Hello, I used to visit this board alot when I was breaking out and desperate.
I'm a medical esthetician & medical assistant for a very prestegious dermatologist who is AMAZING at getting people's skin clear. I follow his program and for the first time in my whole life I have clear skin and really understand how & why this works. I thought I'd come back on here and share what I now know. Hope this helps someone. I'm going to talk about a few different things.
ACCUTANE: This a MUST and is the only oral medication anyone should waste their time with (as long as your healthy). BUT with that said.... you only need a low dose. 20mg of accutane is plenty to do the job. When you take it in this low of a dose you will save your body the side effects. All the side effects you read about are from people taking high doses. If your healthy and your cholesterol & liver tests are good then 20mg of accutane will do the trick. Some people may have to take a longer course or repeat courses if acne comes back. Some people with minor acne may only need to take it every other day. We have many patients who take 1 pill a week for life just to keep the oil at bay. At this dose it's nothing more than a megadose vitamin A suppliment. I cringe when I see people taking high doses. It works in a low dose!! Trust me! I see it every day in our patients.
ANTIBIOTICS: These DO NOT WORK and will Wreck your natural bacteria in your gut. Trust me... I did it too! I took antibiotis for years! and guess what??? I still had acne!! Here's why.... Everyone has bacteria on their faces. So why do some people get acne and others dont? Well because the bacteria is mixing with the oil and getting trapped under the skin. So the problem is the Oil! Not the bacteria. You have to get rid of the Oil! (accutane is the answer for this)
EXFOLIATE EVERY DAY: You must exfoliate becuase people with Acne have a disorder with how their skin naturally exfoliates. This is why some people can have oily skin but not get acne. Becuase their skin is exfoliating properly. Someone with acne has an issue with the way their skin cells shed so the oil is getting trapped. So you have to Scrub every day! But make sure your using a gentle scrub with tiny crystals. Nothing jagged that will tear your skin... like St Ives appricot scrub! YIKES! Don't use that! lol
RETINOID: You gotta use trentinoin. 1% is best. I know it makes you red, dry & peely but this is ok! You have to get your cells turning over quickly to help the shedding process. Cuz remember...... your cells aren't shedding properly. So you gotta help them out. Also... trentinoin will keep you young forever! If you can't tolerate every day that's ok. Just do what you can. Even a few nights a week is better than nothing. You will build a tolerance. And once your get your skin clear you can drop down to a retinol.
MOISTURIZER: DO NOT USE A MOISTURIZER! It's absolute CRAP that people say that you have to put oil or moisture on your skin or your skin will produce more oil. This is FALSE! Moisturizer makes your cells go to sleep. Your body has a natural hydrator called your barrier function. It's a mixture of lipids & water. If you have been using moisturizer then your skin is dependant on it. Like a drug. And in the beginning you will withdraw. But trust me.... once you kick the habit then your skin will thank you. All moisturizer does is trap dead cells on your face. And remember what I said above??? I said that you have an issue with your cells shedding! So don't make that issue worse by trapping them on there eve more.
NOTE: If you are SO DRY from your Trentinoin and you just have to use a moisturizer to "Comfort" you thru the tough part.... then that is fine. Just use it when you feel you really need it.
BENZOL PEROXIDE: Is great for a spot treatment on "pustual" type pimples. An infection can't live in the presense of benzol peroxide. So if you have pimples that have puss in them then you can spot treat with benzol peroxide. But it's pointless to rub benzol peroxide all over your face over blackheads. All that will do is dry your skin out more.
SALICYLIC ACID: Is your friend. Get a wash or even oil control pads with salicylic acid in them.
GLYCOLIC ACID: Is great if the texture of your skin is bad from scars. This will help.
HYDROQUINONE: This will help fade the spots quicker. But NOTE: Don't use hydroquinone higher than 4% and never for longer than 5 months at a time. Your body gets used to it and builds a tolerance. Use it to fade your spots and then get off.
And you can use all these products while on the accutane because if you take a super low dose then your skin won't get so sensitive like a higher dose.
I hope some of this info helps someone. I've learned so much working with this Dr. My skin has changed dramaticly and is so clear now. I know how awful it is to suffer with acne. I'm in my 30's and spent my whole life suffering. I finally figured it out! Hope you all can too.