My skin has fallen and it can't get up!
November 23, 2009 11:52 AM   Subscribe

My formerly oily, acne-prone skin is now severely dehydrated, horribly irritated acne-prone skin. Please help!

I first started getting acne as a pre-teen and still have it to some degree now, at almost 40. I hadn't been getting pimples for at least a decade but did have clogged skin and hyperpigmentation to deal with.

Last year, I started on Tazorac and Obagi Clear for the hyperpigmentation. I was also ocassionally using a 2% BHA wash in the mornings. My skin was glorious for about four months. Then, summer hit and I was outdoors in the blistering sun (using sunscreen with high SPF but no other physical covering.)

By August, my skin was a mess! Pimples, blackheads, uneven skin tone and skin so dry I could barely touch it.

I have tried just about everything over the past two months: rose hip see oil, jojoba oil, hylauroinic acid in cream form, Vaseline, pumpkin enzyme treatment at the esthetician, the oil-cleansing method, aloe vera gel and NOTHING has worked to return my skin to normal!

I can't wear any makeup comfortably (though I want badly to cover the damage from this past summer ... as well as new damage from pimples that have formed, likely from putting too much on my face!) Mineral makeup is out because it's too drying. Moisturizing makeup does not moisturize.

I'd like to make a trip to the derm but I'm without insurance since losing my job.

If anyone's ever had this experience and can offer some help, I'd really, really appreciate it. I'd specifically like to know if my skin is ever going to return to its original state.
posted by anonymous to Clothing, Beauty, & Fashion (19 answers total) 9 users marked this as a favorite
You might consider getting a doctor's prescription for an antibiotic, like Clindoxyl Gel.
posted by weapons-grade pandemonium at 12:00 PM on November 23, 2009

Something similar to this happened to me when I was still using Retin-A Micro, and it turned out I had seborrheic dermatitis.
posted by Coatlicue at 12:04 PM on November 23, 2009

This is a LOT of trauma for your skin to go through! Personal anecdote: my best skincare experience turned out to be stopping the use of all of the stuff I was trying to use to make my skin problems go away. Have you tried just cleansing with a gentle wash 1-2 times a day, and only using a moisturizer and not all this extra stuff that is irritating it?
posted by so_gracefully at 12:13 PM on November 23, 2009 [3 favorites]

When you say "uneven skin tone", is it brownish or pinkish? If it's the latter, you may be developing rosacea. Redness, zits, dryness and extreme sensitivity to alcohol and perfumes are all hallmarks of this.

Treat your skin to the blandest, most gentle treatment right now.

Morning: try a very gentle cleanser like liquid Cetaphil. Wet your face with tepid water, gently rub in the cleanser, rinse with lots of tepid water. Don't add any medications or scrubs to attack the acne just yet. Focus on calming your skin down by adding the most neutral and bland, light moisturizer on top of your still damp face. (I find that Olay Complete Defense with SPF 15 doesn't irritate my face.) You can't add moisture: you retain moisture with a light oily shield. Vaseline will almost certainly make your breakouts worse, as will other rich moisturizers.

Evening: cleanse the same way, add moisturizer if your skin only if feels dry afterwards.

If your skin calms down a bit and you now want to deal with the acne, consider the money you spend at drugstores and the esthetician and compare that to the out-of-pocket cost of a doctor's visit, where you can probably get samples instead of buying a prescription right away. (One possible drawback: going to a doctor now may make whatever you're diagnosed with a pre-existing condition and you may not have these prescriptions covered under future insurance.) You may have a late flare-up of acne, rosacea, or seborrheic dermatitis, but each of these requires somewhat different treatment.

If you REALLY can't go to the doctor, and you want to treat the zits, try something with zinc and/or clay. Garnier's Pure 3-in-1 is a cleanser/scrub/mask that I would NOT suggest you use immediately while your skin is so dry and inflamed. Once it's calmed down a bit, try it as a mask once a week at night. Avoid scrubbing as long as your skin is highly reactive.
posted by maudlin at 12:16 PM on November 23, 2009

i have skin that's so dry that it hurts to touch when i'm not taking care of it. i'll back up so_gracefully - drop everything and go for the gentle cleaner and moisturizer.

i use cetaphil for sensitive skin and then a MAC moisturizer (it's the only one i've found that really works, but i'm sure there are cheaper ones that could work, just haven't found them yet).

also, don't wash with a wash cloth. wash your hands, then wet your face and spread the cetaphil on, then just splash it off and dab lightly with a clean, soft towel.

also, also - how much water do you drink a day? consider drinking more and reducing the salt and caffeine in your diet.
posted by nadawi at 12:19 PM on November 23, 2009

I would suggest a month or maybe even two of taking a break from everything and just using cetaphil and a really gentle moisturizer (cetaphil makes one, too). Give your skin some time to calm down.
posted by mercredi at 12:38 PM on November 23, 2009

I have found that a moisturizer with the ingredient 'magnesium aluminium/aluminum silicate' has worked wonders for my own very dry facial skin.
It took me several years to find the right kind of moisturizer too.
posted by Catfry at 12:50 PM on November 23, 2009

Yep, definitely echoing the drop everything and moisturize suggestion.

A good friend of mine had what he described as terrible acne all through high school and into his 20s. By the time I met him, I could see that he'd had issues in the past, but he hasn't had any in the 9 years I've known him.

I don't even think he used a special soap, other than just his regular old Dove body wash with a washcloth (like many guys I've known, he insisted on having a super-moisturizing body wash). Using a washcloth helped with exfoliation.

Then, while his skin was still wet (but not dripping), he used a generous amount of very plain lotion on his face. He chose Keri, because this was what his tattoo artist had told him to use after getting a tattoo -- nothing in it to irritate very sensitive skin which has been through trauma.
posted by Madamina at 1:12 PM on November 23, 2009

I have skin that gets really weird too, I often have rashes that come from cosmetics, creams I use, and even the weather can make it spot or get hives. The moisturizer I use is just plain Nivea. Many moisturizers make my face sting and my eyes water, but the plain Nivea doesn't. I use it every day.
posted by chocolatetiara at 1:25 PM on November 23, 2009

If you're nearing your 40s, I'm betting this is hormonal. I'm in my early 30s and have skin problems, too. My skin is sensitive to androgens, which means I break out on my chin and jawline, and have oil. That is under control when I'm on my birth control pills (Ocella). (There are risks with taking BCPs over the age of 35, so this may not be the solution for you.) But I also have problems with the weather. Cold, windy or dry weather makes my skin freak out. It gets red, pimply, scaly and just gross. My dermatologist said it's rosacea. I I trimmed down my skincare regimen to Purpose cleanser in the PM, Cetaphil bar soap in the AM (I use that in the shower) and Oil of Olay Sensitive moisturizer. A couple of times a week, I'll use either Finacea or Ziana. That is keeping it under control as we dive into winter here in the Southeastern US.

I think you really need to see a doctor about this. If you really can't afford it, Cetaphil, Purpose or another non-soap type cleanser with warm water twice a day is all you need. Get a very gentle moisturizer, and don't overdo it on the cosmetics. Also, buy your supplies from a store like Ulta or CVS that will let you return something if it doesn't work out.

Best of luck...
posted by FergieBelle at 1:34 PM on November 23, 2009

Try using Dove bar soap for sensitive skin works wonders for me and my fiance had skin trouble and used everything for it like proactiv and neutrogena. She now only uses dove twice a day and has no problems now.
posted by bravowhiskey at 2:28 PM on November 23, 2009

It sounds like your acid mantle has been stripped.
The acid mantle is a thin oily film that sits on top of the outmost layer of our skin. For most people, the pH of the acid mantle is about 4.5 to 5.5. Why is our skin naturally acidic at the surface? Our slightly acidic skin helps to fight off harmful bacteria. Many of the contaminants that might enter our skin, such as chemicals from the atmosphere and harmful bacteria, are alkaline in nature (i.e., they have a pH of higher than 7).
Your acid mantle can be stripped by over-cleansing (with a soap/cleanser), using skin care products with a high pH (EGADS this is why I cringe when people recommend washing your face with Ivory soap, Dr. Bronners or slathering Milk of Magnesia on your face every day. All highly alkaline products will make your skin feel REALLY clean at first then slowly strip your acid mantle).

With skin care the best policy is to use simple (but effective and pH balanced) items, and not too often. In the morning you can rinse your face with just water (or as someone on Metafilter suggested once, washing with a bit of honey! It's mildly acidic which is good for your skin), put on a very mild moisturizer if you want (I don't wear one but I'd recommend Complex 15 if needed) and your sunscreen (not the super-duper bullet proof variety full of silicones).

At night take everything off with a pH balanced cleanser (there are others available, but I've found Philosophy Purity great for removing makeup and sunscreens, plus the pH is 5-5.5 which is ideal for skin care products).

I know oil-cleansing gets a lot of praise but I've found it just dries the heck out of my skin and doesn't do anything particularly wonderful. My esthetician says if you have breakouts, you really shouldn't be putting oils on your skin anyway. Also, keep away from aggressive exfoliation while your skin heals. Hope this helps!
posted by wiretap at 3:30 PM on November 23, 2009

Hm. This happens to me occasionally. Not as extreme as your case sounds, but bad enough get truly frustrating. IANADermatologist, but I've worked in cosmetics and skincare, so I'm really interested the topic. (I'm weird.)

Here's what I do if the break-out comes:

Week 1: Stop using everything— not even cleanser/soap. It seems counter-intuitive, as no cleanser = a bit of dirt/makeup leftover. But when you start adding soaps and moisturizers and toners and zit creams and the kitchen sink, you'll lose track of what IS working and what is actually making it worse. And your skin could use a total breather. Only water, but lots and lots of water.

Week 2: For the love of god, start Proactiv. You'll spend about two weeks adjusting, but yes, the infomercials are true. Just get the starter kit, and don't let them talk you into more. (Also, remember that they'll keep sending you more every month, and charging your card every month. Cancel your account after you buy it.)

The Proactive people will tell you that you HAVE to use all of the products as a system— wash/scrub, toner, and Repairing Lotion. I don't find that to be the case. I love the cleansing cream and only the Repairing Lotion. The other products seem to burn my skin. However, I have a friend who swears by using only the toner. Who knows. You'll find yours.

By the way, I've learned the hard way— do not stop and start. Use it every night.

Week 4: (...Two weeks later...) Now that you're on Proactiv and found the combo of products you need, you might see some drying and peeling, especially around the blemishes. This is good, as it means the stupid things are shrinking. Go to the drug store and get a little face loofah. And BE GENTLE with it. It is not a sander and your face is not a 2x4.

Week 5: Once your face has started clearing, feel free to start wearing a bit of make-up to hide whatever scarring you might have. I highly recommend BeneFit Cosmetics. Their products are generally naturally based, even if they don't toot that horn. Their foundations blend extremely well, cover magically, look as natural as I've ever used, and have never done bad things to my face.

Good luck!
posted by functionequalsform at 4:35 PM on November 23, 2009

I love the cleansing cream and only the Repairing Lotion.

Oops. That's supposed to be:

I love the Repairing Lotion and only the Repairing Lotion.

Writer fail.
posted by functionequalsform at 4:37 PM on November 23, 2009

Check out Run by legit people (unlike the proactiv/murad etc.) Even if you end up not liking the related products there, theres good, unbiased advice and good forums to compare regimens/products, ask questions and whatnot.
posted by baserunner73 at 8:10 AM on November 24, 2009

I didn't have the other issues you describe, but to echo the commenter above, when my oily skin became dry, pimply skin, it was rosacea. My dermatologist suggested a regimen of Cetaphil and tepid water and nothing else until the inital flares calmed down. Nthing the suggestions above to scale your regimen waaaaaaaaay back to a very very gentle washing and a very very gentle moisturizing/sunscreening and just giving your face a few weeks to recover its balance.

Good luck!
posted by oblique red at 8:46 AM on November 24, 2009

I'm in a similar situation, though my skin isn't as dry as yours sounds.

Caveat: I'm assuming that you do actually have acne vulgaris + dry skin + brown hyperpigmentation, and not something else.

Here's what I do:

1. Every morning, splash face with lukewarm water and then smear it with a 2% salicylic acid wash. 2% is the therapeutic dose. Garnier Pure works for me, but Neutrogena leaves me with breakouts, YMMV.
Let it sit while you brush your teeth. Then get in the shower where it will rinse off.

2. If acne bothers your scalp, you can apply hair conditioner, but only on the ends of your hair and only on short hair. Try to avoid letting any of it get on your face or your scalp.

3. The last step of your shower should be washing your hair with a shampoo that doesn't contain proteins or silicones - extremely hard to find nowadays. I use Neutrogena T-Gel as it doesn't have any of these nasties in it.

4. Pat your face dry with the towel, don't ever rub it. Also, don't bother putting moisturizer on damp skin - the water will just dilute it. You are going to put on Cetaphil Daily Advance Ultra Hydrating Lotion for Dry, Sensitive Skin. All over. I even put it around my eyelids, do this at your own risk and don't get any actually in your eye.

5. Set a timer for 10 minutes to let the moisturizer sink in.

6. Apply the sunscreen of your choice. Again YMMV. You may have to experiment with facial sunscreens until you find one that doesn't make you break out. If the sunscreen is thicker than a moisturizer with SPF, dab it on in Smartie-sized dots and blend it in with a cosmetic sponge until it's smoothed over invisibly, but not rubbed away. Throw out and replace the cosmetic sponge at least once a month, preferably more often. If you are using a chemical sunscreen rather than a physical block (i.e. one where the active ingredient is zinc oxide or titanium dioxide), you need to leave it for 10 or even 20 minutes to bind to your skin. You must also be strict about waiting at least 10 minutes after moisturizing otherwise the moisturizer will break the sunscreen down.

7. You may wish to powder the sunscreen in place with a loose powder. This does help it to last. However it may be too drying. Make sure you take some sunscreen to work with you to put some more on at going-home time (if the sun's still out) and possibly at lunchtime (in the summer).

8. Whenever you go outside in daylight, put on a hat with at least a 2-inch brim. Make sure the hat fabric is opaque. You will find some nice fedoras for daily wear at M&S online, some with UPF 40. Also wear sunglasses. This will help to stop the hyperpigmentation from getting worse. If you are taking the Pill, you may find that some of the hyperpigmentation goes away when you stop taking it.

9. At the end of the day, fill your washbasin with lukewarm water. Hot or cold water will irritate your skin and you don't want anything that will irritate. Splash your face with water, and then smear it with Cetaphil cleansing lotion. Rinse with 25 splashes and then pat your face dry.

10. Repeat step 9.

11. Refill your washbasin with lukewarm water and rinse your face with 25 splashes. Pat dry.

12. Empty the basin, run the tap and splash your face with water again. Smear your 2% salicylic acid wash all over, and go brush your teeth.

13. Refill your washbasin with lukewarm water and rinse off the salicylic acid wash with 25 splashes. Pat dry.

14. Put your Cetaphil Daily Advance on and set your timer for 15 minutes.

15. Apply your topical acne treatment of choice. I use 2.5% PanOxyl every other day. It bleaches so keep it away from your eyebrows and hairline (though consider a trade-off if you have acne in your hairline). Every other day I use Differin gel, which is the only topical retinoid that doesn't clash with benzoyl peroxide, the active ingredient in PanOxyl. Both of these treatments will likely irritate your skin and make it more sun-sensitive though, especially the Differin. You may want to work up to using the Differin every other day: start with every 7 days for a month, then every 6, and so on.

16. Set a timer for 30 minutes to let the treatment bind to your skin. If it gets rubbed off by anything in this time (even water running down your chin) it may not have had enough time to work.

17. After 30 minutes you can apply another treatment. If it's not a Differin day I use Black Opal Essential Fade Complex, which has hydroquinone as its active ingredient. Use it only on the brown bits, as it works by gradually inhibiting melanin production. Again, leave this for 30 minutes. Or you may want to go straight to step 18.

18. You can put on another layer of Cetaphil Daily Advance now, if you like (and are still awake).

19. Consider not wasting your time and money on this but going straight to a dermatologist. I know you're broke, but response to skin products is idiosyncratic; a great product for me could make things worse for you. Also, there's no shortage of snake oil salesmen out there who will be happy to lie to you and steal your money. And you could pick excellent and cheap products but still end up wasting time trying to come up with the right combination of treatments through trial and error. And what if you have some other skin condition that's causing all this? You seriously are better off finding the money for the dermatologist because the overwhelming likelihood is that that will be cheaper.

20. And give any treatment at least 2 months to work. If it's not working after 2 months, ditch it. (Except birth control pills, which can take up to 9 months to have any effect on acne - and no-one will tell you this.)

21. Consider applying the benzoyl peroxide in the morning, too, if it's helping your acne but not enough. You will still have to leave it for 30 minutes, though.

22. Go to the gorram dermatologist!
posted by tel3path at 4:09 PM on December 3, 2009 [1 favorite]

The same thing was happening to my cousin. He tried some natural supplements like Lysine, Zinc Oxide and Cayenne. They all seem to help a little bit, but for the most part the problem went away after a certain age. I guess a lot also depends on what type of products you are already using. Most of them irritate the skin more then help.

It might be worthwhile stopping everything and just try to see what is causing the problem one element at a time. If problems such as these don't go away after a certain age, some people find benefit in Dr Clark liver cleansing. That is the one with food grade Epsom salts, Olive oil and pure Grapefruit juice. Hope some of this makes sense. It did for my cousin.
posted by Wellbasics at 3:20 AM on March 6, 2010

My skin is not as bad as yours at the moment but I have suffered with varying degrees of acne for the last 20 years. My skin recently started to flare up more and more without rhyme or reason. I found myself reading up about all manner of topical treatments trying to come up with some kind of regime that was going to work. And then I came across anecdotal evidence from somebody who had only ever used water to wash their face and started to use soap because they felt they should, as normal adult, and started to break out all over the place, abandoned the soap again and skin returned to normal.

So I decided I had little to lose and actually stopped using all soap and moisturiser on my face about six weeks ago. And to my great surprise my skin did not feel dirty, my skin did not clogg up any more and nor break out any more but actually started to calm down. I do wear makeup so I remove this with a cleansing wipe but other than that my face gets was cleaned with nothing but warm water. About six weeks in I still have a few break outs, primarily hormonal before my period starts but my skin is much happier, any pimples and zits are a lot less red and angry than they used to be and heal faster.

And then I also remembered what I read about oil cleansing and had a go a few nights ago. And even after only two treatments over the last week my skin no longer feels dry in places nor is it developing the usual oil slick after a few hours. Clearly this is very early days for oil cleansing for me and therefore I can only say that, at the moment, the oil slick is no longer developing on my face and dry skin is coming off leaving smooth glowing skin, my skin looks much better in tone and texture than it has for years.

So what I would suggest is to be brave and stop all the topicals you are using. Just wash your face with water, if you wear make-up then you need to remove this - I'd suggest usign a moisturiser for sensitive skin and a cotton ball, nothing harsh, followed by warm water only. Eat well, drink lots of water and sleep and give your skin a chance to actually stop reacting to all the stuff you put on it.

When you leave the house wear a light moisturiser with spf and a large brimmed hat - don't care what that looks like - you need to physically protect your face from the sun for the time being to allow your sking to do the healing it needs to do.
posted by koahiatamadl at 1:46 PM on August 30, 2010

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