LionQueen

In the last few days, the mods have had to close several threads in which the OP was threatening suicide. This has caused some resentment and hard feelings, which was not our intention at all. So we'd like to explain a bit more about the way we handle suicide threats -- which is to close the thread and direct the poster to other, more appropriate, resources.

Yes, Acne.org is a support board. But it's an acne support board. We simply aren't able to offer suicidal people the sort of help and attention they need in a time of crisis.

The mods on this board aren't trained in suicide intervention. Also, we can't always be around when such threads are posted ....... and while most members here are warm, kind and encouraging in their responses, there always seems to be that special someone ready to flame you when you're down.

When we close these threads, it's not because we don't care. It's because we want people who are truly suicidal to get help from the experts.

And if someone is threatening suicide primarily to get attention (which does happen!), we really don't think that's fair to the other members of the board. Suicide threats are deeply distressing, and we do not feel that Acne.org is an appropriate forum in which to deal with them.

Thank you for your understanding.

I had a positive experience with a low-dose Accutane regimen.

I've had what I would describe as severe comedonal acne/mild inflammatory acne ever since I was 12 or so. I'm now 44.

A few years ago, I was able to rid my skin entirely of bumps and pimples using an over-the-counter retinol gel called Green Cream. My overall skin tone also improved dramatically. I still had somewhat oily skin though, and my pores still became congested with waxy sebum. This was annoying, but I was resigned to living with it.

Then I took a very powerful course of antibiotics to knock out a kidney infection, and my skin went haywire again ... this time with fungal folliculitis. One of the treatments my derm and I discussed was low-dose Accutane to reduce sebum production. I had read a couple of studies, and agreed to give it a go.

I took 10 mg/day for 60 days. During this time, all of the waxy sebum in my pores came to the surface .... I never got any actual pimples, though, probably because I'd been using GC for so long. I had mildly dry lips, one or two nosebleeds, and no other side effects. I continued using other topicals (mandelic acid and Vitamin C serum) during those 60 days, although I did not use the retinol gel.

Then my derm began reducing my dosage. Over time, it went from 10 mg every other day to 10 mg every 8 days, which is where I am right now. I use all of my topicals now. I have no side effects. My sebum production is that of a normal person ... I get a little bit of oil, but not the thick, waxy, pore-clogging junk that I dealt with all of my life. We are going to try to get my dosage down to 10 mg every 14 days and see if I can still maintain my clear skin.

Accutane has not completely solved my folliculitis problem, btw. It has reduced it quite a bit, but it's not a total solution. Acne and clogged pores, on the other hand, are entirely gone.

I do not believe that low-dose Accutane is the answer for everyone, but it has definitely worked very well for me.

As stated in the title, this thread is here for people who had a POSITIVE experience with Accutane.

It would be helpful to know the length of your course(s), your dosage(s), and when you started or finished. Please make just one post describing your experience, and edit/update it as necessary ... this will make it easier for readers to follow each person's story.

Please do not post until AFTER you have finished your course. Feel free to keep coming back to update your story.

Many or most people do experience some unpleasant side effects, so feel free to expound on those. But on the whole, if you are glad you took Accutane, this thread is for you.

Please do not post links to other sites. This thread is here for personal stories of Acne.org members only. It has been pinned so that it will not be lost in the shuffle.

Neither this thread nor the "negative experience" thread should be regarded as definitive proof of anything, pro or con, about Accutane. This is by no means a scientific sampling and we are not checking up on anyone who posts here. It is simply a place where people can tell their stories and keep them up to date in a simple format that is uncluttered and easy to follow. Arguments, flaming, and off-topic posts will be invis'd.

Topical retinoids are very effective anti-acne AND anti-aging products. They transform your skin cells over time, speeding up the rate at which skin cells form and making them less "sticky". Retinoids also increase collagen production. Long-term retinoid use results in smoother, more even and glowing skin. Topical retinoids are not effective spot treatments, but are meant to be used all over your face, and on a regular basis.

A lot of people get started with retinoids but give up quickly -- usually because they have not been properly taught about how retinoids work, and what to expect in the early weeks.

Here are some key things to remember:

1) IRRITATION

Topical retinoids are irritating to the skin, and you MUST ease into them gradually. Here is a general schedule that I suggest people follow when first starting out:

Week 1: once every 3 days
Week 2: once every 2 days
Week 3: 2 out of 3 days
Week 4: daily

Pay attention to your skin! Red, sore, "sunburned"-looking skin and excessive peeling are signs of irritation. If you experience either, STOP using the retinoid until your skin has gone back to normal. Then pick up the schedule where you left off.

Moisturizing with emu oil (or just adding it to your favorite moisturizer or sunscreen) will help to reduce redness, dryness and inflammation.

2) INITIAL BREAKOUT

Retinoids work by forcing the comedones that are clogging your pores to come to the surface. It takes about 3 months for your pores to clear, and during this time, you will probably see some breakouts. Blackheads may appear larger and more noticeable as they surface; small hard bumps may form; and if you are prone to inflammatory acne, you will probably get pimples. (A short course of antibiotics can help people with inflammatory acne get through this initial breakout, but I do not recommend taking antibiotics for more than 2-3 weeks.)

3) SKIN FRAGILITY

Retinoids make your epidermis thinner and more fragile (don't worry, though, because they actually thicken and strengthen the underlying dermis). DO NOT PICK AT YOUR SKIN! Trying to squeeze out a blackhead can leave you with a red mark for weeks. Be patient.

Be sure to use a very mild cleanser with no other active ingredients while you are getting accustomed to the retinoid, and cleanse your face with lukewarm water no more than twice a day. Once is probably better. Retinoids compromise your skin's barrier function, and excessive washing is going to result in dehydrated skin. You can reinforce your epidermal barrier and reduce dehydration by supplementing your diet with fish oil and moisturizing with emu oil.

4) PEELING SKIN

Some peeling is normal. Not only are your skin cells regenerating very quickly, but they are not sticking together as cohesively, and you will see surface peeling. Gentle exfoliation can help get rid of the shedding layer of skin; you can use a soft facial brush or a silica microbead scrub. BE GENTLE! You can do a lot of damage if you aren't.

5) SUN SENSITIVITY

Retinoids increase your skin's sensitivity to the sun. Wear sunscreen during daylight hours. If you are getting laser or light treatments, be sure to tell them you are using topical retinoids; you may need to avoid product use for a week or so before a treatment.

6) PRODUCT APPLICATION*

You should apply retinoids to clean, dry skin and wait at least 10-15 minutes before applying moisturizer. Many retinoids degrade in sunlight (Differin is an exception, as it's not a true retinoid), so it's best to use them at night.

If you are also using benzoyl peroxide as part of your regimen, do not apply it and the retinoid at the same time, as BP oxidizes retinoids. Usually, you'll want to use BP in the mornings, retinoids at night. Differin (adapalene) is an exception to these rules.

Salicylic acid and retinoids work very well together. (SA loosens comedones; retinoids push them out.) You can use SA in the AMs, retinoids at night, or you can layer the products at night. If you are layering, the general rule is to cleanse; apply SA liquid or gel; wait 30 minutes; apply retinoid.

*A pea sized portion should be used for the ENTIRE face, not a pea sized portion for each section. More product will not make skin cell turnover happen faster or better. Overapplication of product will irritate the skin.

OTC topical retinoids are a great alternative to prescription retinoids (Retin A, Tazorac, Differin) for people with mild/moderate acne who find the prescription products too irritating to their skin.

Topical retinoids are very effective anti-acne AND anti-aging products. They transform your skin cells over time, speeding up the rate at which skin cells form and making them less "sticky". Retinoids also increase collagen production. Long-term retinoid use results in smoother, more even and glowing skin. Topical retinoids are not effective spot treatments, but are meant to be used all over your face, and on a regular basis.

A lot of people get started with retinoids but give up quickly -- usually because they have not been properly taught about how retinoids work, and what to expect in the early weeks.

Here are some key things to remember:

1) IRRITATION

Topical retinoids are irritating to the skin, even the OTC formulations, and you MUST ease into them gradually. Here is a general schedule that I suggest people follow when first starting out:

Week 1: once every 3 days
Week 2: once every 2 days
Week 3: 2 out of 3 days
Week 4: daily

Pay attention to your skin! Red, sore, "sunburned"-looking skin and excessive peeling are signs of irritation. If you experience either, STOP using the retinoid until your skin has gone back to normal. Then pick up the schedule where you left off.

2) INITIAL BREAKOUT

Retinoids work against acne by forcing the comedones that are clogging your pores to come to the surface. It takes about 3 months for your pores to clear, and during this time, you will probably see some breakouts. Blackheads may appear larger and more noticeable as they surface; small hard bumps may form; and if you are prone to inflammatory acne, you will probably get pimples. (A short course of antibiotics can help people with inflammatory acne get through this initial breakout, but I do not recommend taking antibiotics for more than 2-3 weeks.)

3) SKIN FRAGILITY

Retinoids make your epidermis thinner and more fragile (don't worry, though, because they actually thicken and strengthen the underlying dermis). DO NOT PICK AT YOUR SKIN! Trying to squeeze out a single blackhead can leave you with an ugly red mark for weeks. Be patient.

Be sure to use a very mild cleanser with no other active ingredients while you are getting accustomed to the retinoid, and cleanse your face with lukewarm water no more than twice a day. Once is probably better. Retinoids compromise your skin's barrier function, and excessive washing is going to result in dehydrated skin. You can reinforce your epidermal barrier and reduce dehydration by supplementing your diet with fish oil.

4) PEELING SKIN

Some peeling is normal. Not only are your skin cells regenerating very quickly, but they are not sticking together as cohesively, and you will see the surface layers peeling off. Gentle exfoliation can help get rid of the shedding layer of skin; you can use a soft facial brush or a silica microbead scrub each morning to prepare your skin for the day. BE GENTLE! You can do a lot of damage if you aren't.

5) SUN SENSITIVITY

Retinoids increase your skin's sensitivity to the sun. Wear sunscreen during daylight hours. If you are getting laser or light treatments, be sure to tell your consultant you are using topical retinoids; you may need to avoid product use for a week or so before a treatment.

6) PRODUCT APPLICATION

Most OTC retinoids need time to absorb into your skin and do their work. You should apply them to clean, dry skin and wait at least 30-45 minutes before applying moisturizer. Many retinoids degrade in sunlight, so it's best to use them at night.

7) USING RETINOIDS WITH ACIDS

Retinoids can work really, really well in tandem with AHAs or BHAs, but I don't recommend trying to introduce both at the same time. Your best bet is to start with the AHA or BHA product, and when your skin is fully accustomed to it (in other words, you can use it daily with no drying or irritation!), then start gradually introducing the retinoid. I would recommend using the AHA or BHA product in the AM and the retinoid at night.


SOME OTC RETINOIDS I LIKE .....

Green Cream (my personal favorite) is a retinol gel that comes in three concentrations: Levels 3, 6 and 9. Level 3 is quite mild, and is intended for people with highly sensitive skin. Most people with normal skin can start out with Level 6. Level 9 is quite strong and probably not the best one to start with. I didn't start using Level 9 until I could tolerate Level 6 twice a day. GC is pretty expensive, about $45 - $55 for a one ounce bottle (this will last a month or so, depending on how often you use it). I have bought from www.lindasy.com, www.dianayvonne.com, and www.amazon.com. More information and a message board are available on the product website, www.greencream.com.

Diacneal is made by Avene. It's retinaldehyde-based, which some people prefer to retinol, and contains 6% glycolic acid as well. More readily available in Europe and Canada than Green Cream is.

The Vivant Vitamin A products are also very highly regarded. Check them out at www.betterhealthyskin.com.

Here are some links to clinical studies on the diet - hormones - acne connection.

Many thanks to Rubbish for passing these along, complete with descriptions, and for suggesting that we create a pinned topic.


http://www.ncbi.nlm....pubmed/18496812 Low GL diet increased SHBG and increased IGF-1 and reduced free androgens and thus acne and sebum.

http://www.ncbi.nlm....pubmed/17448569  Similar to above.

http://www.ncbi.nlm....pubmed/17616769 Low GL diet and markers.

(Mann's studies are cited by Cordain in his interview with Dan. These studies have resulted in dermatologists re-evaluating diet's role in acne.)

http://www.ncbi.nlm....pubmed/14527633 A non-Mann study on Insulin Resistance showing important hormonal markers with acne.

http://www.ncbi.nlm....pubmed/15202836 Importance of binding proteins yet again in acne.

http://www.ncbi.nlm....pubmed/11334899 Again.



NOTE: I am closing this thread to keep it clutter-free. If you would like to pin more links to other clinical studies relating to the diet-acne connection, please PM one of the moderators to have a new post added to this topic.

More info on pH, compiled by tangal (former poster at the Diana Yvonne Skin Care Board) and edited by me (this is a work in progress, and I am still checking some facts. If you spot any problems, don't hesitate to PM me).



The initials pH stand for “Power of Hydrogen” or "Potential of Hydrogen”. Both terms are correct. This is a measure of the hydrogen ion content in a solution.

The pH scale measures how acidic or alkaline a product is, compared to pure distilled water (which is pH 7.0). Only wet substances have a measurable pH. The skin's pH is actually the pH on the skins surface from the moisture within the skin, and the "acid mantle" which is part of the protective "barrier" on its surface. Hair for example has no pH.

The acid mantle is a fine film layer, slightly acidic, made up from skin oils, sweat, and dead cells. It is one means the skin uses to protect itself from bacteria, moisture loss, and environmental damage. Pollutants, harmful bacterium, contaminants are normally alkaline in nature, so a slightly acid skin surface helps fight off these harmful elements and prevent them from entering into, and damaging the skin. Maintaining the acid mantle is recommended for good skin health. When the acid mantle is damaged it takes approximately 14-17 hours to repair itself (assuming no other damaging products are applied to it).

A damaged acid mantle leads to a number of skin issues, such as over dry skin, dehydration, over oily skin, flaky skin, acne, sensitivity, etc. It would require another long post to detail all this. But incorrect pH products can contribute to acid mantle degradation, and increases in acne-causing bacteria on the skin. (More on this below)

The pH Scale

The pH scale goes from 0-14. This covers most wet substances, and certainly all skincare products.

-Acids have pH values under 7 - they are more acidic then water (acid)
-Alkalis have pH values over 7 - they are more alkaline then water (base)
-If a substance has a pH value of 7 - it is neutral, like water (neither acid nor base)

The difference between each whole-value pH level represents a tenfold change. (For example, a cleanser with a pH of 6 is ten times more alkaline than a cleanser with a pH of 5, and a cleanser with a pH of 7 is 100 times more alkaline then one of 5.) Because of this, only a few units of pH can make a big difference in how your skin reacts to a product.

Some pH examples:

pH 1 = Battery acid
pH 1.5 -2 = gastric (stomach) acid
pH 2 = lemon juice
pH 2.5 = cola soft drinks
pH 3 = vinegar
ph 3.5 = orange juice
pH 4.6-5.5 = healthy skin (and recommended pH range for your cleanser, for best skin health)
pH 5.5 = rainwater (pure water, when exposed to the atmosphere, will take in carbon dioxide, changing its pH)
pH 6.5 = milk
pH 6.5 – 7.4 = healthy saliva
pH 7 = pure distilled water - (This is neutral pH, neither acid nor base)
pH 7.35 – 7.45 = human blood
pH 8.5 = baking soda (damaging to skin's acid mantle)
pH 9 = seawater
pH 9.0-10.0 = hand soap, detergents (very damaging to acid mantle)
pH 10.5 = Milk of Magnesia
pH 11.5 = household ammonia
pH 12.5 = household bleach
pH 13 = lye (sodium hydroxide, or Draino)(Alkaline or Base extreme)

Skin and the Acid Mantle

Newborn baby skin has a neutral pH of 7. Within a few months it adjusts to a more "normal" pH of 4.5 to 5.5, enabling it to be more resistant to bacteria.

Adult skin is normally slightly acidic, a range of 4.5 to 5.5. Different body areas can differ in pH, and disease and acid mantle damage can alter pH. But the preferred range for facial skin pH is 4.5 to 5.5.

Those with skin disease, skin problems, and stressed skin usually have a skin pH over 6.0. Aged, stressed and damaged skin have more difficulty maintaining a “correct” pH.

As skin pH is elevated closer to pH 7.0, it becomes less and less able to function optimally and to kill bacteria. This allows acne-causing bacteria to multiply rapidly on the skin's surface. (Acne bacteria are found on everyone’s skin, even if you never have a pimple in your life.) The damaged skin is unable to fend off the excess bacteria, and they multiply rapidly. Bacteria growth is very slow at pH of 5.5 or less, but a slight shift upward, toward the alkaline levels, causes a marked increase in the reproduction and lifespan of acne-causing bacteria.

So if your skin is at a higher pH (anything over 6, as damaged skin often is) the acne-causing bacteria can multiply much easier and faster -- often faster then your skin can handle. Skin pH is one main contributor to acne.

Skin pH also has an effect on how easily irritated your skin is, how well it ages, and how it deals with product and environmental stress. This is why it is recommended that you cleanse skin with mild, non-irritating products, as close to the skin's natural pH as possible.

Many commercial cleansers are highly alkaline, which also changes the skin's pH to alkaline levels on the skin surface, for a short time. Many alkaline cleansers are in the same pH range as baking soda, and some are nearly as high as ammonia. This is very harsh on the skin, and can lead to increased irritation, acne, moisture loss, skin aging etc. As pimples erupt, the skin is less able to heal itself, or the damage that pimples leave behind.

If a product has a high pH and a considerable percentage of a strong detergent such as sodium lauryl sulfate, or irritant like peppermint oil or menthol, because of the pH destructive activity on the acid mantle, the detergent can contribute to even more damage then it would if the product pH was closer to 5.5. It literally takes a split second for an alkaline product to degrade the skin barrier enough for an irritant or damaging detergent to penetrate. Some people can handle this better then others, but long term daily use on the skin can contribute to long term issues on all skin types. As skin ages, or the barrier function degrades, it has more difficultly dealing with this type of stress.

Even when the skin re-adjusts to its more normal pH (4.5 to 5.5) - it is already damaged, irritated and stressed. The damage recovery involves longer term healing; 14 to 17 days for acid mantle repair. Continued long-term damage, stress, and mild irritation can prevent the skin from maintaining its best pH level of 4.5 to 5.5. With time, and increased damage, it may tend to stay at the 6 range or higher.

As skin become healthier, its pH values lower, and acne growth also lowers. The skin becomes more "normal" and regulated.

Listing of pH of many common cleansers:

http://www.dianayvon...fcommoncleanser

A few examples from above link:

Burt’s Bees Tomato, Carrot, and Lettuce soaps 10
Dial Soap (liquid and bar) 9.5
Dove Bar, Baby Dove Bar 7
Johnson & Johnson Head to Toe Baby Wash 6.5-7.0
Neutrogena Facial Cleansing Bar Original Formula 8.7-9.2
Paula’s Choice (all formulations) 5.5

A product may include the term “pH Balanced” on the label. This does NOT mean that it has an optimal pH of 5.5. The term has no legal definition.

Some products are a good pH, but high in irritants. Which is better then high pH and high irritants, but not great either.

A good cleanser cleans the skin without breaking down the acid mantle, or adding irritants to the skin. It is mild with a 5.5 or lower pH.

Exfoliating Power of AHAs and BHAs

The acids commonly used in skin care treatment (AHAs, BHAs,TCA) are all pH dependent. The lower the pH, the more effective the acid is on the skin. It will work better, penetrate better and deeper, with a more concentrated effect. It can also be more irritating, because it is more “powerful.”

When an acid product is formulated with a pH below 2.0, all of its acid percentage is essentially “free” – or available to work effectively on the skin.

For example:

A 20% lactic acid product at a pH of 1.9 has 20% of the lactic acid “free” or available to work on your skin. This is referred to as the “Free Acid Value” or FAV.

As pH is raised closer to 7.0, less acid is free and the acid's effectiveness is weakened. So for a true understanding of the strength of your acid product, you need to know the acid percentage in the product, AND the pH.

AHAs (glycolic, lactic, mandelic, malic, citric, tartaric, etc.) are basically ineffective over 4.0 pH. To exfoliate the surface of the skin, the pH must be below 4.0. and the product percentage must be over 5%.  5% to 8% with a pH of 3.0 - 4.0 is the MINIMUM level for a daily use AHA; this will not treat scars or rebuild collagen.

BHAs (salicylic acid) are also basically ineffective over 4.0 pH. To exfoliate the skin, and unclog pores, the pH must be below 4.0 and the product percentage must be over 1%. (1% to 2% with a pH of 3.0 - 4.0 is the MINIMUM level for a daily use BHA. Skin with very clogged pores may need a higher concentration, up to 5%, and lower pH.

A pH test strip or litmus strip will give you the pH. (buy some made with a lower pH range, not all strips go from 1 – 14) Strips will not be as accurate as a true electronic pH gage, but for home use it will be close enough.

Here is the link to Diana Yvonne's page on FAV and skin remodeling results:

http://dianayvonne.z...y/16.aboutpeels

This shows two charts.

The first chart covers the FAV available, and the amount of acid percent needed for specific skin effects (exfoliation, collagen rebuilding, skin lightening, etc.).

For example: a 10% (free acid value) glycolic acid (AHA) gives "Significant increase in squamous cell turnover.
Moderate increase in collagen deposition." In other words, 10% concentration of AHA acid working on the skin is enough to remove damaged cells, and rebuild skin collagen or firmness.

The second chart clarifies how the pH affects the amount of acid available for the skin to use (FAV).

For example, the three 20% entries:

20% AHA at a pH of 2.55 has a free acid value (FAV) of 18.6%. (It's only REALLY an 18.6% product in effectiveness, because of the pH over 2.0.)

20% at pH 3.4 drops to 14.6% FAV.

20% at pH 4.3 drops to 4.8% FAV.

When a 20% AHA product has a pH over 3 it has lost approximately 25% of its exfoliation activity. Once pH reaches 4.0, it loses 75% of its exfoliation activity. This is why so many commercial products are ineffective!

BHAs are effective at slightly different ranges, so the FAV scale differs a bit, but the principle is similar.

Skin Biology Exfol serum (2% BHA with a 3.2 pH) and Paula’s Choice 2% BHA (3.4 pH) are very similar products, and strengths. Professional Solutions 2% BHA has a pH of 1.9% so is actually much more active on the skin then either Exfol or Paula’s Choice, even at the same acid percentage.


Layering Products and Wait Times

pH affects the acid you use and how it works. Another consideration is not to disturb an acid while it is on your skin, which can alter pH and affect its action on the skin.

Generally speaking an acid is effective for approximately 20 to 30 minutes on the skin surface. After that point the skin pH has risen enough to lessen the exfoliation action on the skin, and the acid is effectively neutralized. During this 30 minute time frame, the acid is working at effective levels. Anything applied after 30 minutes will not hamper the effect of your acid, as the pH has already changed, and the acid action has slowed a lot.

Acids that are a high (peel) percentage such as 30% and 40% and above are more concentrated. Therefore their activity can continue for longer, so their action should be stopped at appropriate time with the use of a base rinse (baking soda and water) or a mild detergent cleanser. This will effectively halt the exfoliation action, by raising the skin pH.

Washing the skin with an cleanser of pH over 5.5 can slow or lessen the effect of your acid, because the acid must now deal with the high pH level on the skin. The bigger the range difference, the more this will affect your acid action, especially in the case of acids at 2.0 pH or less. So if you use a high pH cleanser, you should wait 30 minutes before using a pH-dependent product, to allow the skin to regulate its pH down to about 5.5. Or you can use an acidic toner to adjust the pH of the skin down before applying the product.

Most commercial astringents and toners contain high levels of irritants such as alcohols, Witch Hazel, Menthols, Mint oils, etc. These should be avoided, as they can damage the skin barrier.  If you want to use a toner to adjust pH to lower levels, either use a liquid acid like Paula’s Choice BHA or AHA liquid first, or a very dilute mixture of Apple Cider Vinegar and distilled water. Vivant's Mandelic Acid toner is another good option, though it is expensive.

The best option is simply to use a cleanser with a pH of 5.5.

If you use a BHA product with 3.2 pH, then immediately apply a treatment product on top with 6.5 pH, the exfoliation action of your BHA is reduced by 75%. So applying a higher pH to your pH dependent acid will neutralize it sooner, or stop its action at the point you added the higher pH product.

Other products are also pH dependent. L-Ascorbic Acid forms of Vitamin C are pH dependent. For good stability and effective action, a good Ascorbic acid product is about 2.0 pH. Since Vitamin C absorbs faster into the skin, you can generally have a shorter wait of about 10 to 15 minutes.

Some Good General Rules

(This info comes from DebbieNIR, former host of the Diana Yvonne Skin Care Board. The original post is now gone.)

1. Use a mild, non-irritating, detergent-free cleanser with a 5.5 pH or lower.

2. If your cleanser pH is higher then 5.5, wait 15 to 30 minutes after cleansing to use a low pH AHA or BHA. (Or use a toner to acidify the skin first.)

3. Acids should be applied to freshly cleansed skin.

4. Both acid percentage and product pH must be used to factor total effective acid amounts. (FAV)

5. If using AHA and BHA together, always apply AHA first (after cleansing) – UNLESS the BHA solution pH is equal to or lower than your AHA. In this case, apply the BHA first, because it penetrates skin oils better, and will enhance the AHA effectiveness.

6. Acids can be used in many different ways – which affect wait times.

a) If a 2% or 5% BHA product is used, and rinsed off, WAIT until it is rinsed off to proceed with other products. (BHA washes are less effective than leave-on products.)

b) If a 2% or 5% BHA product is applied and left on the skin, but no AHA product is following, wait 30 minutes before applying next product. This allows the BHA to work at its most effective, and exfoliate at optimal levels.

c) If a 2% or 5% BHA is applied and left on the skin before a rinse-off AHA, you do not need to wait to apply the AHA – IF the pH of both products is similar and compatible. If you rinse the AHA off after 5 minutes of application (over the BHA) you have also stopped the BHA action at 5 minutes. Both should have a lower effective pH. If the AHA has a higher pH, it will also raise the pH of the BHA, affecting its action also.

d) If a 2% or 5% BHA is being left on the skin, before a leave on AHA, you don’t need to wait to apply the AHA. Apply BHA, then AHA, then wait a total of 30 minutes with both products layered, then proceed to next product application. (This is assuming that both acids have a low pH.)

e) Do not apply a higher pH BHA before a lower pH AHA. The higher pH product will hinder the lower pH product. Wait 30 minutes between both acids, applying the lowest pH first.

f) If using a higher BHA after a lower AHA product, apply lower pH AHA first. Wait 30 minutes for it to work. Then apply higher pH BHA on top, and wait 30 minutes for the BHA to work. Then apply other products on top.

g) If you need to rinse products off sooner then 30 minutes to shorten activity and lessen irritation, you can rinse with water, before proceeding to the next step. If using a high strength AHA or BHA, at strong “professional” peel level strength, you will neutralize product with baking soda and water, and rinse off before proceeding to your next step.

h) Apply low pH before high pH.


Layering Other Products

This information is also from DebbieNIR's posts on the Diana Yvonne Skin Care Board.

Retinols, Retinoids, Vitamin A products
These products are often pH dependent. Apply to clean dry skin, once to twice a day. Wait at least 15 to 30 minutes before adding other active products. In the case of retinols, retinyls, and retinals, wait at least 30 and preferably 45 minutes to allow the active ingredient to convert to retinoic acid within your skin.

DCX:
This is an eye treatment product with soy. It is not an exfoliate. Should be applied to clean skin, once or twice a day. Apply after acids and cleansers, before copper and other treatments. Wait 10 minutes to allow it to absorb. Then apply other products.

DMAE:
Can be used after acids and cleansing. Formulation type can dictate placement. Liquids, gels and serums can be applied before CP serums, lotions and creams. Lotion and cream DMAE should be applied after CP serums and creams. Wait 10 minutes to allow product to absorb.


Product Application by Type

This is a rough guide for product application, based on type/absorbency. This is for products that are not pH dependent, nor limited by activity type. The thickness of a product, dictates its placement. You cannot apply a thin product (like a liquid) over a thick product (like a cream) and expect it to absorb well. The cream can be a barrier to the thinner product.

-Cleanser
-Toner (pH-adjusting product in a liquid, watery form)
-Exfoliant (AHA or BHA, usually requires a wait time)
-Serum (Copper Serum, treatment Serums, DMAE thicker products)
-Gel (DMAE, Green Cream, Differin)
-Oils (Emu, Jojoba, Almond, etc)
-Creams
-Sunscreen
-Foundations

Sounds like it's different for everyone!

10 mg/day cleared my pores completely in 2 months ... and they were almost clear after the first 30 days.

I don't have as much trouble at ovulation as I do during PMS, but I do see a change in my skin then. One Aleve every day or two keeps me pretty clear through that part of the cycle. During PMS, I definitely need at least one tablet each day (and two is better).

I saw a thread in the Research forum recently about naproxen sodium (Aleve) ... said it was supposed to be very effective against premenstrual acne.  link here

I tried it out this month, and it worked very well for me. I took two Aleve tablets each day, one with breakfast and one right after dinner -- and I only got two tiny, tiny pimples the whole week.

Normally during PMS week I would get a number of these little ones popping up on my nose and chin each day.

I stopped taking a regular dose of the Aleve as soon my period started, although I have taken one at night a couple of times since. From what I understand, you really have to be careful not to take too much ... it can cause stomach bleeding and other unpleasant side effects.

Has anyone else tried this?

Wow ... this stuff is really, truly, honestly amazing. I just had to let you all know about it.

After 4 months on retinoids (Green Cream, Diacneal, Retin A), I have managed to get rid of all of my old bumps and inflamed acne ... but the pores in my T-zone were still getting badly congested every couple of weeks, resulting in blackheads and microzits. Since I'm a habitual picker, and my skin is currently very fragile from the retinoids, these clogged pores were creating a real problem for me.

As soon as I started reading about mandelic acid, I knew I had to try it. The trouble was, the first MA product I tried really does not work well with Green Cream -- and I LOVE Green Cream and will not give it up! I could see that the MA was zapping the blackheads and tightening my pores, but unfortunately it was also burning my skin -- which is not supposed to happen. Mandelic is a very mild AHA.

Anyway, I finally found a new MA product that I can use with retinoids, and I am just loving it. My pores are tighter and clearer than I ever thought possible and my blackheads are almost entirely extinct.

So here are my product recommendations:

If you have oily skin and are NOT using retinoids, you should be able to use the Vivant mandelic acid serum sold on the Diana Yvonne site. I suggest buying a sample first to try it out. This is probably the purest, most powerful and effective mandelic product out there.

If you have dry or sensitive skin, are using retinoids or other anti-acne products, or just find that you can't tolerate the Vivant mandelic, you are probably better off going with the alcohol-free mandelic acid serum made and sold by Garden of Wisdom. They make a 10% version and a 15% version. Sample sizes are available. I use the 10% if I'm layering it under retinoids and 15% if I'm using it by itself.

Mandelic acid needs about 30 minutes to absorb into the skin and "do its thing" -- so you should apply it to clean dry skin, and not apply anything else for at least 30 minutes.

A little more info about mandelic acid: here's a quote from Deb, the Forum Host at the Diana Yvonne SkinCare Board:

It works in the same manner as salicylic acid, except it cannot penetrate as deep into the pore as salicylic acid. Thus, it increases cell turnover within the pore, causing the release of comedones. As soon as you stop using it faithfully, just like salicylic acid, back they come!  

I think the reason people rave about mandelic acid is that it is an AHA with some BHA properties. As well as being antibacterial, anti-inflammatory and lipid permeable (thus the pore exfoliation), it is a gentle 15% AHA at a low pH. AHAs exfoliate the epidermis much better than with salicylic acid, which cannot penetrate very deeply into the epidermal layers. So, the skin is smoother, tighter and more even in tone. Thus, the AHA activity combined with the lipid permeability aids in the appearance of smaller pores.

CHECK IT OUT!!!!!!

41. How nice, I have my own private bracket.

Q