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Stubborn closed comedones



Three years ago I had a small breakout of closed comedones on one of my cheeks by my hairline. I hadn't had much acne before (the odd, isolated closed comedone here or there) so I panicked and went to the dermatologist. A year and a half later, I had tried antibiotics, Duac, Tazorac, Benzaclin, Klaron, Clindamycin, and hundreds (and hundreds of dollars) of over-the-counter cleansers, spot treatments, etc. The closed comedones were still there, but had also sprung up on the other cheek and around my mouth, not to mention the number benzoyl peroxide did on my skin - suddenly I had cysts and pustules too (me and bp just do not get along, I suspect I'm allergic). My dermatologist finally put me on Accutane and after one month, I was completely clear, with no IB and very few side effects. Unfortunately I had to stop because of a problem with my blood test. I was very nervous that my acne would come back, especially since my insurance was ending in a few months. Amazingly, one month of taking Accutane managed to clear me for another year and a half before I woke up one morning this July with a patch of comedones very similar to the ones that had started it all.

I don't have insurance anymore, but my sister also takes Taz, so I borrowed some of hers. When I had acne before, I found that I was extremely tolerant of Taz, with no peeling skin, itching, or redness at all. Then again, maybe that was part of the reason that it didn't do much for me (see the interview posted on these boards with the creator of retinoids, who says the more peeling, the better). I washed my face with Cetaphil, then applied Taz and moisturizer every night before bed for two weeks and saw absolutely no change in my acne. It didn't get better, nor did it get worse. It just sat there, looking as bumpy, abundant, and flesh-colored as ever. So I decided to do some experiments with Taz. I tried waiting anywhere from 10 to 40 minutes between cleansing, application, and moisturizing. I tried putting on moisturizer first. No change. Finally, I washed my face with Cetaphil, waited 20 minutes, and just put the Taz on without moisturizer. The next day, my acne was red - not itchy or peeling, mind you, just red. For many people, this might be bad news, but I was overjoyed that something had actually made my acne look different. I decided to keep going.

Six weeks later, my comedones are significantly better. The redness has faded (week 4), they have decreased in number (gradual, with a noticeable difference by week 4), and the few that remain are blackheads, which I take to mean that my skin is pushing out the trapped oil and bacteria. Over the weeks I've developed about 3 pustules at different times, but they each flattened within a few days. Other than these pustules, I've experienced no IB. I can't help but think that for people who are not seeing any sort of change with Taz, no moisturizer is the way to go.

Before someone responds that moisturizer is necessary to repair the skin's barrier, I'd like to suggest preemptively that maybe the skin's barrier only needs to be repaired if Taz seems to be damaging it in the first place. If you're applying Taz with moisturizer and not seeing any redness or peeling, perhaps your skin is just more tolerant of the medication than others'. It seems logical to me that if you don't normally NEED moisturizer, and Taz doesn't affect your skin so that you NEED moisturizer, it doesn't make sense to put something on your skin that is meant to fix a problem that you don't have.

I also think that Taz should only be applied to the affected areas (the areas with acne), since applying it to areas that are fine could cause breakouts. This happened to me the last time I had acne, and the breakouts never went away.

Obviously I am no expert on this, and could be giving bad advice. I just know that this is what seems to be working for me, and every morning I wake up excited to see how my acne is becoming less and less of an issue.


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