sometimes it's the way i notice that i need to relax.
posted by poweredbybeard at 7:52 PM on October 31, 2005

I had acne into my early 20s, and no treatment or habit recommended by the dermatologist had any effect. He even had me on antibiotics. Charlatan.

What worked for me is stopping washing my face with soap. Hot water only. Your skin is a delicate ecosystem, and soap is like nuking it from orbit (not to mention antibiotics!). Hot water will remove excess oils without killing the beneficial bacteria that inhabit your skin.
posted by jimfl at 8:09 PM on October 31, 2005

Tea tree oil does wonders for taking care of my flare-ups. Also, Tweezerman makes this pretty fab "skin care tool"/zit popper that works like a charm and keeps you from picking at your face with your fingers. I've noticed that I have far fewer blackheads than usual since I've started using it.

(And Neutrogena's Combination Skin moisturizer is a lifesaver, I swear.)
posted by Vervain at 8:13 PM on October 31, 2005

Two ideas, neither one is cheap, but neither one involves pills. Find a local doctor who has a SmoothBeam or a Blu-U. FWIW, the Blu-U is a cheaper device so the treatment may be a little cheaper.
posted by ilsa at 9:39 PM on October 31, 2005

As for the long term, possibly evaluate your diet (processed/greasy foods). Large amounts of people having acne problems is a more recent thing; i've asked about 15 people ages 50+ about this and they confirm it (need more evidence though).

I had a fairly strict diet for a few years and had virtually no acne during this time (had a fair amount beforehand). Once I slipped, I started getting acne on my face and other random parts of my body. I took up my diet again and it has dissapeared. Check the vitamin amounts you get too. Vitamin A, E, etc. are essential for skin health (just don't do megadoses). I recommend giving something like this a shot before you get an acutane prescription.
posted by frankie_stubbs at 12:04 AM on November 1, 2005

Accutane was also the only thing that worked for me and I tried a lot of different drugs and alternative therapies. I didn't have any major side effects aside from my acne getting worse for the first month I was using it.

Despite the anecdotal stories, there is no clinical evidence that Accutane is connected to depression. This reason article is quite good, and I liked this quote from the article invisible ink linked.

"Although the high risk of birth defects and the other side effects should be taken seriously, it seems a shame that Accutane has been kept away from many acne patients. It is the most effective, short-term drug for acne available today. All other acne treatments require ongoing, tenacious adherence to the program and they don't offer a cure. The public is largely misinformed about Accutane's potential dangers as well as its potential benefit. Many doctors believe that if it weren't for the proven risk of birth defects, Accutane would be prescribed almost as frequently as antibiotics. Not surprisingly, it is prescribed much more frequently to men. "

I also have a friend who claims that Accutane turned his hair curly, so there's another data point.
posted by afu at 12:14 AM on November 1, 2005

The Queen Helene Mint Julep Mask has helped me temporarily clear up my skin - it's also very gentle to your skin (mine is sensitive) and quite cheap (about $2 a tube where I was). Definitely worth trying.
posted by jb at 1:36 AM on November 1, 2005

I second the Cetaphil cleanser - it's very, very mild. Try to start thinking of your skin as "sensitive" - use gentle and mild products. Neutrogena products have been good for me - I use the sensitive skin moisturizer after the Cetaphil cleanser.

For the quick fix, I swear by Origins "Spot Remover" - about $10 at a department store Origins counter. It really is just for spots though - I wouldn't recommend using it all over.
posted by Puppy D at 8:05 AM on November 1, 2005

I have a suggestion that is probably useless for the 99.99% of the population that is not as idiotic as I am, but on the off chance you are, I will mention it:

Do not wash your face with Dove moisturizing soap bars (or a similar product) if you are prone to acne.

And if you DO wash your face with Dove, and your acne gets worse, don't think to yourself, "Gosh, I am clearly not washing my face enough. I better start washing with Dove twice a day instead of just once."

I am embarrassed to admit how long it took me to realize that washing my oily forehead with a product designed to moisten dry skin was severely exacerbating my acne.
posted by yankeefog at 8:21 AM on November 1, 2005

Just a word of caution regarding Vervain's skin care tool (I have one and I use it) - be very very careful.

Do not use it on anything that isn't... "ripe." You'll risk damaging the floor of the acne and bacteria can migrate deeper into the skin and cause even worse problems.

Be very very careful. Use sparingly and only on whiteheads are are ready to come out. If it's oozy when it comes out, it was too early and you'll risk infection which looks even worse. When it's ripe, the white stuff will be a solid, coherent mass.

Also, after using the tool, wash your face with (antibacterial) soap and water, and if possible, follow up with an astringent.
posted by PurplePorpoise at 8:43 AM on November 1, 2005

I think one key point is that different things work for different people. Retin-A and The Pill were both great for me, but they caused some problems with my hair (making it fall out -- doesn't happen to everyone) so I went off them.

I have been to about 8 dermotologists in my lifetime and have always had better luck with self-medication. I have tried just about everything OTC. Here are the products that currently work for me:

Cetaphil face wash (in the morning)
Jurlique Face Wash Cream (at night -- pricey but amazing)
Neutrogena Sensitive Skin Moisurizer
Clinique Salicylic Acid Spot Treatment
Murad Spot Treament (both spot treatments at once)

One thing I'd advise for anyone is skip the Cetaphil moisturizer and switch to Neutrogena. Their mild wash is great but their moisturizer is not quite right for the face.

Hope this helps -- I feel your pain! Good luck!
posted by mandlebrotz at 8:45 AM on November 1, 2005

Oops, one more thing I forgot to mention is that I agree with poweredbybeard... diet can definitely play a role. Avoid sugar, and try to stick to hormone-free meats and dairy product -- see if this helps.
posted by mandlebrotz at 8:50 AM on November 1, 2005

DDF has a great 10% glycolic acid lotion (a little dab will do your whole face). That plus Murad's spot treatment for a particularly pesky zit changed my life. Sephora has both.

Use it at night and use sunscreen daily. I also wash with Purpose soap morning and night (before applying anything). Absolutely clear skin these days! :-)

Oh, and it works FAST -- within just a few days I had no pimples whatsoever.
posted by mdiskin at 11:54 AM on November 1, 2005

Please do not take Accutane! It's an antibiotic and it will destroy your internal flora, which can create a lot of problems down the road, like yeast infections and the like. Also, it can cause severe birth defects if you happen to get pregnant while on it.

OK, now for the solutions: first of all, it sounds like a lot of your problem areas are near your hairline (your forehead and your cheeks near your ears) I was wondering if a hair product you use isn't aggrivating your skin. Secondly, here's what worked for my adult acne: I started taking zinc (15 mg) and Pantothenic Acid (B5, 500mg) every day, I restricted or sometimes eliminated my intake of white flour and sugar, and I started using a 2% Salycilic Acid cream (I used a Clearasil cream that they don't make anymore... I think Neutrogena and Paula's Choice make good ones) and I started being really gentle to my skin.

Finally, as a last-minute, last resort, an ice cube on the zit can reduce swelling so that the zit profile is smaller and it's easier to cover with makeup.

Good luck!
posted by semidivine at 1:55 PM on November 1, 2005

semidivine, though it can have some serious side effects, Accutane isn't an antibiotic--it's a retinoid, and it works by inhibiting sebaceous gland function and keratinization. Maybe you're thinking of tetracycline?
posted by needs more cowbell at 3:03 PM on November 1, 2005

My diet:acne correlations:
(mostly black/white heads, pimples are rare now)

Bad: Folic acid, egg yolks, progesterone, cheese - the egg's effect will be noticeable by the next day.

Possibly bad: breads, cheap frozen burritos

Neutral: chocolate
(and while potato chips make the skin greasier, it's a lightweight grease not a clogging one)

Good: salmon/sardines, raspberry (squashed onto skin overnight)


And a warning on the Biore strips - I think I had a thin layer of skin covering most of each pore, which the Biore helpfully ripped off - making my schnozz look even worse than before. So be careful.
posted by niloticus at 11:07 PM on November 1, 2005

I have had acne since I was 10 (I'm 24 now) and, while most of my facial acne has gone away, my back and chest remain pretty bad. My comment is mostly to offer another heretofore unmentioned side-effect of accutane (I can't BELIEVE the doctor didn't mention the almost crippling depression or any other side-effect).
I took accutane for about two months (which is how long my self-esteem could take the chapped lips) and now I have reverse pock marks on my chest and back. Every dermatologist I've seen goes back to their office and starts flipping through books, "what the hell's that??"
I would also like to point out that while it's true a lot of guys are pretty shallow, I've seen some absolute knockouts who had acne. It's not like I'm in a position to judge anyhow, but it didn't affect their beauty. You might get lucky and the other party will break out by Thursday ;)

Good luck. I'm glad so many people here are pulling for you.
posted by hoborg at 11:07 PM on November 1, 2005