Can you help me with a changing, but still there skin problem?
June 14, 2017 1:35 PM Subscribe
I am sort of at a loss as to what to do about a continuing - but now changing - acne problem I have, and hoping that kind metafilter members might have some good advice. Why is my acne changing in nature, and what should I do about it?
Since my teens more or less, I've had acne. Got a lot better in my twenties, then thirties, and now around 40, I still have some. Not debilitating, but a few months ago I figured I'm too old for this and went to the dermatologist. Went on a short antibiotic cycle, got some aczone topical, and it cleared up very easily, so that was exciting.
BUT a few months later, post antibiotic, I seem to have an entirely new kind of acne problem.
Since teenage-dom, I had that sort of small but reddish, whitehead pimples around my chin, nose... classic acne, I suppose.
Now, post-antibiotic, still using the topical, I don't seem to have many, if any whiteheads - I have a lumpier, non-whitehead type of pimples on my forehead, temples. They are harder, more painful, without a head... I don't recall getting these much before. Now they are constant, stick around for a week or so, go away, but I always have a few.
So what gives? How does one have "changing" acne? I thought this would be over by now... I have other problems to worry about in my forties!
Yes, I will go to the dermatologist again. But does anyone know why this might happen? Am I doing something to cause this, and do you have any suggestions or remedies?
Since my teens more or less, I've had acne. Got a lot better in my twenties, then thirties, and now around 40, I still have some. Not debilitating, but a few months ago I figured I'm too old for this and went to the dermatologist. Went on a short antibiotic cycle, got some aczone topical, and it cleared up very easily, so that was exciting.
BUT a few months later, post antibiotic, I seem to have an entirely new kind of acne problem.
Since teenage-dom, I had that sort of small but reddish, whitehead pimples around my chin, nose... classic acne, I suppose.
Now, post-antibiotic, still using the topical, I don't seem to have many, if any whiteheads - I have a lumpier, non-whitehead type of pimples on my forehead, temples. They are harder, more painful, without a head... I don't recall getting these much before. Now they are constant, stick around for a week or so, go away, but I always have a few.
So what gives? How does one have "changing" acne? I thought this would be over by now... I have other problems to worry about in my forties!
Yes, I will go to the dermatologist again. But does anyone know why this might happen? Am I doing something to cause this, and do you have any suggestions or remedies?
Those are cysts. It could have a hormonal origin (as could the rest of your acne, for that matter). It's certainly possible that your change in skin care regimen created a change in how your skin responded. I had a similar incident after a course of Accutane, where my old skin care routine definitely did not apply to my new skin care requirements. It took me a few months to get that figured out.
Consider the following:
1. Your skin may simply be adjusting from having been on antibiotics and a new product
2. Maybe your skin doesn't like that topical product and you should try something else
3. ??? (Which is why it's good that you're going back to the dermatologist)
I personally find salicyclic acid to do almost nothing to prevent acne, and have much better results from benzoyl peroxide. I use Jan Marini 5% BP lotion (it also comes in 2.5% and 10%) which is very effective and a good deal for the price ($40 for a 4oz bottle on Amazon).
As for cleansing, I personally go with oil cleansing or a non-soap cleanser like Purpose or Cetaphil Daily (the gentle was too gentle for me) and a cleansing buff (I have hearty skin and it responds well to this). In the morning I just wash with water and a washcloth. For moisturizer, I use jojoba oil ($8 at Trader Joe's) and sometimes a moisturizing gel. I think the bottom line is that I went through a decent amount of trial and error to find a good regimen, but I started with the basic regimen as specified on Acne.org and adjusted as needed. (One application of benzoyl peroxide at night works fine for me, for example, and my skin *likes* to be exfoliated, etc.) As long as I'm consistent, I get good results.
posted by Autumnheart at 2:05 PM on June 14, 2017
Consider the following:
1. Your skin may simply be adjusting from having been on antibiotics and a new product
2. Maybe your skin doesn't like that topical product and you should try something else
3. ??? (Which is why it's good that you're going back to the dermatologist)
I personally find salicyclic acid to do almost nothing to prevent acne, and have much better results from benzoyl peroxide. I use Jan Marini 5% BP lotion (it also comes in 2.5% and 10%) which is very effective and a good deal for the price ($40 for a 4oz bottle on Amazon).
As for cleansing, I personally go with oil cleansing or a non-soap cleanser like Purpose or Cetaphil Daily (the gentle was too gentle for me) and a cleansing buff (I have hearty skin and it responds well to this). In the morning I just wash with water and a washcloth. For moisturizer, I use jojoba oil ($8 at Trader Joe's) and sometimes a moisturizing gel. I think the bottom line is that I went through a decent amount of trial and error to find a good regimen, but I started with the basic regimen as specified on Acne.org and adjusted as needed. (One application of benzoyl peroxide at night works fine for me, for example, and my skin *likes* to be exfoliated, etc.) As long as I'm consistent, I get good results.
posted by Autumnheart at 2:05 PM on June 14, 2017
I use Jan Marini 5% BP lotion (it also comes in 2.5% and 10%) which is very effective and a good deal for the price ($40 for a 4oz bottle on Amazon).
Or you could buy Clearasil or similar product at the drugstore for a fraction of the cost...
posted by praemunire at 2:08 PM on June 14, 2017
Or you could buy Clearasil or similar product at the drugstore for a fraction of the cost...
posted by praemunire at 2:08 PM on June 14, 2017
Or you could buy Clearasil or similar product at the drugstore for a fraction of the cost...
No, because Clearasil is 10%, which is too irritating for me, and a tube of it is about $7 for 1oz. So it'd be $28 for the equivalent amount, which is not tremendously cheaper than the product I use that actually works. I used to use Neutrogena, but they changed their formula so it doesn't work for me, and ounce for ounce, actually cost nearly twice as much as the Jan Marini. Do the math.
posted by Autumnheart at 2:13 PM on June 14, 2017 [2 favorites]
No, because Clearasil is 10%, which is too irritating for me, and a tube of it is about $7 for 1oz. So it'd be $28 for the equivalent amount, which is not tremendously cheaper than the product I use that actually works. I used to use Neutrogena, but they changed their formula so it doesn't work for me, and ounce for ounce, actually cost nearly twice as much as the Jan Marini. Do the math.
posted by Autumnheart at 2:13 PM on June 14, 2017 [2 favorites]
If a BP percentage is too high for you, you can dilute it with a proportionate amount of suitable moisturizer.
I find that Cetaphil Daily Advance Ultra Hydrating Lotion is the best. Since BP breaks down on contact with air, you will have to re-mix it for every application, but it's a useful tip if you ever find you can't lay your hands on your preferred BP product.
But from what you've said, it sounds like you have cysts and nodules, which originate deeper in the skin. Topical treatments will probably help, but they won't likely be the whole solution. The cause may be hormonal, since you ask, but it's more a question for an expert.
Since cystic acne originates fairly deep in the skin, it probably is not caused by anything you're doing - or, if it is, it's probably not anything that science can yet identify. If you were putting the wrong thing on your face it would probably be showing up in the form of pustular acne, which you already have under control.
I would however make *one* suggestion, as someone who's suffered the full range of cystic acne through pustules all my life. This was in my twenties so I can't quite remember what changed, but I discovered that technique almost by accident and got better results than I expected. So yeah... try washing twice then adding a final rinse in the evening, though probably it'll only help a bit, it won't cure you.
One last thing - did you eat any food in recent weeks? If any morsel of food passed your lips, people will tell you that's where you're going wrong. And I'm not saying it isn't, but if you're going to investigate dietary cures I suggest you go all-out and do a proper, systematic elimination diet - don't just do random stuff like giving up chives.
Also - have you experienced stress in recent weeks? Ahh, that's it. Stress causes acne! Just get rid of stress and voila, acne no more. Unfortunately you will be dead by then, but you'll also be remarkably untroubled by acne.
posted by tel3path at 2:51 PM on June 14, 2017 [5 favorites]
I find that Cetaphil Daily Advance Ultra Hydrating Lotion is the best. Since BP breaks down on contact with air, you will have to re-mix it for every application, but it's a useful tip if you ever find you can't lay your hands on your preferred BP product.
But from what you've said, it sounds like you have cysts and nodules, which originate deeper in the skin. Topical treatments will probably help, but they won't likely be the whole solution. The cause may be hormonal, since you ask, but it's more a question for an expert.
Since cystic acne originates fairly deep in the skin, it probably is not caused by anything you're doing - or, if it is, it's probably not anything that science can yet identify. If you were putting the wrong thing on your face it would probably be showing up in the form of pustular acne, which you already have under control.
I would however make *one* suggestion, as someone who's suffered the full range of cystic acne through pustules all my life. This was in my twenties so I can't quite remember what changed, but I discovered that technique almost by accident and got better results than I expected. So yeah... try washing twice then adding a final rinse in the evening, though probably it'll only help a bit, it won't cure you.
One last thing - did you eat any food in recent weeks? If any morsel of food passed your lips, people will tell you that's where you're going wrong. And I'm not saying it isn't, but if you're going to investigate dietary cures I suggest you go all-out and do a proper, systematic elimination diet - don't just do random stuff like giving up chives.
Also - have you experienced stress in recent weeks? Ahh, that's it. Stress causes acne! Just get rid of stress and voila, acne no more. Unfortunately you will be dead by then, but you'll also be remarkably untroubled by acne.
posted by tel3path at 2:51 PM on June 14, 2017 [5 favorites]
This thread is closed to new comments.
What's your skincare routine like at the moment? You should definitely be seeing a dermatologist to figure out why you're suddenly getting cysts (that's what those lumps sound like), but in the meantime a gentle skincare routine can go a long way in terms of preventing inflammation and treating existing cysts. This involves:
- Using a gentle low pH cleanser + double cleansing with an oil cleanser followed by gel/foaming cleanser at night if you wear sunscreen or makeup during the day.
- Using appropriate actives - for acne, this is typically a salicylic acid product to exfoliate within the pore combined with a benzoyl peroxide to disinfect.
- A lightweight moisturiser (this post on r/SkincareAddiction is a good start.
Good luck!
posted by nerdfish at 1:43 PM on June 14, 2017 [2 favorites]