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I am 21 years old and am experiencing my first ever what I think could be cystic acne break out on my lower cheeks. In high school I always had clear skin and no problems with acne what so ever. I do wear make up but I take very very good care of my skin. I never go to sleep with it on, and I make sure to wash my pillow covers. I have been experiencing patches on my cheeks that have a lot of small bumps and the area is pretty red. A white head never arises, they are seriously just small bumps. Ive tried so many products and every time it starts to die down it flares right back up again. Due to research I have read that where the break out is placed on my face it could be hormonal but I haven't experienced any recent changes in lifestyle so I think stress is definitely out of the question. It's really put a damper on myself esteem. Has anyone experienced anything similar, and if so, what worked for you?

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Let's start with the basics... Do you use an oil based makeup? How do you remove it? and What other skin care products do you use? (cleansers, toners, moisturisers, serums, etc)

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No I don't use an oil based foundation, and I use the Purity Cleanser by Philosophy as well as an oil free moisturizer from that brand as well. I use the Mario Badescu buffering lotion every night as well. Here is what I'm dealing with  



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Sorry, but I'm just going to be brief today. 

You would benefit from a topical antibiotic. I would recommend using it without any other benzoyl peroxide if you can manage it, however if you can get Duac (clindamycin + benzoyl peroxide - or equivalent)  then that would be ok. Opt for a topical AB over an adapalene based treatment at first. Why? Because I don't believe jumping to a retinoid, which actually changes how your skin 'operates', is necessary as often as it's prescribed. In addition to the AB, get a glycolic acid based skin care system, extra points for one with salicylic acid also. Just a cleanser and night serum will do. Use that morning and night, and don't be afraid to use a good organic facial oil every second or third night, in place of the glycolic night serum. You can use both the glycolic serum and facial oil over your AB. It's a little more difficult with DUAC because it's a cream. If you get a straight AB (preference clindamycin), these are mostly alcohol based, so remember to keep moisture up to the skin. You can use your oil free moisturiser over you ab in the mornings however the glycolic serum or facial oil in the evening should be fine. Just monitor your skin. If you start getting ANY dryness, and I mean dryness, not natural shedding that can sometimes occur if your glycolic products are too strong to use that often (aim for 2-5% max for that often).

If you want to stick with your current cleanser and moisturiser, morning and night, that's completely up to you. Just get a 10-15% glycolic face peel/exfoliator and use as per the instructions. My point is you want to try to kill active infections with the AB and soothe inflammation/increase cellular turnover with the glycolic acid/salicylic acid. The facial oil is for nourishment, anti-inflammation and moisture, (plus extra support if your acid mantle is taking a hit from other products). Not all oils are the same, be very particular on that one because it can be make or break. Aim for organic (you know, only that goes to great effort to show you how it doesn't contain parabens, petroleum products, mineral oils, etc). A big one that people don't consider to be detrimental is cocoa butter (not shea butter) is comedogenic.

So to summarise your goal right now, how you attack it is your prerogative:
- Kill active infection
- Soothe inflammation
- Increase cellular turnover (as naturally as possible, hence no retinoids)
- Nourish your skin to maintain your acid mantle (oils are not the devil, just use them appropriately)

We do this by:
- Limiting irritation
- Preventing stripping the skin
- Good hand hygiene whenever touching your face
- Using good quality, natural, organic, non-comedogenic products.

Ok so maybe not so brief... I just got into it.

Good luck!

(Sorry but I won't be answering any more questions beyond today. I received just enough backlash from a post last night to make me rethink my position on this site. Some people just don't want to hear how it is. I'll leave it to everyone else and there respective medical treating teams)

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