Adult acne--help!
May 29, 2024 5:41 PM
This may get long. The tldr is that I am having issues as a 42 year old afab woman and I'd love any suggestions!
So I've struggled on and off w acne since puberty. But last weekend I got my face waxed for the first time and now I have allll these pimples on my chin, sides of my mouth, and jawline (which I think is hormonal?). My derm hasn't seen me since this acne started (will make an appt w her asap and I know none of you are my dr or giving me medical advice). For general skin bumpiness she prescribed tretinoin (forget the strength but red and white tube). I've been verrrry lax about using it. I used to go to an aesthetician place where you couldn't have soy, peanuts, coffee, or dairy. I will NOT be restricting my diet in ANY way (though I don't eat well :(). I'm on progesterone-only bc and can't do estrogen.
Do you have any products or supplements you may recommend to calm my skin down? I will of course also see what my derm says but not sure when her soonest appt will be. Thanks for reading!
So I've struggled on and off w acne since puberty. But last weekend I got my face waxed for the first time and now I have allll these pimples on my chin, sides of my mouth, and jawline (which I think is hormonal?). My derm hasn't seen me since this acne started (will make an appt w her asap and I know none of you are my dr or giving me medical advice). For general skin bumpiness she prescribed tretinoin (forget the strength but red and white tube). I've been verrrry lax about using it. I used to go to an aesthetician place where you couldn't have soy, peanuts, coffee, or dairy. I will NOT be restricting my diet in ANY way (though I don't eat well :(). I'm on progesterone-only bc and can't do estrogen.
Do you have any products or supplements you may recommend to calm my skin down? I will of course also see what my derm says but not sure when her soonest appt will be. Thanks for reading!
I just wash my face in the shower w a cleanser from
That aesthetician place or a cleanser from glossier. Sometimes I moisturize after w a good moisturizer that was recommended by New York mag.
posted by bookworm4125 at 5:58 PM on May 29
That aesthetician place or a cleanser from glossier. Sometimes I moisturize after w a good moisturizer that was recommended by New York mag.
posted by bookworm4125 at 5:58 PM on May 29
I started slathering my face up with diaper rash cream at night a week ago, after seeing dermatologists on instagram do it. To be honest it was on a lark, I figured worst case scenario my face would never get diaper rash and I could text a couple lols to some friends.
I have woken up the last 4 days in a row with the clearest skin of my LIFE. So I guess this is what I do now.
posted by phunniemee at 6:09 PM on May 29
I have woken up the last 4 days in a row with the clearest skin of my LIFE. So I guess this is what I do now.
posted by phunniemee at 6:09 PM on May 29
What did the waxer suggest for caring for your post-waxed face? It’s pretty traumatic to do to skin, especially skin that has never experienced it before, especially a complicated area like the face with lots of glands and curves and different directions of hair growth. It makes sense that your follicles and the surrounded skin would be irritated and possibly inflamed or even a little infected - your face skin just had stuff ripped out of it! It’s really susceptible to other things like acne causing bacteria getting in there, too. So I would suggest babying your skin as much as possible. A really simple moisturizer, maybe just aloe gel, maybe something with jojoba oil which generally plays well with most skin types, some thick overnight occlusive to help keep that moisture in, wash your sheets and pillow cases and make sure you use clean towels to pat dry your face, washing with cool to barely warm water, and not scrubbing or rubbing or poking or popping. Give your skin a chance to heal and repair its barriers.
posted by Mizu at 6:12 PM on May 29
posted by Mizu at 6:12 PM on May 29
Moisturizing makes a huge difference. In my late 30s my skin absolutely changed and I had to switch to an oil based moisturizer (tiny amount! like 4 drops in my palm) in the winter and lighter in the summer. The trick is moisturizing right after washing / shower, with something that works for you. May take a few trials for weight and specific products (hemp oil works for me and jojoba does not, for example.)
posted by cobaltnine at 6:15 PM on May 29
posted by cobaltnine at 6:15 PM on May 29
Waxing breaks me out like crazy, even though I’m
not prone to breakouts. I think the kind of skin I have, the follicles need fine hairs to help guide out the oil and keep the pores open and clean. If the hairs are gone, it’s like the oil gets trapped inside and turns into pimples or blackheads and even ingrown hairs.
When this happens to me, I very gently exfoliate with baking soda and mild face soap (like CeRaVe foaming face wash) every day, and moisturize with something very light and oil free (like The Ordinary light moisture, the gel one). Those two products are very affordable - under $20 each - and pretty well regarded.
In future, sadly, the solution is probably just never to wax or thread your face again. Shaving would be slightly less bad but probably still cause breakouts. Those depilatory sandpapers also break me out.
Depilatory creams like Nair or Veet might work for you - that’s what I use for facial hair. Apply with a q-tip, make sure to pat it down so it gets to the root of the hairs, not just resting on top of them. Wait til the hair looks squiggly then scrape it off with a piece of paper and rinse very well with cool water. Do it the night before your event in case of redness.
posted by nouvelle-personne at 6:27 PM on May 29
not prone to breakouts. I think the kind of skin I have, the follicles need fine hairs to help guide out the oil and keep the pores open and clean. If the hairs are gone, it’s like the oil gets trapped inside and turns into pimples or blackheads and even ingrown hairs.
When this happens to me, I very gently exfoliate with baking soda and mild face soap (like CeRaVe foaming face wash) every day, and moisturize with something very light and oil free (like The Ordinary light moisture, the gel one). Those two products are very affordable - under $20 each - and pretty well regarded.
In future, sadly, the solution is probably just never to wax or thread your face again. Shaving would be slightly less bad but probably still cause breakouts. Those depilatory sandpapers also break me out.
Depilatory creams like Nair or Veet might work for you - that’s what I use for facial hair. Apply with a q-tip, make sure to pat it down so it gets to the root of the hairs, not just resting on top of them. Wait til the hair looks squiggly then scrape it off with a piece of paper and rinse very well with cool water. Do it the night before your event in case of redness.
posted by nouvelle-personne at 6:27 PM on May 29
In my mid-40s, I took 200mg doxycycline on a daily basis for about 8 months. This helped immensely in stopping cystic acne breakouts.
I tapered to 100mg daily, and then I stopped altogether over 3 months. When flare-ups occur, now very infrequently if at all, I go back to a 100mg daily dose. I haven't had to do this in over a year.
I did need to see a dermatologist to get the prescription; but boy howdy, doxy has changed my life for the better. I can actually go outside. I hope your situation clears up.
posted by They sucked his brains out! at 6:50 PM on May 29
I tapered to 100mg daily, and then I stopped altogether over 3 months. When flare-ups occur, now very infrequently if at all, I go back to a 100mg daily dose. I haven't had to do this in over a year.
I did need to see a dermatologist to get the prescription; but boy howdy, doxy has changed my life for the better. I can actually go outside. I hope your situation clears up.
posted by They sucked his brains out! at 6:50 PM on May 29
This just happens sometimes in response to waxing, but it's not quite acne, it's folliculitis. The first time I got waxed I had this happen all over my bikini line but my legs were entirely fine. I never waxed my bikini line again, it was very traumatic and incredibly uncomfortable and took 2-3 weeks to heal (though I admittedly did not care for it correctly and kept going in hot tubs because I was on vacation in Hungary). You may or may not need to similarly swear of face waxing.
I've successfully had my upper lip and eyebrows waxed roughly a dozen times, but a few weeks ago I broke out after waxing my upper lip. It was a noticeably more painful experience than usual - the aesthetician was kind of zoned out and slow - so I think it was a consequence of a bad wax job damaging the skin more than usual. Or I had bad luck and shouldn't get waxed on my period. I share this because it is possible that you had bad luck once and might be fine in the future.
I treated my face folliculitis roughly the same way I low-key treat acne non-invasively. Use a gentle cleanser once or twice a day so that there isn't any more infection. Use the same moisturizer that you normally do if it doesn't irritate your skin. Apply a hot compress to see if you can open up the pores, and if you do get them open, cleanse again, dab away any pus/bleeding with clean cotton rounds, and don't touch it as it heals. If you need to, cover the open pores with those little round hydrocolloid acne bandages both to help heal and to keep you from touching and reinfecting yourself. My 8-10 pus-filled upper lip bumps cleared up after about a week.
posted by A Blue Moon at 7:53 PM on May 29
I've successfully had my upper lip and eyebrows waxed roughly a dozen times, but a few weeks ago I broke out after waxing my upper lip. It was a noticeably more painful experience than usual - the aesthetician was kind of zoned out and slow - so I think it was a consequence of a bad wax job damaging the skin more than usual. Or I had bad luck and shouldn't get waxed on my period. I share this because it is possible that you had bad luck once and might be fine in the future.
I treated my face folliculitis roughly the same way I low-key treat acne non-invasively. Use a gentle cleanser once or twice a day so that there isn't any more infection. Use the same moisturizer that you normally do if it doesn't irritate your skin. Apply a hot compress to see if you can open up the pores, and if you do get them open, cleanse again, dab away any pus/bleeding with clean cotton rounds, and don't touch it as it heals. If you need to, cover the open pores with those little round hydrocolloid acne bandages both to help heal and to keep you from touching and reinfecting yourself. My 8-10 pus-filled upper lip bumps cleared up after about a week.
posted by A Blue Moon at 7:53 PM on May 29
Waxing Side Effect #5: Bacterial Reaction (From The Wax Chick's troubleshooting guide for fellow professionals). Can be the most upsetting, because they don't present right away like a Histamine Reaction. It takes a few days for the signs to appear, which are little white "pimple like" bumps. So when the client calls to alert you, it can make you feel out of control and as though you have done something wrong. That is generally not the case.
This type of reaction commonly occurs on the lip for women and the back or chest for men.
The #1 cause of bacterial reactions are the hands. They are little "bacteria babies". The first thing everyone wants to do after waxing is to feel how soft and smooth their skin is. By doing this they are basically main lining bacteria right into the open pores. And a couple of days later, BAM, it's pimple city.
See your dermatologist. After your skin clears, decide if you'd like to continue with waxing; if you do, read the tips at the link to prevent this and other common post-wax issues.
posted by Iris Gambol at 10:24 PM on May 29
This type of reaction commonly occurs on the lip for women and the back or chest for men.
The #1 cause of bacterial reactions are the hands. They are little "bacteria babies". The first thing everyone wants to do after waxing is to feel how soft and smooth their skin is. By doing this they are basically main lining bacteria right into the open pores. And a couple of days later, BAM, it's pimple city.
See your dermatologist. After your skin clears, decide if you'd like to continue with waxing; if you do, read the tips at the link to prevent this and other common post-wax issues.
posted by Iris Gambol at 10:24 PM on May 29
Seconding folliculitis or bacterial reaction, seconding a gentle exfoliant, preferably BHA imo. I like this toner by Somebymi because it's also soothing, if you can find it or a similar formula, give it a try.
About 15 years ago I started on exfoliants from Paula's Choice before the entire concept got popularized from kbeauty because I went for a couple of cheap facials that left me with deep almost cystic acne and I've never had those kind of pimples before.
posted by cendawanita at 10:32 PM on May 29
About 15 years ago I started on exfoliants from Paula's Choice before the entire concept got popularized from kbeauty because I went for a couple of cheap facials that left me with deep almost cystic acne and I've never had those kind of pimples before.
posted by cendawanita at 10:32 PM on May 29
(but on second thought I would suggest a more straightforward chemical formulation like from Paula's Choice without the additional ingredients like in Somebymi because the help you need is in clearing out your blocked pores, and they're already irritated)
posted by cendawanita at 10:35 PM on May 29
posted by cendawanita at 10:35 PM on May 29
Dr Dray is a dermatologist on Youtube with countless videos on how to care for skin prone to acne and how to care for skin in general. Recognizing you have a particular trigger for your skin to be unhappy at the moment I'll still link things that focus on the title of your question. I like that she provides a lot of detailed information and doesn't have her own product line to flog e.g. Clear audult acne, Why you're getting acne in your 40s
posted by koahiatamadl at 1:45 AM on May 30
posted by koahiatamadl at 1:45 AM on May 30
What’s been helping my hormonal acne is hypochlorous acid spray. I use the SkinSmart brand that is meant for eczema, but I find that even if I do get pimples now, they don’t get red and inflamed like they used to.
I have oily, acne-prone skin, so I double cleanse morning and night with an oil-based cleansing balm, followed by a water-based cleanser. Then I follow it up with the hypochlorous acid spray, letting it air dry before applying serum, moisturizer, and sunscreen (in the morning). I use tretinoin at night a few times a week.
Dr. Michelle Wong at Lab Muffin is a cosmetic chemist and runs a really helpful account. For products widely available at US pharmacies, I follow @sighlurskin.
You might want to read up on the different types of acne and how to treat them here (SkincareAddiction subreddit).
Good luck! Adult acne can be SO aggravating.
posted by charcoals at 5:56 AM on May 30
I have oily, acne-prone skin, so I double cleanse morning and night with an oil-based cleansing balm, followed by a water-based cleanser. Then I follow it up with the hypochlorous acid spray, letting it air dry before applying serum, moisturizer, and sunscreen (in the morning). I use tretinoin at night a few times a week.
Dr. Michelle Wong at Lab Muffin is a cosmetic chemist and runs a really helpful account. For products widely available at US pharmacies, I follow @sighlurskin.
You might want to read up on the different types of acne and how to treat them here (SkincareAddiction subreddit).
Good luck! Adult acne can be SO aggravating.
posted by charcoals at 5:56 AM on May 30
I recommend not overreacting your current breakout - it was caused by waxing; once it calms, there's no reason to think this particular thing will come back.
You should still see your dermatologist. Otherwise, it seems like you could get a lot of mileage out of a solid routine, like this:
1. If you wear makeup, take it off prior to cleansing. I use a disposable wipe, but you can use washable towels with bottled makeup remover (have a designated set of towels for this.)
2. Wash your face once or twice a day with a mild cleanser. Cerave gets recommended a lot; there's a version for dry skin and one for oily. I have drier skin, so I use the dry skin once at the end of the day.
3. After washing your face, pat it dry with a clean towel and then let it airdry a bit. If it's nighttime, apply a small blob of your retinol - smaller than how much toothpaste you use - evenly over your face.
a. You want your face to be dry to minimize irritation.
b. You want to be consistent about this because the retinol works over time to increase skin cell turnover and your skin needs to get used to it. Using it sporadically irritates your skin without getting much of the benefits.
c. You want to apply it all over, not just on troublesome spots, in order to maintain a sort of veil of coverage. Your whole face will benefit from using it, too - it will be brighter, smoother, and less dry.
4. Apply a mild moisturizer. I used to use Cerave; I've switched to Kiehl's Ultra Facial Moisturizer with Squalene.
5. During the daytime, use a facial sunscreen. tbh I get a little lazy about this, and just use a tinted moisturizer with SPF.
If you mentioned your retinol use to the waxer, they shouldn't have gone ahead with the waxing - it's explicitly contraindicated.
After you've been consistent with those steps for six weeks or so, take a look at your skin, maybe visit your dermatologist again. They can add in medications - spironolactone is a popular one for afab people are age. I also have a prescription sulfur skin treatment that I use instead of the Cerave for my nighttime wash (I use the Cerave only after workouts/being sweaty.)
But yeah, you really don't need a full force attack quite yet; you can probably improve/stabilize your skin with a month or so of consistent cleansing, moisturizering, and tretinoin use. Good luck!
posted by punchtothehead at 6:15 AM on May 30
You should still see your dermatologist. Otherwise, it seems like you could get a lot of mileage out of a solid routine, like this:
1. If you wear makeup, take it off prior to cleansing. I use a disposable wipe, but you can use washable towels with bottled makeup remover (have a designated set of towels for this.)
2. Wash your face once or twice a day with a mild cleanser. Cerave gets recommended a lot; there's a version for dry skin and one for oily. I have drier skin, so I use the dry skin once at the end of the day.
3. After washing your face, pat it dry with a clean towel and then let it airdry a bit. If it's nighttime, apply a small blob of your retinol - smaller than how much toothpaste you use - evenly over your face.
a. You want your face to be dry to minimize irritation.
b. You want to be consistent about this because the retinol works over time to increase skin cell turnover and your skin needs to get used to it. Using it sporadically irritates your skin without getting much of the benefits.
c. You want to apply it all over, not just on troublesome spots, in order to maintain a sort of veil of coverage. Your whole face will benefit from using it, too - it will be brighter, smoother, and less dry.
4. Apply a mild moisturizer. I used to use Cerave; I've switched to Kiehl's Ultra Facial Moisturizer with Squalene.
5. During the daytime, use a facial sunscreen. tbh I get a little lazy about this, and just use a tinted moisturizer with SPF.
If you mentioned your retinol use to the waxer, they shouldn't have gone ahead with the waxing - it's explicitly contraindicated.
After you've been consistent with those steps for six weeks or so, take a look at your skin, maybe visit your dermatologist again. They can add in medications - spironolactone is a popular one for afab people are age. I also have a prescription sulfur skin treatment that I use instead of the Cerave for my nighttime wash (I use the Cerave only after workouts/being sweaty.)
But yeah, you really don't need a full force attack quite yet; you can probably improve/stabilize your skin with a month or so of consistent cleansing, moisturizering, and tretinoin use. Good luck!
posted by punchtothehead at 6:15 AM on May 30
I used retinol and tretinoin interchangeably there. Retinol is lower strength and available off the shelf; tretinoin is stronger and available by prescription. I meant the tretinoin that your derm prescribed to you.
posted by punchtothehead at 6:17 AM on May 30
posted by punchtothehead at 6:17 AM on May 30
Everyone will think this is terrible, and it kind of is, but it DOES help me.
My skin is very reactive, and there are very few things I can put on it without triggering sensitivity. Like, VERY few. Sometimes I can't even wash with a cleanser. Even the most gentle (think CeraVe and Cetaphil, commonly recommended for people with super sensitive skin) often trigger the kind of bumpiness and discomfort you describe.
When this happens, I use little alcohol pads to dry the affected areas out - the kind they use at the doc's office after you get a vaxx or they draw blood. I run it over the affected areas of my face a couple of times a day (avoiding my typical dry patches, where I'm unlikely to be broken out anyway).
Then at the end of the day, I use whatever cream the doc told me to use - in my case it's usually clobetasol or Protopic. Nothing else - none of my "usual" routine.
This usually clears me up in a couple of days. I can feel it's working day 1, day 2 is noticeably better, day 3 I'm usually clear. I haven't noticed any barrier deterioration from this fix, but YMMV of course. I am a very special snowflake when it comes to skin care.
posted by invincible summer at 6:43 AM on May 30
My skin is very reactive, and there are very few things I can put on it without triggering sensitivity. Like, VERY few. Sometimes I can't even wash with a cleanser. Even the most gentle (think CeraVe and Cetaphil, commonly recommended for people with super sensitive skin) often trigger the kind of bumpiness and discomfort you describe.
When this happens, I use little alcohol pads to dry the affected areas out - the kind they use at the doc's office after you get a vaxx or they draw blood. I run it over the affected areas of my face a couple of times a day (avoiding my typical dry patches, where I'm unlikely to be broken out anyway).
Then at the end of the day, I use whatever cream the doc told me to use - in my case it's usually clobetasol or Protopic. Nothing else - none of my "usual" routine.
This usually clears me up in a couple of days. I can feel it's working day 1, day 2 is noticeably better, day 3 I'm usually clear. I haven't noticed any barrier deterioration from this fix, but YMMV of course. I am a very special snowflake when it comes to skin care.
posted by invincible summer at 6:43 AM on May 30
Thank you so much for the extremely helpful suggestions and lack of judgment! I definitely didn't use the tret before waxing... it had been like 6 mo. Just trying now. Also it is not white bumps--to me it def seems like acne. I sure could be wrong, though. Ok ALSO this is important and I forgot to mention--since maybe summer or so? I have also major BACKNE!!! Ack. I just use body wash on my back. I guess I'll ask my derm about it too. I've also tried spirinolactone like 12 years ago and prefer not to again. Thanks everyone!!!
posted by bookworm4125 at 7:06 AM on May 30
posted by bookworm4125 at 7:06 AM on May 30
I'm on spironolactone and it's been a game changer for me. I get my prescription through Apostrophe - not covered by insurance or cheap, but highly convenient.
posted by ThePinkSuperhero at 7:31 AM on May 30
posted by ThePinkSuperhero at 7:31 AM on May 30
I agree the waxing reaction sounds like a one-off thing, but for the overall phenomenon of adult acne (and especially body acne)—after a lifetime of trying many of the OTC and prescription remedies mentioned in this thread, I finally pulled the trigger on Accutane in my early 30s and I really, really wish I had done it sooner. The side effects were very manageable and the only lasting impact for me has been that my skin is clear for the first time since I was a child. I still have other skin concerns (for example, Accutane can't erase the scarring from decades of acne...), but it is really freeing to not constantly have at least one unsightly and painful sore on my face or body.
posted by telegraph at 7:51 AM on May 30
posted by telegraph at 7:51 AM on May 30
I saw your update! Please take it easy on your skin when it’s inflamed and avoid retinols and anything harsh while your skin barrier heals. Really focus on hydration and locking in the hydration with moisturizers. Some things that help my skin barrier when my skin gets “angry” are snail mucin, Cicaplast balm, Aquaphor, and hydrocolloid patches to keep germs and dirt out.
posted by charcoals at 8:01 AM on May 30
posted by charcoals at 8:01 AM on May 30
Retinol really does do a good job of keeping skin clear and has anti-aging benefits, I started using a tiny amount of the OTC stuff twice a week, lots of moisturizer, and within a few months my skin was absolutely clear which never happens for me (also in my early 40s and lifelong oily/acne-prone skin). The trick is to start small and stay consistent once your skin has cleared up (and avoid eyes and the area above your lips). I also use BHA (Stridex red pads or Paula's Choice) once or twice a week. Using a BHA right after you get your face waxed might help prevent future breakouts.
Instead of waxing I use the little face razors from sephora about weekly after I shower, super effective and if you learn how to do it properly not irritating. It's called "dermaplaning" and is also good for skin clarity. FYI I don't use the little razors on my mustache area, for that I use a regular razor and am experimenting with IPL to see if it stops my hair growth there.
posted by lafemma at 8:36 AM on May 30
Instead of waxing I use the little face razors from sephora about weekly after I shower, super effective and if you learn how to do it properly not irritating. It's called "dermaplaning" and is also good for skin clarity. FYI I don't use the little razors on my mustache area, for that I use a regular razor and am experimenting with IPL to see if it stops my hair growth there.
posted by lafemma at 8:36 AM on May 30
Quickly scanning through the replies here, I haven't seen SPF mentioned. If you're using retinol (which tretinoin is), you NEED to use sunscreen!
posted by gakiko at 10:40 AM on May 30
posted by gakiko at 10:40 AM on May 30
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