I made a new thread for this because it did not fit well in any *one* thread. This is going to be a short synopsis and reasoning behind my acne struggle, how I chose the products I did, and the varying results I received. My goal is to spare you all the trials and tribulations I went through.
I am currently 19 years old. My skin is fair but warm-toned, exceptionally oily, and slightly sensitive. My acne began to emerge in 8th and 9th grade--only as clogged pores, blackheads, and whiteheads. Come sophomore year in high school, my acne turned highly inflammatory. I had large red bumps all over my face in conjunction with the previous whiteheads, blackheads, and clogged pores. My acne was primarily located on my forehead, my chin, and around my jawline. I would define my acne as moderate to severe--but more along the moderate side. I did not have a face-full of pimples, but the pimples I had were horrible. I was, and still am, a heavy make-up wearer.
To deal with the acne during high school, I relied on drug-store things. I used foam cleansers, cream cleansers, cleansers with benzoyl peroxide in them (various strengths, no more than 10%), cleansers with salicylic acid in them (no more than 2%), scrubs (round beads or natural asymmetrical grains), tea tree oil, ACV, toners, masks, literally everything possible without a prescription.
For those, like me, who did not want to go to a doctor, I would recommend:
---Apple Cider Vinegar either full strength or distilled 50/50 as a toner every other night, or, Q-tip spot treatments
---Scrubs with round, synthetic beads
---Cream cleansers, I highly recommend Cetaphil
---Clay masks every once in a while
I would not recommend:
---Cleansers with benzoyl peroxide or salicylic acid. For me, having an all-over-the-face drying chemical was simply too much and often, I felt like my acne got worse.
---I would absolutely stay away from scrubs with walnut shells or asymmetrical grains in them. Retrospective research has revealed to me that these are sharp and tear at your skin. They do exfoliate, for sure. However, they do more damage than good. Many say that damage is good for your skin because it spurs healing processes. This is true and I did notice that my un-acne-affected skin looked brighter and smoother. For active acne lesions, though, I would stay away from these harsh scrubs. Tearing the inflamed skin over already red and swollen pimples is a bad idea. IF you do want to stick with one of these harsher scrubs, I recommend lessening its use. Once or twice per week is adequate. More is likely hurting you in your quest for clear skin.
---Foam cleansers tended to dry me out. Even though I have oily skin, the answer was not to dry me out. Drying my skin actually led to increased oil production. My skin felt the need to compensate from my harsh oil-stripping techniques.
---Tea tree oil was okay, it wasn't great. It was a nice anti-inflammatory. Through my troubles, I have found that Visine Red-Eye Relief actually does a better job of that--contains a non-harmful chemical that constricts blood vessels.
Results: This cleared me up only marginally. The scrub with round beads was a lifesaver and the ACV helped to bring down the pimples that I had at the time and re-balance the alkalinity of my skin. Cetaphil was gentle enough not to over-dry--which can lead to more breakouts. Clay masks helped some of my clogged pores, but only slightly. There was barely noticeable, but still discernible, improvement in my skin. For those who want to stay away from expensive prescriptions or doctors, this may be a step toward helping you out.
Spring of my senior year (2010) I caved and saw a dermatologist. She prescribed me Retin-A Micro at night .025% and 1% Clindamycin pledgets morning and night. This was a breakthrough for me and I couldn't believe I waited so long to seek a professional.
---The Retin-A Micro is a chemical derivative of vitamin A called Tretinoin. The brand name comes solely from the delivery system--a gel-base with some jive micro-delivery technology.
---Clindamycin is an antibiotic
Results: From the Retin-A Micro, I suffered a horrible initial breakout for which the clindamycin helped only nominally. My skin was purging all of it's clogs-in-waiting. While I was getting substantial numbers of new pimples, they were coming to a head faster and clearing faster. My old acne scars also faded slightly. I did suffer side-effects. My face was persistently red (which made me incredibly self-conscious given that I'm already a super-easy hardcore blusher) and my skin peeled constantly. Makeup was incredibly difficult to wear during this period---despite the fact that I needed it more--and often, my skin took to unsightly and embarrassing flaking. It took a good 6-8 weeks before I saw improvement in my acne breakouts, but when I did, it only got better. The side-effects never went away. I was always red and always peeling/flaking. Within four to five months, I was almost completely clear. It was truly wonderful. I was still using heavy make-up, Cetaphil was my cleanser, and I used Neutrogena Eye-Makeup Remover. No toner, no scrub--as per the dermatologist orders.
It was during the summer/fall of that year (2010) that I made the mistake of stopping my prescriptions. I was fed up with the side effects--redness and peeling. I was also getting really bad sunburns despite my constantly applying high SPF sunscreen--the Retin-A Micro seemed to be doing more harm than good. And, I figured that, since I was completely clear, there was no need to continue. This was an absolute disaster. The Retin-A Micro and clindamycin were making my skin function as if it were normal--the products did not change the biological and genetic factors that predisposed me to moderate to severe acne. Thus, once I stopped, the acne slowly came back to full force.
I also made the mistake of changing the other aspects of my skin-care regimen. I am constantly wooed by products that I think will be miracle-workers. Instead of Cetaphil, I switched to the original Noxzema. My grandmother recommended it for me and internet reviews made it seem wonderful. I also added in St. Ives Apricot Scrub (regular, timeless (alpha-hydroxy acids), and blemish control (salicylic acid)) thinking that, since exfoliation was the new thing, I needed some intense exfoliation to scrape off the dead skin cells before the got trapped in my oily pores.
I kept trying to restart myself on the regimen that had worked so well before. This time, though, the side effects were even worse and I just kept purging and purging and purging even with the Clindamycin.
Results: My acne stayed pretty bad. It hit a point of stasis where it was bad, but it didn't get any worse. I still had many big, red pimples. I constantly purged. My skin was dry and flaky, so I exfoliated more and more with harsh (and sometimes chemical) scrubs. The Noxzema dried out my skin and left a residue. The clindamycin and Retin-A Micro prevented my acne from getting worse, but my acne never got better because the other aspects of my skin care regimen were sabotaging my efforts.
January of the following year (2011) I had the Mirena IUD put in place. I did have hormonal acne prior to the Mirena, but the hormones in the IUD exacerbated the problem. On top of my forehead and chin issues, my jawline issue escalated and my cheeks began to break out horribly with deep, red, inflamed, painful pimples. I gave up on regular applications of the Retin-A Micro and clindamycin. I stuck with the Noxzema and St. Ives. I also started using a salicylic acid spot treatment (Clean and Clear Acne Advantage).
Results: Nothing changed, in fact, the Mirena made everything worse. I was using heavy make-up still, bad cleanser, harmful scrubs, and the spot treatment worked only marginally. While I was sporadically using the Retin-A Micro and clindamycin, my lack of regularity forever delayed the benefits and made me constantly suffer with the side effects. I was doing everything wrong. I did not have the Mirena out. I loved it too much in other respects. But, tor the next few months, my acne went up and down. Some days/weeks were better than others, but any clearing up never lasted for very long.
Summer before my sophomore year in college (2011), I decided I wanted to really restart myself on my prior regimen (only slightly stronger). However, intricacies in my insurance coverage changed. Instead of being able to purchase the brand name Retin-A Micro, I needed to purchase the generic Tretinoin. I was prescribed it in .025% strength as well as .05% and .1% strength--my derm told me to work my way up. I was also placed on clindamycin again. I turned down Spironolactone. I kept with Noxzema and the various St. Ives.
Results: The newfound consistency helped me greatly. My acne did clear up slightly even with the bad cleanser and scrubbing habits. However, I must say that the tretinoin .025% was far harsher on my skin than the Retin-A Micro .025%. The delivery system (reason for the brand name) really does make a difference and, if you have a choice, you should really go with Retin-A Micro. With the tretinoin, the clindamycin pledgets were actually burning my skin. I kept with it, but my redness was far worse than it was on just the Retin-A Micro and my peeling was also worse. I never actually upped myself to the .05% or the .1%. While I did see overall improvement, especially on my forehead, my cheeks, jawline, and chin remained pretty bad.
January of my sophomore year (2012) I returned to the dermatologist. I told her that I had been consistently on the same regimen for 6 months and saw only slight improvement. It was certainly better than nothing, but I wanted to see if I could do more. Instead of tretinoin, I was placed on .1% adapalene (the generic version of Differin) and instead of clindamycin pledgets (which contain alcohol in them, that's why I was getting the harsh burn) she placed me on clindamycin lotion.
This prescription regimen has been a life-saver. The side-effects from adapalene are FAR more mild and transient than those of tretinoin and the clindamycin lotion was much gentler on my skin than the alcohol-infused and abrasive pledgets.
On a whim and a need for chance, I switched away from the Noxzema cleanser and St.. Ives scrubs. I went back to Cetaphil and replaced scrub exfoliation with exfoliating pads (cheap target brand, circular abrasive sponges). Since I was peeling less and my skin was generally less irritated, this made a big difference. Even though I still had the Mirena, within three months this regimen showed me marked, but not 100%, improvement. Unlike times before, I didn't mess around with what worked.
Recently, I have slightly changed my routine. I have transitioned away from the scrubbing pads--they worked, but I was going through them like crazy and I started to get scratches and broken capillaries.
I did my research and splurged on a Clarisonic Plus. For a dirt-poor college student, this was a hefty purchase. I received the typical 20% discount bringing the price down from 225$ to 180$. I was FULLY ready to return it within 30 days if I was IN ANY WAY unsatisfied. Luckily for my skin, but unluckily for my bank account, the Clarisonic has been really wonderful. Since the majority of my inflamed acne lesions around my jawline and cheeks had been tamed and had been starting to go away, I was left with a lot of small bumps and clogged pores. As a consistently heavy make-up user, someone with clogged pores, oily skin, slight flakes from the adapalene, and still some inflamed acne on my cheeks, the Clarisonic seemed like it could really do some good for me. It has done everything promised and, though my skin took about a week to adjust to it, it has been simply magnificent.
Results: I am satisfied.
My current regimen:
Cetaphil All Skin Types
Clarisonic (two runs of the sensitive brush)
Olay Complete moisturizer
Neutrogena eye makeup remover
Clarisonic (two runs again)
Adapalene cut with moisturizer (75 adapalene/25 moisturizer)
I have taken myself off the antibiotic lotion. With no purging and less active acne, it was not needed and made my skin a bit shiny. The Clarisonic has begun to make inroads on my clogged pores. It helps clear off the flakes on my skin. It cleanses my skin deeply and makes sure all my makeup is off. I cut the adapalene with moisturizer now because I am verging on clear and don't need the full strength.
After years of dealing with acne and many missteps along the way, I am almost clear. Those who read this, I hope to spare you the mistakes I made.
Edited by Sassamatazz, 04 May 2012 - 01:36 AM.