New here, but not new to cystic acne (unfortunately), and hoping someone can shine some light on this confusion.
My dermatologist pushes glyolic acid products like an annoying used car salesman. The conversation is getting very old because I do not fare well with AHAs. They burn, sting, and irritate my skin to the point that the pain feels like I'm being shocked. I have had extensive abdominal surgery, and have a pretty high pain tolerance, but these AHAs are something else. The stinging and shock-like sensation reach the point that I become tachycardic and diaphoretic. It's at that point that I scream "uncle," and go wash it off.
My question is why does my derm push AHAs so? And why is it part of the acne.org regimen? My understanding was that it is BHA (salicylic) that has the ability to exfoliate the pore itself because BHA is oil-soluble and actually able to break down the oily gunk build-up within the pores. AHAs just exfoliate the top layer of skin, not the pore lining.
I just finished watching one of the videos on this site on mechanical vs. chemical exfoliation, which says that chemical exfoliation with AHAs is not irritating to the skin, while mechanical exfoliation is highly irritating and ends up causing more acne. This is not true for me. AHAs burn the living daylights out of my face, but a good BHA scrub calms it down, reduces redness, soothes any itching, and actually reduces the number of lesions and blackheads. Topical retinoids only cause me to break out and become oilier (even after a full year of consistent use-- talk about the never-ending initial breakout phase).
So, what gives? Has anyone else experienced this? Or does my body just respond to all of the usual treatments in a manner opposite of what is expected? Any insights are greatly appreciated.
Quick overview of what has been tried over the past years...
Minocycline, doxycycline, Bactrim - all failed
Topical retinoids, AHAs, Benzefoam, Clarifoam - either irritation station, or not effective
Only grain I touch is rice (minimal consumption); wheat and dairy free for a decade - necessary due to GI disease; I wish it helped my face!
Have had spironolactone prescribed, but I'm not thrilled with the side effect profile and have not started it yet (likely will not due to significant GI and GYN issues- two periods per month is the last thing I need)
Current supplements: multivitamin, zinc, green tea extract, lysine, grapefruit seed extract