How do I improve my dull, lifeless skin?

December 28, 2007 8:50 AM

My skin is terrible. It's not just the acne, though I do have that. It is mottled and dull. I have deep shadows under my eyes. Wrinkles are spreading under my eyes and from the corners of my nose to my mouth. I don't (and never have) smoked, nor lived around smokers. I drink at least 2 liters of water a day. I'm a female in my early 20s, and I've got the skin of a nicotine and alcohol addict in their forties. What am I doing wrong? More treatment details inside.

On top of what I already said, I do the following:
- I wash with Cetaphil and warm water, no washcloth or face scrubbing outside of a once or twice-weekly exfoiliation scrub.
- At night I apply either a 2.5% benzoyl peroxide treatment or a 2% salicylic acid treatment, though never both at once.
- In the mornings I use a retinoic acid moisturizer.
- At different times of the day (so they don't interfere with one another), I take biotin, a multivitamin, B-vitamins, a calcium-magnesium-zinc combination pill, an extra zinc vitamin, and fish oil.
- I exercise regularly.
- I am approximately ten pounds overweight, but otherwise in good health
- I sleep at least 7-8 hours per night 90% of the time
- I have taken various forms of birth control, but they didn't do anything for my skin and made me crazy.
- I have tried Differin and Retin-A, neither which did much (though that was years ago, maybe I should give it another shot?)

Possible Causes
- I have had a history of bad, blistered sunburns when I was younger--though only two or three times have they blistered on my face. Now I wear sunscreen.
- There was a six-month period two years ago when I drank way, way too much almost daily. This has long since ended.

In terms of treatment, I feel like I'm doing most everything right, but my skin just seems to get worse. I get tiny bumps all over my forehead and blemishes on my cheeks (it is not cystic acne). My skin is dull and lifeless-looking. It's awful. I could deal with the acne if I at least had a healthy glow, but I don't. What more can I do?

posted by anonymous to health & fitness (35 answers total)

See a dermatologist.
posted by grouse at 8:54 AM on December 28, 2007 [1 favorite]

Do you spend any time outside? Don't tan, but a healthy dose of sunlight does wonders for the complexion. Other than that, see a dermatologist.
posted by purephase at 8:59 AM on December 28, 2007

You might get a lot of comments here with suggestions on various products or practices. It will be very hit or miss, and you'll likely spend too much time and money trying them all out. It sounds like you're at a point where seeing a dermatologist would help a lot. You'll be able to get a professional opinion from someone who can examine your condition and put you on a regimen that will hopefully get you on the path to better skin.
posted by roomwithaview at 9:00 AM on December 28, 2007

I certainly think you're going to need to get personalized advice from either a dermatologist or a well-respected, well-trained skin care specialist.

But one thing that you don't mention is diet. A friend once mentioned to me that you can always tell who drinks too much Diet Coke because their skin is doughy and dull; others have made similar remarks about people who eat too much white sugar or flour. Those may be slightly overstating it, but do make sure you're getting enough fresh vegetables and healthy fats (like fish and avocado).
posted by occhiblu at 9:01 AM on December 28, 2007

Anecdotal Data point: but fish oil can backfire. My skin was getting all bruised and a bunch of shaving cuts I had wouldn't heal. Turned out my dose of fish oil was too high and was causing this. I switched to eating fish two times a week. In general I think supplements might not be the best idea.

This article about diet and acne in pretty interesting. I've had success eliminating my mild acne by cutting sugar in my diet in half. I also used to have to wear foundation (at a very young age) to deal with uneven skin tone, and now my skin looks pretty great. The article also talks about dairy, which I also cut, though I still eat a significant amount in form of cheese. I still have ugly shadows under my eyes, but taking allergy medication has helped that a bit.

Also, what % of your diet is fat? Too much or too little could be a problem.

I'd also still see a dermatologist and a primary care physician to rule out anything serious (liver problems, gluten intolerance etc.), but I found the former was unhelpful.
posted by melissam at 9:02 AM on December 28, 2007

You really have to see a dermatologist. My skin got pretty bad (acne under my skin, so itchy and gross), and only once I started treatment with a dermatologist did it start to improve. I only wish I wouldn't have waited so long, because I do have some scarring. What's best of all is that my insurance covered the treatments.
posted by ThePinkSuperhero at 9:19 AM on December 28, 2007 [1 favorite]

There was an article in the nyt yesterday about skin in general. Some advice there.
posted by jourman2 at 9:20 AM on December 28, 2007

I agree: See a dermatologist.

It might be a hereditary thing. Does your mother or father have premature wrinkling?

I have deep shadows under my eyes.

Again, probably a hereditary thing. Or a sleep deficit. Do you have dark circles all the time. Or, maybe your hemoglobin is low since you are a menstruating woman.

Wrinkles are spreading under my eyes and from the corners of my nose to my mouth.


Some people have premature wrinkling in the nasolabial fold. I find mine are more pronounced when I'm bloated. Buy a satin pillowcase to prevent further wrinkling. Your face glides against a satin pillowcase instead of pressing and creasing on a cotton case. Get one with a zipper so it won't slip off your pillow. My mother's dermatologist pointed out a wrinkle caused by sleeping on her left side.

If the wrinkles from your nose to the corners of your mouth are pronounced and bother you a lot you can have them filled with Restylane or another cosmetic filler.
posted by LoriFLA at 9:23 AM on December 28, 2007

Well, for what it's worth, I think you're putting way too much junk on your face. I suffered from bad skin for years until a dermatologist said I just had sensitive skin and to quit using that stuff on my face. She had me switch to only using a non-soap, fragrance free skin cleanser (I use one made by Oil of Olay) and it was like a miracle. I still get a single pimple every two or three months, but my overall skin tone is clear and smooth. One day, a co-worker who didn't know the "before" me actually complimented me on my skin. However, I do think it's worth seeing a doctor about.
posted by Lockjaw at 9:29 AM on December 28, 2007 [4 favorites]

I'm a big fan of glycolic acid. I have extremely sensitive, dry skin that also burns very easily and my skin improved dramatically when I started using glycolic acid about 10 years ago. I started off going to a dermatologist who suggested it and he applied some higher concentration peels (less severe than what you're thinking -- I was able to go right back to class after). I no longer get the in-office peels, but I swear by a 15% gel solution I use on my face in the morning and before bed and I get lots of compliments on my skin. I use the Neo Strata brand but I'm guessing other brands of AHAs would work just as well. A lower concentration might be better at the outset. You likely know this already, but any acids you're using on your skin will increase your sun sensitivity.

Also, have you looked at what makeup you're using? You don't mention any, but I've had great experience with Bare Minerals. I've been using that brand of makeup for about five years and it evens out my skin without irritating it.

But bottom line, get thee to a dermatologist before doing anything too drastic.
posted by awegz at 9:46 AM on December 28, 2007 [2 favorites]

If you are drinking or using a lot of artificial sweetners, give them up immediately. I know they do horrible things to my health in general and my skin will show it as well. And, see the dermotologist!
posted by knotknitter at 9:54 AM on December 28, 2007

couple of thoughts -

nthing the diet thing - plenty of fresh vegetables and fruit, reduce sugar and any refined flours and get adequate sources of oils/fats into your diet - as opposed to supplements, i.e. eat fish rather than cod liver oil etc.

also, the skin is one of the organs that eliminates waste so it may be worth looking at your digestive system and making sure your liver and kidneys are in good shape.
posted by koahiatamadl at 10:02 AM on December 28, 2007

More anecdotal data: through dumb genetic luck I have good skin, but the quickest way for me to wreck it is to put anything on it. I don't wash it. I get it wet in the shower and dry it gently with a towel and that's it. Your skincare regimen would ruin my face in a week.

Things like tone and black circles are almost always diet for me, though some people are stuck with them genetically. If I eat more fresh fruit and veggies and have a steak now and then it usually goes away, unless I'm not sleeping or unless I'm sick or have allergies.

So- can't hurt, might help: For 2 weeks cut out the chemicals (sodas), eat well-balanced meals, sleep an extra 45 minutes every single day, if you can manage it. If that doesn't work, I'd go to the dermatologist.

Sleep's the hardest one for me to manage- it's always at the bottom of my list of priorities even though I know it's the easiest, cheapest way for me to keep my health up and my stress and depression down. (The second easiest, cheapest way is exercise, and the third is diet.)
posted by small_ruminant at 10:05 AM on December 28, 2007

I agree with Lockjaw, it might do you some good to do some experimenting with eliminating some products to let your skin rest.

On the other hand, I love beauty products and think that some products are a godsend. Some people don't give Retin-A enough time. I would say to definitely give it another shot. It's one of few things that have been proven to stimulate collagen production. That is a very good thing for wrinkle-prone skin, or for any skin, for that matter.

Maybe you are a candidate for a chemical peel. The peel slightly traumatizes the outer layers of skin and can get rid of the dullness and superficial wrinkles.

In the meantime you might be interested in some of my favorite products.

Bare Escentuals makeup. I love this stuff. It's natural looking and gives that healthy glow.

Sheer pink blush. You know why those movie stars look so fresh? Well, besides airbrushing? They all wear a little bit of pink blush on the apples of their cheeks. Don't skip the blush! A lot of people swear by Nars Orgasm, but I don't think it's a good choice for acne and wrinkles. It contains shimmer which only accentuates flaws. I like pink blushes like this Neutrogena blush in "Fresh". There are a ton of pink blushes on the market. Swirl a little on the apples of your cheeks. Avoid anything too muddy.

Also, look for products that tout, "skin-brightening" "light-diffusing", etc. I like Aveeno "Skin Brightening" products and Skin Effects Advanced Brightening Complex. Many products have ingredients that will give a glow. Everything to high-end, like Kinerase, to drugstore products.

I also love Neutrogena anti-wrinkle serum. I put it under and at the corners of my eyes -- even in the daytime. It's awesome stuff.

Good luck.
posted by LoriFLA at 10:08 AM on December 28, 2007 [2 favorites]

Fixed my link: Bare Escentuals
posted by LoriFLA at 10:11 AM on December 28, 2007

I don't remember well, but I think Retin-A and sunlight don't mix.
posted by small_ruminant at 10:26 AM on December 28, 2007

This is somewhat off topic. You mentioned you'd tried Retin-A before. So did I, when I was 16 and it totally wrecked my skin. That was 12 years ago. I recently went to a new dermatologist because I was having problems with androgen-sensitive acne (I'd gone off birth control in an attempt to conceive and was breaking out way too much for my taste). Hormonal control, which works like a charm for me, was obviously out of the question. This doctor prescribed three things for me: Rosula, a face wash and Metrogel and Ziana, both topicals. Rosula and Metrogel are intended for people with rosacea (which I don't have) and Ziana is the "next generation" of retinoids--it also has an antibiotic in it. The combination of those medications made my skin soft and glowing. It was awesome. Almost as good as the pregnancy glow I have going on now. I was so surprised with the Ziana. That stuff is the bomb. It exfoliates gently (no irritation), smooths and clears. I love it. It's pricey but if your doc prescribes it, ask for samples and always check the manufacturer's Web site for rebate forms. Anyway, the rosacea meds worked well too, because they also had a smoothing and brightening effect on my skin, but the Ziana totally rocked.
posted by FergieBelle at 10:28 AM on December 28, 2007 [2 favorites]

ABSOLUTELY see a dermatologist. I think the scads of available skin care products make it seem like we laypeople can just figure out what's wrong with our skin ourselves and easily treat it, but I think that's very inaccurate. You could have something like rosacea that can take many forms, is stubborn, and needs to be treated by prescription. You're just shooting in the dark (and possibly making things worse) until you see a professional.
posted by FlyByDay at 10:39 AM on December 28, 2007

I found that benzoyl peroxide was just wreaking havoc on my skin. I mean, sure, it dried up the tiny pimples but my skin was always, always irritated. I gave it up for a natural regimen for a while, which I still do in part, but I've also added Retin A .05% nightly and have had good results.
posted by notjustfoxybrown at 11:20 AM on December 28, 2007

Forgot to add that I, too, previously used Retin A with no luck but my more-mature skin seems to like it.
posted by notjustfoxybrown at 11:21 AM on December 28, 2007

I found that benzoyl peroxide was just wreaking havoc on my skin

Same. My skin improved when I stopped using BP.
posted by puffin at 11:44 AM on December 28, 2007

Tiny acne-like bumps and a slight coarsening of features could be an indication of rosacea. Ask a dermatologist. Rosacea doesn't always present as a bright-red and obvious flush, especially at first. It begins gradually.

As far as wrinkles go, you might just be out of luck on the genetic jackpot.

Nothing over-the-counter is really going to help. See a good dermatologist and see what treatments are available now. It sounds like you're doing all the right things for your health. Good luck.
posted by tejolote at 11:44 AM on December 28, 2007

You don't mention what you eat, and I would start with diet, as mentioned above. No sodas, no candy, no crappy sugar filled drinks from Starbucks. Lots of vegetables and whole fruits- the best skin I've ever had was when I was crazy about raw organic spinach, and ate it every single day. Cut back a bit on all the acids on the face, especially during the day.
posted by oneirodynia at 12:33 PM on December 28, 2007

Peroxide or salicylic acid every night seems... way much. Sure it helps with the acne, but it probably also kills your skin in other ways. I would skip, or cut down, on this step. If your face rebels and gets oily, try blotting with face paper during the day.

With the dark circles, definitely consider genetics... I have dark marks in the inner corners underneath my eyes, and so does my grandmother. In my case, they've been there as long as I can remember, since I was a wee little one...they just grow that way.
posted by anaelith at 12:49 PM on December 28, 2007

Leaving benzoyl peroxide on your skin all night probably isn't doing it any favors, and it may be reducing the effectiveness of your retinoid -- BP and retinoids are contraindicated, and will cancel one another out if used too closely together. I use a BP cleanser for 1 minute in the morning, and a retinaldehyde moisturizer at night, but my skin is pretty tough. YMMV. It's also possible that your skin needs more moisture. Using a cleansing oil instead of Cetaphil could help brighten your complexion and (I know it seems weird) do a better job of cleaning your pores.

Your skin is unique; what works for another person may not work for you. I highly recommend the Skincare Board at Makeupalley.com; those ladies (and gentlemen) know a lot about treating problem skin and choosing products based on ingredients instead of marketing hype. Educate yourself there, and your derm visit will be much more valuable.

The sad fact is that most derms who accept insurance don't have much time to spend with each of their patients, and tend to solve everything acne-related with a script for Differin or Retin-A -- and then it takes months to get another appointment if the treatment isn't working. (Cosmetic dermatologists, OTH, can spend more time on your beauty regimen, but they cost $$$$.) Busy dermatologists are more focused on checking your moles for skin cancer than recommending a photostable sunscreen and an effective antioxident serum to make your skin bright and glowy. Get educated, and you'll find the solution to your skin's problems.
posted by junkbox at 1:20 PM on December 28, 2007

See a dermatologist.

And nthing the diet deal. You say you take fish oil, but is that part of your multi? Because then it isn't doing squat for you. Eating fatty fish and avocados is a much tastier and by far cheaper way to get your omegas.

Also, why are you taking a multi, a b-vitamin, and biotin? It sounds like a lot of expensive urine dye. Keep track of your diet for a week using a program like Cron O Meter (it is free) to see if you really need to be taking all that.
posted by munchingzombie at 1:22 PM on December 28, 2007

Are all these skin treatments you use prescribed or recommended by a doctor? If not, it sounds like you're going a little overkill and possibly making it worse. I also agree that you should see a dermatologist and if your diet is not as healthy as it could be, work on that, too. Supplements aren't a replacement for a healthy diet and usually aren't as effective as eating foods that contain them naturally.
posted by fructose at 2:36 PM on December 28, 2007

Devil's advocate: are you sure your skin is really this bad (i.e. you look like a rough-livin' 40 or even 30 year old at the age of 24), or are you overly scrutinizing yourself?

FWIW, I could moan and groan to you about how rotten my skin is as well, and I certainly can point out every last flaw. HOWEVER, I routinely get compliments (from women, not just men trying to get into my pants) for having "such great skin" and "looking much younger than my age."

Either way, it doesn't hurt to see a dermatologist, but maybe it's time to also put down the magnifying mirror and the unrealistic standards.
posted by availablelight at 3:12 PM on December 28, 2007

I actually get less acne now that I no longer use benzoil peroxide and salycylic acid, which completely surprised me.
posted by croutonsupafreak at 3:32 PM on December 28, 2007

are you wearing uva-blocking sunscreen?
posted by ifjuly at 7:27 PM on December 28, 2007

Quit looking in those dark mirrors in dimly lit rooms, or in that mirror in the room with the window on one side giving you shadows. You may look a lot fresher than you think you do.
posted by serena15221 at 11:00 PM on December 28, 2007

Luckily, I inherited my mom's lovely skin. I do see dermatologist once each year. She checks me for moles and gives me really good advice about skin care. I learned most of what follows from her...

• Retinoids should be used in the evening, not the morning. They really do make your skin more prone to sun damage.

• Depending on the dosage of that retinoid you've got quite a bit of exfoliation going on there. You've got a 2% beta hydroxy acid in the salicylic acid (3-4x/week) and a retinoid (7x/week) and a manual exfoliation (1x/week). That may be too much and it may be causing the bumpiness.

• Often, it's more effective to use a more concentrated product less often. I use Retin-A once a week which is much more effective than the same amount of vitamin A spread across 7 daily applications.

• Stop touching your face. Don't rest you chin in you hand or constantly brush back your bangs. Your hands are often germy or oily from moisturizer - not stuff you want on your delicate face.

• Allergies can cause a lot of skin problems and it's a huge pain to find the cause. With contact dermatitis is easier to identify the allergen; it's from detergents and make-up and whatever touches your skin. The sneakier culprit is systemic allergens like food sources. The tiny bumps could be an allergy reaction. (This happens to me.)

• Personal product preference - Cetaphil does not work for me at all. I don’t say that because I think you should ditch it. It’s just that even really good products don't work for everyone.

• And the big secret - you need to give products time to work. Your skin needs about 8-12 weeks before a product can do any good. Products can temporarily hydrate and plump, but really working on wrinkles on underlying acne takes time. Tempting as it may be, stop switching products. Pick a skin care regimen and stay with it for a 2 months. Then re-evaluate what you’re using. Of course, if you find a product irritating you should stop using it.

This is completely contrary to what advertisements promise. The ads make you think that a product that doesn’t perform a miracle in 3 days is a bad product. That’s just marketing BS to make you buy lots of products. Evaluate your products at the bottom of the jar, not the top.
posted by 26.2 at 9:54 AM on December 29, 2007 [1 favorite]

Look at what you are eating, simply eating healthy won't cut it. Omega 3's and Vitamin E are wonderful for your skin. Also, what are your moisturizing habits? I agree with everyone about going to a dermatologist, but consider a dietician as well. If I go through one week without my moisturizer (it is Loreal's Vitamin E with SPF 15), my skin starts to get dull and bumpy and I start to have acne cysts, not pimples, all over my skin.

Do you take any prescriptions? Certain medications, such as birth control or allergy pills, can dehydrate your skin as well.
posted by dnthomps at 8:14 PM on December 30, 2007

Salycilic acid was a pretty surefire way to irritate my skin. I used benzoyl peroxide for a while when I was younger but it was a trade-off - less pimples but I got dry skin and sometimes flaking. Once I stopped both my skin produced less oil because it wasn't trying to compensate for the overdrying.

I use sensitive-skin dove soap, unscented, and I really like it. I also like neutrogena oil-free moisturizer.
posted by mai at 12:35 AM on December 31, 2007

Maybe you have an iron deficiency? You should see a general practitioner about this. If you have a deficiency, taking a multivitamin would not be enough and you'd need to discuss the treatment with your doctor. Common symptoms can include paleness, cold hands and feet, cracks at the side of your mouth and fatigue. It's something that a blood test can confirm, and not something that you should self-medicate for (you don't want iron overload, so your intake should be monitored by a professional).
posted by hooray at 3:57 PM on January 6, 2008