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Regimen no longer works after 10 years

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I started the Acne.org regimen when I was around 14 when the breakouts were getting unbearable. I've sworn by the regimen for the past decade as it was the only thing that made me clear. It's something I actually hold near and dear. Of course, I did get the occasional acne and small breakout but that was to be expected and was short lived. Now I'm 25 and for the past year and half, the regimen has gradually slowed down in terms of effectiveness, and as of right now, just no longer works.

When I first started the regimen, it pretty much cleared me up within a month and a half. 2 years of going by the book for the Regimen before I started lowering the amount used and eventually only using it once a day, to sometimes once every two-three days(and taking out the moisturizer as I didn't even need it) when I pretty much grew out of acne when the early 20s started. 

Started getting more and more breakouts mid 2019 and 6-8 months ago is when the breakouts started ramping up after YEARS of being clear. Decided to get back on the Regimen by the books again close to 3 months ago but my acne is worse than it had ever been. 3 months in again and my face is still dry as hell, still flaking, red as a tomato(didn't even have much of these issues when I first started), and have more acne than I did as a teenager.

What is going on? I definitely was at a stage where I could genuinely say I grew out of acne. When it started coming back heavy I thought maybe my body isn't as good with processing and controlling toxins, bacteria and oils as it used to so I'll start using the regimen religiously again. Keep in mind I never stopped using the BP since I was 14, just cut down on it as time went by.

Is it hormonal(im a guy)? Can BP lose its effect after years of using it? I'm stumped. Has anyone had any similar experiences?


Edited by LongTile
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The Regimen contains ingredients that work on Bacterial Acne.  So either its not effective against the type of bacteria you may have OR its not bacterial acne.   Based on the fact that you say your face is red and you appear to have acne, that leaves 2 possible options:  a fungal infection OR microscopic demodex skin mites.  Seborrheic dermatitis caused by fungus can make your face red, dry and flaky but doesn't typically cause acne.

Since you say your face is red and you have acne, Rosacea Subtype 2 with papules and pustules is a major possibility.  If Rosacea Subtype 2 is the cause, you need an anti-parasitic treatment for demodex skin mites.  Everybody has these mites - a healthy immune system keeps them in check.  The mites aren't a problem until they get overpopulated typically due to a suppressed immune system caused by stress or illness.   Seb-d or bacterial infections may coexist with demodex mites since they come out of the pores and oil glands at night to mate on the surface of the skin then go back down into the pores.  As they move around they can track bacteria and fungus around with them.

Good news is that it is treatable.   

A good dermatologists can test for demodex, bacteria and fungus to nail down the diagnosis.  Old school dermatologists may be less enlightened about demodex than their eye doctor (opthalmologist) colleagues.  I advise you to take a copy of the paper at the URL below to your doctor in case they don't know about this treatment.

Oral Prescription Option: Fastest and most effective treatment is the 2 week, oral treatment with Oral Ivermectin + Oral Metronidazole  as reported in the May 2013 issue of The International Journal of Infectious Diseases.   The 2 drugs have been around for decades and have good safety records.  They are both available as cheap generics.   With insurance  copay the cost is around $13-$20 or about $50-$60 full retail price with no insurance.  This is the only whole body treatment and clears face, scalp and body.

Paper title: "Evaluation of the efficacy of oral ivermectin in comparison with ivermectin–metronidazole combined therapy in the treatment of ocular and skin lesions of Demodex folliculorum"

The journal paper on the treatment is here:  https://www.sciencedirect.com/science/article/pii/S120197121201315X

Topical Prescription Option:   Soolantra (1 % Ivermectin) Cream - Treat at night for 16 weeks.  Soolantra can be expensive and treatment takes longer.   Non-prescription and cheaper option is The 1.87% Ivermectin Horse Paste available on Amazon for about $5 for a small tube.

Over the counter topical options in addition to the Ivermectin Horse Paste include products with Tea Tree Oil or boric acid.  Both ingredients are anti-microbial and kill mites on the surface of the skin:

1.  Tea Tree oil facial cleanser - (Including products from Desert Essence, The Body Shop and eye eco to name a few).

2.  Tea Tree oil ointment (Use at night on face before bed) - Desert Essence

3.  5% Tea Tree Oil moisturizer - Use at night instead of the Tea Tree Oil ointment.

4.  Hypochlorous Acid Spray (very weak, mild, acid as made by the human body in response to a scrape) - Anti-microbial and kills juvenile mites.   Heydrate (Amazon) and Occusoft both make over the counter versions.

5.  Cliradex wipes for eyes and faces with a tea tree oil extract.  Recommended by Opthalmologists for blephariitus demodex (aka ocular rosacea).  Use one wipe morning and night.

6.  Boric Acid Face Mask - Made of Boric Acid Powder + a few drops of glycerin to make a paste.   Makeup Maven has a YouTube showing how to make the mask here:   https://www.youtube.com/watch?v=gfVGV9aIS0Y

7.  If you have any scalp problems Tea Tree Oil shampoo and conditioner or DIY Borax Powder Shampoo can help.

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