You could have oily skin from a unbalanced PH. It levels your skin basically so too oily or too dry is not leveled. Try a toner after washing your face with salilicacidon T-zone and clogged pores. Not needed all over face unless nessasary.

Moisturizing may not seem to help but it keeps your face from producing too much oil, clogging pores, and producing blackheads (oil free moisturizer and or with water basedingredients : aveeno, neutrogena, dermalogica ect.) apply smallamount on finger (pea size or two) and dab on face. Neverapply on t-zone just on cheeks side of forhead and jaw. Neverneed more than you think it should just be a thin layer starting from those areas onto the t-zone. (T-zone needs a little moisturizing too)

Exfoliate about out oncea week at night time because too much can cause more pores to clog. When scrubbing to Often or too hardit can cause the sebum and bacteria to spread. What I usually do it put a clay mask on after I exfoliate. (It just feels nice and balances PH)

For the redness if you ever get ahold to a dermatologist ask for ACZONE which helps overall redness and for bacteria in your pores ask for doxycycline. And for dandruff try selsun blue. This stuff is amazing. I promise!

*oily skin face wash*
dermalogica dermal clay cleanser (can be expensive but totally worth it

*toner*
Dermalogicamulti active toner
salilic acid treatment (for nose)

*mousterizer*
mattifying gel

*scaring and redness*
aczone

*clay mask*
indian healing clay (Aztec)

**

I understand your pain.
I have had everything you have and tried everything also but with cystic acne (including the dandruff). It's because oily skin in general produce so much oil on the face (even hair + hair naturally produces sebum which clogs pores) it can make you feel annoyed and you just want it to go away. Your not the only one. I didn't get to the drematoligist until 2 months ago because of certain reasons so I understand the impatience you have to just get rid of it. Going next week again to get more info.

Thanks @LuvLyssa I really appreciate you taking the time to respond. Sorry I didn't get back sooner but I did read your response right away and have since incorporated an exfoliator and changed moisturizers (still haven't found one I really like) and am looking into toners (something I never considered before).

I've also started washing my face with a gentle cleaner in the morning in addition to at night. My forehead actually looks a bit worse in terms of bumps but my tzone is substantially less oily. So long story short I'm still battling. Again really appreciate your response and wish you the best for your own journey. Hope the dermatologist appointment went well.

You may want to look into Pityrosporum Folliculitis (also called Malassezia) for the bumps. I was convinced that the bumps on my forehead and sides of my face were clogged pores, but nothing I EVER did made them go away or get better. I was on this website when I found information about PF and posted my experience with clearing it up on the link. Let me know if this works for you!!
http://www.acne.org/messageboard/topic/360641-tiny-bumps-that-dont-go-away-it-may-be-pf/

My skin is exactly like yours bro, oily and sensitive. I've previously had success with moisturizers, and it did keep my breakouts at bay. But I still had oily skin, and we all know excess sebum = acne. I've been on a topical regimen of tretinoin and azelaic acid from my dermatologist, and it seems to be keeping my skin relatively clear (until I stop using the products). I'm going back in 2 weeks and asking for accutane which will surely permanently shrink the oil glands meaning less oil for the rest of my life, and hopefully, 0 acne.

On 7/26/2016 at 11:57 AM, fitCanuck said:

Hello,

 

This is a long post but I've tried to summarize my situation in the first couple paragraphs. The rest is background information.

 

I've been lurking here for a while seeking advice for my own problem but haven't posted until now. The community seems great here and I appreciate any advice you may have. I've been searching for cure for several years now and have made some improvement but not complete. I know everyone says it but I feel like I've tried everything...

 

I'm a 30 y/o male with extremely oily and sensitive skin, particularly my T-Zone. Overall, I know my skin is not nearly as bad as others but I am still trying to get to the root of the problem as it causes me a fair bit of stress.

 

I've posted pictures below (taken after washing with water, so not too much oil visible) but essentially I have very oily and what seems to be very sensitive skin. It gets dehydrated immediately after washing (even if just washing with water, even if water just touches my face it gets very dry, tight and flakey) yet very shortly after it is incredibly shiny and oily. It is only my face that is like this, the rest of my skin is very well behaved aside from being dry and flakey (legs, arms, etc).

 

I've included what I think are relevant details about my skin and current regiment below, I know it's a bit of a long read. In summary I'm wondering if anyone has had a similar condition and found a way to minimize the skin oil and gently exfoliate the sebum plugs without causing too much irritation or dryness. Moisturizer suggestions for my skin type would also be appreciated.

 

What I've tried:

 

I've tried not washing (to give skin a rest) but this leads to whiteheads and alot of clogged pores. It seems like each day I wake up and I have sebum coming out of the pores on my face (particularly on my nose and cheeks). The areas that are oily are also often red, particularly after I rub or wash them (even gently). 

 

I've tried washing twice per day, various cleansers and moisturizers. Tried salt water, honey, ACV and other "natural" methods.

 

My doctor (GP) told me I had a mild case of seborrhea causing the redness but I have tried treatments for seborrhea like ketocanozole as well as metronidazole (treats both rosacea and seborrhea). Neither of these worked. My scalp is also greasy and I have dandruff (it's pretty mild though and seems to be controlled using keto cream a couple times a week). I'm in Canada and it's difficult to see a dermatologist.

 

Diet:

 

My diet is extremely clean and I've done multiple eliminations of "common" triggers. My diet now consists of fresh meat and vegetables. I cook with a small amount of butter. I use olive oil for dressing on salads (i eat a ton of spinach). I eat oats (though I have cut these oat to test) sweet potatoes and green vegetables as carb sources. Dairy in excess does seem to cause a problem for me. As such the only dairy I consume now is the butter. I have also cut that out completely in favor of coconut oil. Coconut oil appeared to make my face significantly oilier so I cut it out. I can post a full diet if anyone believes it to be relevant.

 

Topical Regimen:

 

I currently wash my face with only water in the morning (have been using filtered water as a test to see if my tap water could be causing problems), I take a cold shower. After that I have been trying to use no moisturizer, sometimes I need to use a little bit of cerave moisturizer (not on tzone), i try to use none as it does seem that the moisturizer leads to clogged pores for me (I've tried a bunch...). I used to wash my face in the morning with a cleanser but it would get oiler much faster in the day. I wash my face at night with paula's choice PC4Men face wash. It seems to be the best facewash I have found but still significantly dries out my face and makes it appear red and irritated after washing. I then use the Paula's choice 2% BHA gel. I believe this is causing some irritation but I believe it has made a great contribution to removing active whiteheads and acne. I used to get alot of forehead bumbs and some whiteheads, since using the BHA I don't get many whiteheads, still some bumps but far less.

 

My skin is very rough and bumpy as well as red and oily in my T-zone and it's filled with many sebum plugs. I'm wondering if there is a more gentle way to remove these sebum plugs which perhaps will get rid of all the clogged pores and redness (which I think may be inflammation from the clogged pores). I'm wondering if anyone has experienced a similar condition and found a way to remove the excess oil and cleans the clogged pores without being overly irritating.

 

Hey man, I'm a 25 year old male with the same exact skin as you, albeit a little worse with the redness.  I also get closed comedones that turn into pimples, but really no inflamed acne.  I've been trying to figure out what the sebum flakes in my pores are for some time now, and have not been able to find a concrete diagnosis.  I also have these on my cheeks and chin, and I know they directly correlate to the pore, not dryness.  Some say Seb Derm and others hyperkeratinization.  But I know it's really from my damn skin being so oily.  I have found diet to do nothing for this condition, or any topical regimen.  It's the excess of oil, plain and simple, and their is only one treatment on the market that gets rid of the oil: accutane.

P.s. On another forum I know a guy in his forties who has been dealing with the same problem for years now.  He said the only thing that ever helped was accutane, although they returned after treatment.

I'm not telling you to just go on accutane, but after trying to treat my skin for 10 years, I have never put a dent in the oilyness.  

Hi there,

I believe I know what's going on with your skin. For years my skin looked exactly like yours. I was using cleansers, and moisturizers, and topicals for nearly 10 years and nothing ever got better. I picked my skin a lot too which created problems. And the oiliness was always so extreme. I finally went on accutane which was amazing and totally stopped me from getting acne, but the quality of my skin was terrible. I then tried only washing my face with water and using moisturizer. I didn't break out and things looked ok with this regimen, but I still hated my skin. Then one day about 4 months ago I decided to stop using moisturizer so I was only splashing my face with water at night, the lightest my regimen had ever been, and something started to change. Of course my skin was dry at first, but it slowly started to adjust. And then my skin began to look better, more normal, healthier. It occurred to me that all the shit I was putting on and doing to my face was killing it. And then I started reading about the "Caveman Regimen" and things became clearer. This regimen talks about not washing your face with anything, not even water, for like 3 months. You develop this "dead skin mask" and after long enough, you scrape it off and New skin has formed. I could see that this was what I needed to do with my skin. You see my cheeks and mouth area always had beautiful skin, but it was my nose and forehead, where I always washed harder and applied topicals, that were so bad. I needed to just let my skin naturally heal. Nothing was ever wrong with it, it was all the shit I was doing to it that was the problem.
I have not used anything on my face, cleanser or moisturizer, nothing, for nearly four months now. I do not even splash water on my face. The only time water touches my face is indirectly in the shower. And my skin is TRANSFORMING. The oiliness is gone, and all those dents and red spots that I thought would be there forever are starting to heal from the inside out. I know it will be a long time before my skin is fully healed, which makes sense given how long I abused it, and I know there will be some permanent scars and imperfections that will not go away. But I know that it will be healed one day if I just let it alone so the skin's natural healing process can happen.
Your skin wants to be healthy. Give this a try and don't do anything to it for a while. Things are not gonna look good for a bit, but you will see that REAL healing is happening. I hope this helps you.

On 8/20/2016 at 7:14 PM, Tretinoin said:

My skin is exactly like yours bro, oily and sensitive. I've previously had success with moisturizers, and it did keep my breakouts at bay. But I still had oily skin, and we all know excess sebum = acne. I've been on a topical regimen of tretinoin and azelaic acid from my dermatologist, and it seems to be keeping my skin relatively clear (until I stop using the products). I'm going back in 2 weeks and asking for accutane which will surely permanently shrink the oil glands meaning less oil for the rest of my life, and hopefully, 0 acne.

Hey @Tretinoin

I have been doing tons of research about accutane specially the low-dose treatment.

From my readings, it seems that accutane does not permanently shrink the oil gands. The oil glands will stop producing oil (or produce less oil) while you are on accutane. But once you stop, it goes back to how it was before. I also read studies that says it could be possible that high dose will shrink oil glands but only around 10%. It does not fully shrink it.

Now, I can't attach all the studies with this post because I usually read tons of studies in my phone before I sleep. I don't end up saving the links.

PC4Men has Carrageenan in it. It rates a 5 on the comedogenic scale.
The PC BHA gel has Butylene Glycol. I recently discovered that most topical acne treatments have recently replaced the propylene glycol with butylene glycol. Probably because it's cheaper. Unfortunately, they replaced something non-comedogenic with something comedogenic. I had a holy grail that reformulated and made this change--the only change--and it now breaks me out instead of clearing me up.
I noticed that the BG contributed to larger, inflamed comedones and cystic spots. I also recently noticed that anything that contains any kind of corn starch products contributes to blackheads.

So obviously this thread is pretty old but I promised myself that if I ever got a handle on all this I would update the old threads I had in case anyone else comes across them as I know how frustrating this can be.

I tried a lot of things to get to the bottom of what was going on with my skin. To some extent this is a blessing as my skin problems actually caused me to make a lot of better dietary and health choices.

Ill summarize with where things are at and what got me here.

In short my skin is way better feeling and its been within the last year that the change occurred. Ill briefly mention what worked and what didnt.

What didnt

Almost everything I tried :), while I was diagnosed with seborrheic dermatitis and given medical treatment for that the antifungals really never helped. I tried the conventional treatments and also tried the natural treatments (including oils, natural antifungals, honey, sea salt, dead sea salt, no soaps as well as more extreme ones like ACV on the face).

I also tried a bunch of dietary changes, these didnt help my skin (I tried keto, vegetarian, low fat, low saturated fat, a bunch of elimination diets - gluten, eggs, dairy, etc). I will say that some of these changes led to me feeling better and I was probably eating in a bad way for my overall health (I am into strength training and I was probably overeating meat - I do still eat meat but cut down and feel better - but I digress..) With respect to my skin the only changes I noticed were: dairy gives me minor breakouts, I noticed cutting out whey in particular cleared some random spots Id get on my back and body. I very rarely get any inflammed acne after cutting out dairy. I still do eat some dairy but find if I keep it minimal then I can deal with the outcome skin wise, but no dairy is best. I have naturally oily skin, I also have alot of lean muscle mass, male pattern baldness and other indications that make me think I have high testosterone and androgen levels leading to excess sebum production. On that note, I find cutting down on saturated fat helps with skin oiliness but this is harder to quantify. I would say all other dietary interventions had negligible effect. I always had a pretty clean diet though.

So what helped me was a few things.

1 - I finally had enough and stopped stressing so much and learned to accept things. Interestingly, this may have led to healing and now I dont have to worry about the things. Maybe some things were blown out of proportion as well. Looking at some posts on some other forums when I was posting this I was thinking things really didnt look that bad. Im going to copy and paste this so I wont say which forum had the worst looking pics.

2 - I stopped thinking conventional soaps / etc were evil. I got on a pretty serious natural kick for awhile and realized later that this is probably foolish and that technology (including soap) is a good thing. If soaps were terrible there probably wouldnt be a market. This led me to being ok with using some gentle soaps.

3 - I could never really figure out what was going on, did I have SD, did I have eczema, did I have something else since no conventional medical interventions helped I was a bit stumped. However, research I did led me to believe I probably had a severely compromised skin barrier. I dont know how but somehow along the way I damaged my skin and it was having trouble healing. So I looked into this, found out that eczema sufferers may have a genetic deficiency in produce filaggrin and that exogenous filaggrin can help them. Also externally applied ceramides can help heal skin. So I found a moisturizer with filaggrin and noticed it helped the most with my dry itchy skin in the winter on my legs, arms, etc. Finally I worked up the courage to start using it on my face and it really helped. (will mention specific products at end).

4 - I do think I have SD (noticed after growing a beard and shaving it some more distinctive yellowish flakes on my upper lip. Shaving made them go away but these looked more fungal than anything else. This led me to using a pyrithione zinc soap on my face. I tried Head and Shoulders shampoo for my dandruff but it dried out my scalp so much I didnt like using it. I forced myself to use ti and I still had dandruff.. so i looked for a soap that just had the active ingredient and not all the cheap surfactants that head and shoulders has.

5 - out of all the natural remedies, honey seemed to help the most but was a pain to use practically. I found a honey based moisturizer supposedly formulated for SD.

Currently, my skin is very clear and much smoother than it has been, I dont really worry about my complexion, my tightness and itchiness has gone away. I've also noticed I can actually splash some water on face if I take a mid day shower and I don't get extreme tightness and dryness which wasn't possible previously - this is really what led me to the skin barrier repair path.For these reasons I felt compelled to write this.

Here is my specific routine:

Morning:

Wash face with cerave hydrating liquid soap, moisturize (lightly) with honey based moisturizer (I really liked this stuff called phat 5.5 seb derm moisturizer cream but I cant find it anymore so I bought this other one with the same ingredients called honeyskin face and body cream ( https://www.amazon.ca/gp/product/B00QUKS6NW )

Night:

Wash face with dr. baileys zinc pyrithione soap. Its a bar soap. I tried this before but it dried me out too much, however after moisturizing regularly I can use this and it seems to have reduced redness in my face and is well tolerated so I use it. After the soap I moisturize with cetaphil pro restoraderm ( https://www.amazon.ca/gp/product/B003TQU1Q0 ) this is the moisturizer with filaggrin in it and I think this has done the most to heal my skin. I was pretty liberal with this for awhile, I started one winter when my skin was obviously dry (I kept wondering if it was yeast or dry skin and it became obvious my skin was screaming for moisture). Now that my skin is in better shape and feels much more supple I use less of it.

Twice a week at night (usually Thursday and Sunday) I will wash my face with the cerave hydrating and then followup with paulas choice 2% BHA salicylic acid gel (a dime sized amount which I rub in and leave overnight). no moisturizer after this. This gel helped the most with whiteheads and closed comedones out of anything I ever tried, it does feel a bit strong which is why I use it only twice a week.

Usually the next day Ill VERY gently rub my face with a damp facecloth or a wet cotton pad which gets rid of various hard sebum bumps that dont clog my pores but make my skin feel rough.

Thats it.

I hope this can help someone. The most important thing for me was to stop worrying so much about it. I was going crazy researching seb derm, skin barrier, etc. It was taking away from other things in life. So I hope this post gives hope to someone else that eventually things can get better. I dont think about my face anymore, I just randomly thought about my old posts one day and thats what caused me to write this.

I wish you well.