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belerak9

Questions regarding oily skin on forehead after years of Benzoyl Peroxide

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Hello everyone,

I just have a few questions for anyone that is interested in helping me out.

To give a little bit of background information: I eat a paleo-based diet (lean meat, vegetables, fruits, some dairy here and there, seeds nuts - so, no gluten, only little bit of rice, little bit of corn - also I drink occasionally, trying to stick to wine and beer). I exercise daily, in the form of olympic lifting and crossfit-based workouts. I drink coffee daily. I take some vitamins (Vitamin A, B5 (sort of on a megadose, I'll explain in a second), fish oil, acidophilus, and a B allaround vitamin). I get some sun, not ever finding myself sunburnt though.

Only once did I have a severe breakout, about 6 years ago - I'm 22 now (on my forehead, might have been a combination between awful diet then and bangs on the forehead). From what I recall it was a large collection of blemishes (sorry I can't remember what type they were), that occasionally bled, and I'm sure in my young naive state I poked and prodded at them a lot. I was studying abroad at the time, and upon return I used benzoyl peroxide nightly to make them subside.

Towards the age of 19-20 I started getting more self-conscious about my skin, since the breakout seemed to leave a bizarre texture on my forehead. I started using the regimen (even though I really didn't have bad acne whatsoever), and used it for about six months before one day I stopped entirely, sick of putting all this shit on me. About a week later, I woke up one morning with a huge collection of these white and red dots on my forehead, some of which itched, and after seeing a dermatologist they prescribed Hydrocortisone Butyrate in lieu of a perceived rash. It went away after using that for a week, then came back about a week later. When I went back in they gave me some samples of Epiduo, which I began to apply daily - it worked wonders, cleared all the bumps. After I ran out of the samples, I went back in with the same problem to the same office, different doctor, but this time my skin had started to become very very oily, which he noticed and again prescribed me Epiduo (2.5% BP/.1% Adapalene).

I then began to use this stuff daily, then twice a day, becoming mesmerized by the effects it had on my skin (now realizing that this has morphed somewhat into a form of OCD, or Body Dysmorphic Disorder - working on that too!). I did eventually want to stop using all of this stuff though, as I know I don't want to constantly be putting chemicals on my skin. So, I eventually ran out of that, starting using other forms of BP (on the spot, stuff like that), and tried stopping for a few weeks in the winter. Bumps came back. Tried again over Spring Break. Bumps came back again, but fewer. Got back on the Epiduo for a few weeks, starting about three weeks ago. Over the past week I tried quitting again (I thought that maybe the majority of the bumps were caused by dry skin - was over-applying the stuff and leaving my forehead a dry mess), but a few bumps are starting again, and I hate the idea of presenting myself like this, considering I'm 22 and have had (artificially created) clear skin all the time. My skin now feels very soft (obviously from stopping the Epiduo), but the forehead still has these weird texture/oil/blemish problems.

The only difference now is that my skin has become very, very oily. The strange thing is that it's kinda oily all over, but the forehead area is the only place developing these bumps. The reason I'm trying the B5 megadose is to see if it subsides some oil production, only started that 2 weeks ago though. So my questions are:

1) Can long term use of benzoyl peroxide alter the texture of the skin, or cause certain areas of the skin to produce more oil? (I understand the myth of reactive sebhorrea, just hoping anyone might have insight) (I've also seen posts about people claiming that long-term use of topicals did change the way their skin behaved, I just don't see any science-based evidence behind it [these would be the folks talking about not letting anything touch their face for around a year, creating a dead skin mask, and then hoping they went back to normal]).

2) If #1 is true, then will the high doses of B5 help at all?

3) Any insight as to why even though my whole face appears to be slightly oilier, my forehead is the only spot that develops bumps?

4) Any reason for all of a sudden my sebaceous glands to be going into overdrive and causing this (hot weather, overuse of topicals, anything?)

Last bit of information if I didn't mention this already (my proofreading skills are lazy and subpar): I've never really had acne before in any way. For some reason I obsessed over my skin, making it worse from irritation, but have not had a problem with this at all. When I just wash my face with water, every part of my face stays clear - except my forehead!!!!

Thanks for reading and for any (constructive) input, just looking to figure this out, don't want to have to worry about this any more than I already do!

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Also, I've been doing a ton of looking up on this form of folliculitis that seems to be plaguing everyone: pityrosporum, or the currently named "malassezia". While it seems like a possibility, if it happened to be a fungal-based problem I don't want to be too quick to assume. Signs could point to yes though, that it has a similar look, there's no acne on other parts of my face, my forehead is extra oily now, I sweat a lot (from exercise and from biking around everywhere). So for anyone that's interested in helping, would something like Nizoral or any sort of zinc-including shampoo/wash be detrimental to the skin if it didn't happen to be this? And is it possible that the Benzoyl Peroxide abuse killed off all the bacteria allowing for fungus to inhabit the forehead? And lastly, would something like Epiduo, with the combined BP and adapalene, be effective in killing this off as well? The reason I ask is because when I spoke to my dermatologist a year ago she said that it had to be acne if BP was working; comically, when I asked her when this would go away on its own she laughed and said that maybe it would, or maybe it would stick around forever. How delightful! Anyway, any help is much appreciated.

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