How to I find professional help for my adult acne?
July 8, 2017 1:04 AM Subscribe
I have moderate adult acne. I’ve tried many things to fix it and still have the same skin I had in high school, which is somehow oily and dry at the same time. I probably need professional help, but I’m not sure if I should be looking for a dermatologist or someone else. How do you find a good treatment specialist who is serious about acne?
I’m a woman in her mid-30s who works in a highly male dominated field. I get breakouts once every few weeks, usually around my chin and the corners of my mouth, and some subtle but persistent nasal blackheads. It seems like I always have a breakout or am healing from a breakout. Up until recently, I’ve been okay with covering it up with makeup or not really caring and letting my face be my face. However, I’ve had some success in my career and am now photographed and interviewed in the media often enough that I am recognized on the street in my mid-sized US city. This is extremely weird and has made me pretty self-conscious about my appearance.
I’ve been experimenting with fixing my skin for a few years and have seen no long-term changes. I try to keep my routine fairly simple without too many products and am a clean person in general. I make only one change to my skin-care routine at a time and continue the ones I like for three to six months to see if there is a difference past the short-term honeymoon phase. Guys, I have a face journal.
Things I’ve tried (one at a time with significant gaps) that did not make a difference:
- Topical gels and creams: Salicylic acid, benzoyl peroxide, Mario Badescu drying lotion
- Taking large daily doses of pantothenic acid (with the supervision of my doctor)
- Cutting out dairy
- Regular every other day Clarisonic Mia use
- Clay masks, sheet masks, charcoal masks, etc.
- Tea tree soap, egg white soap, etc.
- A Japanese collagen gel that makes it look like your skin is peeling though it really isn’t
- Murad Sulfur gel (despite the face the one thing in my life that made my skin better was living in a town where the tap water came from a sulfur spring)
Other than bathing in sulfur water nightly, nothing has really changed my skin. Winter or summer, makeup or bare face, it stubbornly cycles between being clear and having a small handful of blemishes. I’m on birth control and somehow my skin still seems to be beholden to my hormonal cycle. My mother had similar skin and dealt with breakouts until menopause. I’d rather not wait that long.
I’ve read thousands of internet articles and comments (including many on this very site) and tried to learn from them. I’m really happy for everyone who has found their solution, but none of it seems to work for me. I think I need professional help, but I don’t even know where to start. I was raised by poor people who generally did not spend money on skin experts. Are there dermatologists out there who won’t automatically go to Accutane or other harsh drugs (which I don’t want to take for personal reasons)? How do I find one? Do I need someone else like an aesthetician (which is a profession that I just learned is a real)? I have health insurance and some cash to throw at this problem.
On the bonus side I look a decade younger than my actual age.
Thanks, everyone. If you’ve had a similar ordeal please tell me your story.
I’m a woman in her mid-30s who works in a highly male dominated field. I get breakouts once every few weeks, usually around my chin and the corners of my mouth, and some subtle but persistent nasal blackheads. It seems like I always have a breakout or am healing from a breakout. Up until recently, I’ve been okay with covering it up with makeup or not really caring and letting my face be my face. However, I’ve had some success in my career and am now photographed and interviewed in the media often enough that I am recognized on the street in my mid-sized US city. This is extremely weird and has made me pretty self-conscious about my appearance.
I’ve been experimenting with fixing my skin for a few years and have seen no long-term changes. I try to keep my routine fairly simple without too many products and am a clean person in general. I make only one change to my skin-care routine at a time and continue the ones I like for three to six months to see if there is a difference past the short-term honeymoon phase. Guys, I have a face journal.
Things I’ve tried (one at a time with significant gaps) that did not make a difference:
- Topical gels and creams: Salicylic acid, benzoyl peroxide, Mario Badescu drying lotion
- Taking large daily doses of pantothenic acid (with the supervision of my doctor)
- Cutting out dairy
- Regular every other day Clarisonic Mia use
- Clay masks, sheet masks, charcoal masks, etc.
- Tea tree soap, egg white soap, etc.
- A Japanese collagen gel that makes it look like your skin is peeling though it really isn’t
- Murad Sulfur gel (despite the face the one thing in my life that made my skin better was living in a town where the tap water came from a sulfur spring)
Other than bathing in sulfur water nightly, nothing has really changed my skin. Winter or summer, makeup or bare face, it stubbornly cycles between being clear and having a small handful of blemishes. I’m on birth control and somehow my skin still seems to be beholden to my hormonal cycle. My mother had similar skin and dealt with breakouts until menopause. I’d rather not wait that long.
I’ve read thousands of internet articles and comments (including many on this very site) and tried to learn from them. I’m really happy for everyone who has found their solution, but none of it seems to work for me. I think I need professional help, but I don’t even know where to start. I was raised by poor people who generally did not spend money on skin experts. Are there dermatologists out there who won’t automatically go to Accutane or other harsh drugs (which I don’t want to take for personal reasons)? How do I find one? Do I need someone else like an aesthetician (which is a profession that I just learned is a real)? I have health insurance and some cash to throw at this problem.
On the bonus side I look a decade younger than my actual age.
Thanks, everyone. If you’ve had a similar ordeal please tell me your story.
2% BHA cream- Paula's choice is good. I use it every day and maybe get one small pimple a month, if that, down from it being about as bad as what you're describing. I use the one that also has salicylic acid, but I'm pretty sure they sell one without too. only thing is- it can make you a little extra prome to sunburns so make sure to use sunscreen.
posted by Homo neanderthalensis at 1:37 AM on July 8, 2017
posted by Homo neanderthalensis at 1:37 AM on July 8, 2017
This is what I use But it comes in a liquid and a gel as well.
posted by Homo neanderthalensis at 1:39 AM on July 8, 2017
posted by Homo neanderthalensis at 1:39 AM on July 8, 2017
Hello, fellow adult acne sufferer.
What you want is a dermatologist. Most of the ones I have been to have been very receptive to my "no Accutane" stance, and they have a lot of prescription face creams and gels that work with all sorts of different skin types. Mine switched me between three different prescriptions before we settled on Differin as being the most suited for me, and being on differin has mostly solved my skin woes, though I do have minor breakouts some of the time.
As far as non-medication routes, I've found that layering different skin treatments helps with decreasing my acne - you might want to try mixing up a few of the things that sort-of worked for you in the past and layering them into a basic cleanse-exfoliate-treatment-moisturize routine. I discovered the Asian Beauty and Skincare Addiction subreddits a few months ago, and they've really helped with the few breakouts I get.
posted by MFZ at 2:38 AM on July 8, 2017 [5 favorites]
What you want is a dermatologist. Most of the ones I have been to have been very receptive to my "no Accutane" stance, and they have a lot of prescription face creams and gels that work with all sorts of different skin types. Mine switched me between three different prescriptions before we settled on Differin as being the most suited for me, and being on differin has mostly solved my skin woes, though I do have minor breakouts some of the time.
As far as non-medication routes, I've found that layering different skin treatments helps with decreasing my acne - you might want to try mixing up a few of the things that sort-of worked for you in the past and layering them into a basic cleanse-exfoliate-treatment-moisturize routine. I discovered the Asian Beauty and Skincare Addiction subreddits a few months ago, and they've really helped with the few breakouts I get.
posted by MFZ at 2:38 AM on July 8, 2017 [5 favorites]
Find a well respected cosmetic dermatologist. That's one of the things they do all day every day. For ideas of what a treatment plan may entail have a look here.
posted by koahiatamadl at 2:40 AM on July 8, 2017 [3 favorites]
posted by koahiatamadl at 2:40 AM on July 8, 2017 [3 favorites]
Yes, why is "seeing a dermatologist" not on your list? Do it!
I also occasionally get hormonal acne, and it's taken care of via topical creams applied every 1-2 days - either: TactuPump [which is just Differin + benzoyl peroxide - I believe it's called Epiduo in the US], in winter, or BP layered over 2% salicylic acid in summer (to reduce, if not eliminate photosensitivity caused by TactuPump. Sunscreen's needed at all times - I like LRP 60 Anthelios Ultra Light). Both SA & Differin are good for both problems you mention.
If one of those hormonal fuckers comes along, per my derm, I put a lot of whatever I'm using on there right away, which sometimes stops it. If that fails, I head over to the derm's for a kenalog injection. (Obviously, it helps to have no sleeps without makeup being taken completely off, only wear non-comedogenic, water-based makeup, etc.)
posted by cotton dress sock at 3:14 AM on July 8, 2017
I also occasionally get hormonal acne, and it's taken care of via topical creams applied every 1-2 days - either: TactuPump [which is just Differin + benzoyl peroxide - I believe it's called Epiduo in the US], in winter, or BP layered over 2% salicylic acid in summer (to reduce, if not eliminate photosensitivity caused by TactuPump. Sunscreen's needed at all times - I like LRP 60 Anthelios Ultra Light). Both SA & Differin are good for both problems you mention.
If one of those hormonal fuckers comes along, per my derm, I put a lot of whatever I'm using on there right away, which sometimes stops it. If that fails, I head over to the derm's for a kenalog injection. (Obviously, it helps to have no sleeps without makeup being taken completely off, only wear non-comedogenic, water-based makeup, etc.)
posted by cotton dress sock at 3:14 AM on July 8, 2017
A good aesthetician can really help. The one my friend went to worked miracles. They can pull the blackheads and pimples out using special tools and give advice on any products or lifestyle changes they feel you should make based on the success of their previous clients. Try that first; you'll at least be able to get those stubborn blackheads removed and your clogged pores and skin treated.
posted by LuckySeven~ at 3:39 AM on July 8, 2017
posted by LuckySeven~ at 3:39 AM on July 8, 2017
Nthing see a dermatologist. A good dermatologist will hear and respect your concerns about Accutane (although I will say that prescription strength topical retinol can be life changing), and there are a range of treatments and approaches you can try.
posted by nerdfish at 4:23 AM on July 8, 2017 [3 favorites]
posted by nerdfish at 4:23 AM on July 8, 2017 [3 favorites]
Have you ever gotten a facial before? Try one that is "pore cleansing", not "relaxing". As an adult acne sufferer, I found this more effective than any soap, cream or medicine.
posted by Toddles at 4:30 AM on July 8, 2017 [1 favorite]
posted by Toddles at 4:30 AM on July 8, 2017 [1 favorite]
Definitely see a dermatologist. Acne is a medical issue and your insurance may cover your prescription.
posted by ThePinkSuperhero at 5:00 AM on July 8, 2017
posted by ThePinkSuperhero at 5:00 AM on July 8, 2017
Oh my, please see a dermatologist. Mine gave me a choice of Accutane or topical medication. I chose the latter, and it was quite effective, much more so than any OTC meds/washes I had tried.
posted by deadweightloss at 5:35 AM on July 8, 2017 [2 favorites]
posted by deadweightloss at 5:35 AM on July 8, 2017 [2 favorites]
You don't mention diet at all, so I don't know if that's something you've tried. Feel free to ignore if you're not interested, but my adult acne all but disappeared when I switched to a vegan diet. Here's an article by someone who had the same experience. This article is by two young women who had severe acne on a vegan diet that went away went they changed to a very low fat vegan diet.
I did start breaking out again some when I was on steroids for cancer treatment, but as soon as I went off the steroids, the breakouts stopped. I really have no idea whether your birth control could be affecting this, but that's something to consider as well.
posted by FencingGal at 6:05 AM on July 8, 2017
I did start breaking out again some when I was on steroids for cancer treatment, but as soon as I went off the steroids, the breakouts stopped. I really have no idea whether your birth control could be affecting this, but that's something to consider as well.
posted by FencingGal at 6:05 AM on July 8, 2017
Dermatologist for sure. Mine didn't even consider Accutane for me, but rather topical treatments until we found a combo of Retin A and Clindamyacin that worked so well. Insurance covered my visits and prescriptions.
posted by buttonedup at 6:31 AM on July 8, 2017 [1 favorite]
posted by buttonedup at 6:31 AM on July 8, 2017 [1 favorite]
I know this struggle well. I too have a mix of oily and dry skin and hormonal acne that clusters at my chin. I've had very clear periods, very bad periods, and everything in between. Agreeing with the suggestion to see a dermatologist and a good esthetician - both helped me find my way to understanding skin care. In the meantime, here's a few things I've picked up along the way.
- I'm not sure what you're using now, but something that really changed my life was working on balancing my skin. If you have dry patches and oil, sometimes that means you just have dry skin and you're now over-producing oil because you're not moisturizing enough. It's counter-intuitive when you have acne to think you need more moisture, but once I embraced this as a possible reality my skin got better consistently. It's still not perfect, but it's been years since my worst cycles have resurfaced (pun intended). The instinct when you have acne is to go deep on treating the acne, but unless you are truly oily skinned, that often backfires and produces more acne and oil. It's pretty screwed up!
- Stay away from all skin care products with any oil or butters in them. "organic all natural" skin care is my worst enemy. If you see an essential oil, run. That will clog your pores.
- Ask a derm about Spironolactone to treat hormonal acne. It blocks testosterone absorption. It made a HUGE difference for me.
- another derm one: cortisone shots. They aren't so bad actually and if you have a monster cyst it's the only thing that will get rid of it quickly. Build a relationship and just pop in and let your derm zap it. Once you have your skin under control you'll get them less and there is no reason to suffer with a cyst for 3 weeks!
- Consider switching up your makeup. Some things my now too fancy to even see me because she only treats celebs facialist ok'd: giorgio armani luminous silk foundation and powders, anything by cle de peau, and hourglass mineral primer.
- Make sure you remove all of your makeup before bed religiously. I use makeup remover and then cleanse. Millicer water is great for the makeup removal step. I like bioderma best.
- reddit has a group called skincareaddiction that is a great resource for learning about skin care. It's a little overwhelming at first but there's a ton of enthusiasts and experts there that can answer questions, give tips and provide general support.
Finally, here are some skincare brands I think are worth checking out. Not every product will work for you but I've found some winners:
High End:
Chantecaille
Skinceuticals
Jan Marini
Arcona
Drunk elephant
Boscia
Drugstore:
Cetaphil
Cerave
Best of luck!
posted by amycup at 6:35 AM on July 8, 2017 [1 favorite]
- I'm not sure what you're using now, but something that really changed my life was working on balancing my skin. If you have dry patches and oil, sometimes that means you just have dry skin and you're now over-producing oil because you're not moisturizing enough. It's counter-intuitive when you have acne to think you need more moisture, but once I embraced this as a possible reality my skin got better consistently. It's still not perfect, but it's been years since my worst cycles have resurfaced (pun intended). The instinct when you have acne is to go deep on treating the acne, but unless you are truly oily skinned, that often backfires and produces more acne and oil. It's pretty screwed up!
- Stay away from all skin care products with any oil or butters in them. "organic all natural" skin care is my worst enemy. If you see an essential oil, run. That will clog your pores.
- Ask a derm about Spironolactone to treat hormonal acne. It blocks testosterone absorption. It made a HUGE difference for me.
- another derm one: cortisone shots. They aren't so bad actually and if you have a monster cyst it's the only thing that will get rid of it quickly. Build a relationship and just pop in and let your derm zap it. Once you have your skin under control you'll get them less and there is no reason to suffer with a cyst for 3 weeks!
- Consider switching up your makeup. Some things my now too fancy to even see me because she only treats celebs facialist ok'd: giorgio armani luminous silk foundation and powders, anything by cle de peau, and hourglass mineral primer.
- Make sure you remove all of your makeup before bed religiously. I use makeup remover and then cleanse. Millicer water is great for the makeup removal step. I like bioderma best.
- reddit has a group called skincareaddiction that is a great resource for learning about skin care. It's a little overwhelming at first but there's a ton of enthusiasts and experts there that can answer questions, give tips and provide general support.
Finally, here are some skincare brands I think are worth checking out. Not every product will work for you but I've found some winners:
High End:
Chantecaille
Skinceuticals
Jan Marini
Arcona
Drunk elephant
Boscia
Drugstore:
Cetaphil
Cerave
Best of luck!
posted by amycup at 6:35 AM on July 8, 2017 [1 favorite]
You should definitely see a dermatologist, but in the meantime I recommend this travel size kit. It's not a huge investment; I found that my skin freaked out a bit for the first week or so that I used it, and then settled down completely. I am now a complete devotee of Paula's Choice products (I've added a retinal serum and moisturizer with SPF to my regimen). Also, consider doing a Whole30; I know MeFites tend to disdain the program, but my skin looks best when I'm following that style of eating. It's only 30 days and could be a big help.
posted by katie at 7:00 AM on July 8, 2017
posted by katie at 7:00 AM on July 8, 2017
Accutane is not generally a first-line treatment for acne, and is not commonly used for moderate acne that amounts to "breakouts every few weeks" (which sounds hormonal to me, a not-doctor with hormonal acne controlled by spironolactone). People with severe acne that causes serious pain and scarring often have to beg to go on it. While there are presumably some dermatologists with weird ideas about it out there, I've never come across one who'd try to pressure anyone into Accutane. There are lots of other treatments a dermatologist can offer you that are definitely worth trying. Go see one!
posted by lemonadeheretic at 7:06 AM on July 8, 2017 [2 favorites]
posted by lemonadeheretic at 7:06 AM on July 8, 2017 [2 favorites]
It took many years for me to understand that my fair skin is really sensitive and also that a lot of my acne was due to slightly ingrown hairs. What works: Exfoliating so the hair that's trying to get free can. A very mild antibiotic salve to help my hypersensitive skin heal promptly. Cautious use of a mild benzoyl peroxide wash. I use a bufpuf weekly, and a soapy washcloth twice daily. When I shower, I rinse my face directly in the water for at least a minute. Wash pillowcases weekly. Wash phone screen and phone handset (work). I have way less acne since menopause, 90% is ingrown hairs.
posted by theora55 at 7:46 AM on July 8, 2017
posted by theora55 at 7:46 AM on July 8, 2017
Since you respond to sulfer - I had a sulfer-based antibiotic cream that I used in my 20s called Sulfacet that worked well for me.
posted by Dashy at 7:58 AM on July 8, 2017
posted by Dashy at 7:58 AM on July 8, 2017
I had similar problems with breaking out occasionally around my jaw and chin, which is usually correlated with hormonal acne. My dermatologist put me on a combo of spironlactone and a retinol, and it's worked absolute wonders. I have some other adult female friends also on spiro for acne. It's not a quick fix, but it's led to huge improvements in my skin. Good luck!
posted by kinsey at 8:18 AM on July 8, 2017
posted by kinsey at 8:18 AM on July 8, 2017
Have you tried an oil cleansing method? Basic premise is like cleans like, so you use oils to remove the sebum/facial oils and deep clean your pores. I am mid thirties with adult acne and am trying oil cleansing for the first time. I am a week in, so I can't speak to results yet (they say give it 3 weeks before you make a decision)- but my skin feels so much cleaner after using oil without feeling tight and over dried. I use 1 part castor oil to 3 parts carrrier oil (like sunflower seed oil) every other day.
Here is a link to an instruction site about how to do it.
posted by Suffocating Kitty at 8:25 AM on July 8, 2017
Here is a link to an instruction site about how to do it.
posted by Suffocating Kitty at 8:25 AM on July 8, 2017
I have heard good things about Curology though have not tried it myself.
posted by Threeve at 8:49 AM on July 8, 2017
posted by Threeve at 8:49 AM on July 8, 2017
Yes, go to a dermatologist. They are doctors so they will know what they are looking at, and have access to treatments you can't get from a store or aesthetician. Retin- a totally transformed my skin (and I had used OTC retinol products before to no effect.) That's me, though--everyone is different so you need an expert. Accutane isn't really pushed hard these days so if you get a derm who's convinced that's the answer, they're very old-school and you can switch doctors if that's not the approach you want.
posted by kapers at 8:55 AM on July 8, 2017
posted by kapers at 8:55 AM on July 8, 2017
I've also suffered from this type of acne (chin/jaw) all my adult life (my skin was relatively clear as a teenager). One thing was getting my hypothyroid under control (long story stretching back to a bout of mono in college), but that's another whole battle. Definitely agree with everyone saying to see a dermatologist, but that didn't really work for me...unfortunately I had bad side effects/allergic reactions from the few treatments that seemed to work on the acne.
It sounds simple, but I've had visible, albeit not complete, improvement with washing my face at night before bed (no moisturizer), just rinsing my face in the shower in the morning , and then applying a light moisturizer with salicylic acid.
posted by Preserver at 9:00 AM on July 8, 2017
It sounds simple, but I've had visible, albeit not complete, improvement with washing my face at night before bed (no moisturizer), just rinsing my face in the shower in the morning , and then applying a light moisturizer with salicylic acid.
posted by Preserver at 9:00 AM on July 8, 2017
Definitely go to a dermatologist, not an esthetician. Dermatologists have gone to med school, completed a residency, and can prescribe medications. Estheticians may or may not have had much formal training and while some are fantastic and knowledgeable about skincare, some are not.
I don't think you need to worry that the dermatologist you see will push you to try Accutane. It sounds like your acne is persistent but relatively mild and you haven't tried any other prescription treatments. Accutane is usually more of a last resort treatment once topical treatments have failed.
posted by insectosaurus at 11:12 AM on July 8, 2017
I don't think you need to worry that the dermatologist you see will push you to try Accutane. It sounds like your acne is persistent but relatively mild and you haven't tried any other prescription treatments. Accutane is usually more of a last resort treatment once topical treatments have failed.
posted by insectosaurus at 11:12 AM on July 8, 2017
seeing a dermatologist is a very good idea
that said, the thing that conquered my adult acne was regular european facials with extraction about once every 6-8 weeks and daily use of the products they recommended. this is not cheap and its a long term commitment but it healed my skin, from deep. I had painful cystic breakouts along my jawline and they were completely stopped (not immediately!! it takes some time to heal the skin but you will see surface improvements right away)
if you are in/near a city there will be salons to choose from. check yelp to find someone gentle and thorough.
posted by supermedusa at 11:24 AM on July 8, 2017
that said, the thing that conquered my adult acne was regular european facials with extraction about once every 6-8 weeks and daily use of the products they recommended. this is not cheap and its a long term commitment but it healed my skin, from deep. I had painful cystic breakouts along my jawline and they were completely stopped (not immediately!! it takes some time to heal the skin but you will see surface improvements right away)
if you are in/near a city there will be salons to choose from. check yelp to find someone gentle and thorough.
posted by supermedusa at 11:24 AM on July 8, 2017
if you are in SF Bay Area you can PM me for a very good recommendation, if you like.
posted by supermedusa at 11:24 AM on July 8, 2017 [1 favorite]
posted by supermedusa at 11:24 AM on July 8, 2017 [1 favorite]
A dermatologist will give you a mild retinol treatment that will do more for you than anything else you could possibly do, and if you have insurance it will almost certainly be covered. This is far cheaper than facials and other options.
posted by ch1x0r at 2:04 PM on July 8, 2017 [1 favorite]
posted by ch1x0r at 2:04 PM on July 8, 2017 [1 favorite]
Lots of good recommendations here. As an acne lifer (I'm in my 40s) I've had luck deterring breakouts with Cetaphil cleanser (rubbed on with the fingers, only at night- in the morning I just wash my face with water in the shower) and Retin-A cream. I haven't tried spironolactone, but only because I'm already on birth control pills, which have more or less the same effect on hormonal acne. A dermatologist will be able to help you evaluate your options, and as many folks here have said, Accutane is usually a last resort and not something that doctors push on people. I have recommendations for two excellent dermatologists in the East Bay if you're in the area.
posted by foxy_hedgehog at 2:51 PM on July 8, 2017
posted by foxy_hedgehog at 2:51 PM on July 8, 2017
Nthing going to a dermatologist. Accutane is for severe acne (which it doesn't sound like you have). I would be kind of surprised if a dermatologist brought that up as a front-line option in any case. I struggled with my skin similarly for years, finally went to the dermatologist, got started using a topical gel called Epiduo (containing adapalene and benzoil peroxide), and my skin was markedly better in about a month. I was kicking myself for waiting so long. The prescription strength retinoid (adapalene, brand name Differin) is what really made the difference I think.
The whole thing (appointment + med) cost me maybe $50 in insurance copays and took like 10 minutes. I saw the dermatologist's physician assistant so I could get in faster. Seriously. Don't even fuck around with anything else.
posted by jeoc at 7:00 PM on July 8, 2017 [1 favorite]
The whole thing (appointment + med) cost me maybe $50 in insurance copays and took like 10 minutes. I saw the dermatologist's physician assistant so I could get in faster. Seriously. Don't even fuck around with anything else.
posted by jeoc at 7:00 PM on July 8, 2017 [1 favorite]
Minimize stress/depression.
Vitamnin D - if you don't get enough sun, take 1000 to 2000 IU/day of vitamin D3. Jamiesones is a really realiable brand. Relates to chronically activated T cells and keratinycytes hyperproliferation.
Topical Clindamycin solution (prescription required, available in roller form dissolved in 2-prop); the gel formulations tend to degrade very rapidly (a month or two versus 6 to 9; iirc, the solution is much less expensive than the gels). Add (over the counter) benzoyl peroxide on top to minimize risks of resistance development to clindamycin.
Helped a lot, but can't counter the deep pore cystic ones that are mostly secondary to stress/depression.
Got put on prescription Biacna recently - topical clindamycin and tretinoin. It has zapped everything (over a couple/few days) except one deep pore cystic bugger, but it calmed it down and opened it up (able to express the plug(s)) without it going down the typical path of scar-inducing open sore, so still a huge win.
Induces a lot of cellular turnover; treating a bad body acne in a sensitive area was... a little too much especially with BP on top - minor burning and peeling, but on my face, at worse only a little scaling that a facecloth took away (and freeing the underlying plugs).
Systemic tetracycline is an option, but for me its pretty temporary and I hate what it does to my intestinal microflora.
posted by porpoise at 9:35 PM on July 8, 2017
Vitamnin D - if you don't get enough sun, take 1000 to 2000 IU/day of vitamin D3. Jamiesones is a really realiable brand. Relates to chronically activated T cells and keratinycytes hyperproliferation.
Topical Clindamycin solution (prescription required, available in roller form dissolved in 2-prop); the gel formulations tend to degrade very rapidly (a month or two versus 6 to 9; iirc, the solution is much less expensive than the gels). Add (over the counter) benzoyl peroxide on top to minimize risks of resistance development to clindamycin.
Helped a lot, but can't counter the deep pore cystic ones that are mostly secondary to stress/depression.
Got put on prescription Biacna recently - topical clindamycin and tretinoin. It has zapped everything (over a couple/few days) except one deep pore cystic bugger, but it calmed it down and opened it up (able to express the plug(s)) without it going down the typical path of scar-inducing open sore, so still a huge win.
Induces a lot of cellular turnover; treating a bad body acne in a sensitive area was... a little too much especially with BP on top - minor burning and peeling, but on my face, at worse only a little scaling that a facecloth took away (and freeing the underlying plugs).
Systemic tetracycline is an option, but for me its pretty temporary and I hate what it does to my intestinal microflora.
posted by porpoise at 9:35 PM on July 8, 2017
I went to regular dermatologists for years, but they just kept giving my retinol. Finally I found an aesthetic dermatologist and he was way more understanding and aggressive in making my skin look good. I'm thirding the combo of spironlactone and a retinol (the prescription stregths were too much for me and now I'm using Skincentuals .05% retinol). There's a big quality of life difference in not spending time covering up acne, worrying if it's visible, and then re-applying thought the day. It's not extravagant to take care of yourself !
posted by Bunglegirl at 2:34 PM on July 9, 2017
posted by Bunglegirl at 2:34 PM on July 9, 2017
I live in a country where people don't get referred to dermatologists until their faces or melting or something, so I can't advise on that, but it might be worth checking whether the hormonal breakouts have an underlying cause - PCOS causes jawline acne for me.
AHAs seem to help heal them faster for me. Glycolic or mandelic acid seem to be the best AHAs. The Ordinary do cheap acids which are reasonably priced enough that you can patch-test and see how you get on with them.
posted by mippy at 12:16 PM on July 10, 2017
AHAs seem to help heal them faster for me. Glycolic or mandelic acid seem to be the best AHAs. The Ordinary do cheap acids which are reasonably priced enough that you can patch-test and see how you get on with them.
posted by mippy at 12:16 PM on July 10, 2017
This thread is closed to new comments.
posted by bookworm4125 at 1:16 AM on July 8, 2017