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I'm 41 and have had mild/moderate acne since I was 11. So that's 30 years of purgatory, and still counting.

Here's a little background on my skin:

Under the care of various mediocre and unconcerned dermatologists, I have tried:

Benzoyl peroxide (turned my skin into scaly still-pimply red mess)

Tetracycline (worked wonders for 1 month, but what about the rest of my life?)

Retin-A (cleared my pores nicely, but I still broke out after I went off the tetracycline)

Topical antibiotics (useless)

I have also spent more money than I care to think about on facials and spa products involving the usual suspects: glycolic acid, salicylic acid, AHAs, BHAs, sulfur, etc. etc. Some of these have helped, some not.

In my 20s, I spent way too much time in tanning beds trying to kill my acne ... it worked pretty well in the short term, but I ended up with sun-damaged skin that is still acne-prone. So now I walk a very fine line between trying to keep my skin clear and trying not to look like an old hag. I've found that Murad's anti-aging, anti-acne products are great, as are some of Neutrogena's creams & cleansers.

Also, the Jessfoliation method makes an incredible difference for me. I have the kind of skin that doesn't shed properly, which results in an endless battle with clogged pores on my face.

All of this brings me to my current problem: FACIAL BUMPS.

I went to Spain for 2 months last spring and came back with a whole new look (and not the kind a girl would prefer). I had acquired a rash of pebbly skin all along my jawline and lower cheeks, with additional bumpy patches on both sides of my neck and one side of my forehead.

My aesthetician grilled me about my trip and we narrowed it down to, oh, a half-dozen possible factors: air pollution, sun exposure, bad food, a cigarette smoke allergy, a long-term sinus infection, stress of travel. She also mentioned the possibility of a demodex mite infestation. I googled demodex to get more info ... and that is what brought me to this site in the first place. I had absolutely no idea that mites were going to become such a controversial topic, and I still don't know if they have anything to do with my problem, so I really don't want to get into a brawl about them here. I've already had my regimen log vaporized and I'd like to avoid a recurrence of that.

So anyway: as I said, I'm 41, and these bumps came on pretty recently. I personally know at least 4 other women in the 35-45 age range who have developed similar problems. None of us have the redness or flushing that characterize rosacea.

Does anyone have any ideas about what's going on here? Does anyone have similar problems? Does anything help? Can food allergies come on suddenly in midlife?

I've been Jessfoliating for about a month now, and the bumps are much, much smaller -- but they still show up every now and then. When they do, it's in the area all along my jawline, in a prickly rash that looks like plucked chicken skin. They aren't red, just raised.

Ideas???

Q

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Hi Queen,

I am 36 and battle acne as well. I am finally getting clear after the worst acne of my life earlier this year. What is helping is getting my hormones into balance (I stopped BCP last Nov 04) and alot of trial and error. Have you ever tried anything to help with your hormones? Hormonal acne is supposed to show up on the jaw, chin, lower cheek areas. I started getting cystic acne in my early 20's.

I was using Carleys clear and smooth facial scrub for a few months and while it did help a bit, I noticed that I got alot of little bumps on my temples, cheeks and forehead areas. Since I stopped using this scrub, these bumps have gone away completely. Are you using anything like that which could be clogging your pores? I used to use Proactiv which worked great for a while, but stopped working and then became way too harsh for my skin. I have not heard very good things about Murad products and I am really glad I didn't waste my money on it. Are you sure the bumps aren't from any of those Murad products your using?

The only thing that helps hormonal acne IMO is to get your hormones balanced as best as you can, then the topical stuff will start to work as in my case.

I take a very high quality vitamin/mineral/EFA supplements twice per day. I also take Vitex, Evening Primrose oil, and calcium. I needed to use progesterone cream for a few months to assist my body in making it's own female hormones again. I also use liquid Saw Palmetto which functions as an anti-androgen which are male hormones that cause acne in females. It takes about 3 months to kick in and I am just over the 3 month mark and my face is the clearest it has been since mid 2004.

My current regime is as follows, I hope this post helps you as I know all to well what having acne is like when you think you shouldn't be dealing with this crap anymore. I originally went on Ortho Tri Cyclen to control my breakouts, which never completely stopped while using it and made my cystic acne 10 x's worse when I stopped taking it.

Morning:

Avalon Organics Co-Q10 facial cleansing milk (love this stuff)

Jess brush exfoliation VERY gently with a FACIAL brush and avalon cleanser (the pedicure brush & toothbrush is too harsh for us with more mature skin IMHO- I wouldn't dare try those)

spot treat with neosporin if needed

Proactiv BP lotion on cheeks, nose, chin & jaw line only (had alot left over but I do like this stuff-it is not very drying)

Carley's clear and smooth moisturizer (I like this stuff too- I wanted to like the scrub but it didn't work out)

(some days I skip the BP and use Avon Anew Alternative intensive anti aging lotion which has glycolic acid-Love this stuff too)

Evening:

Same as morning but switch the BP for Avon stuff here and there. I sometimes use the Proactiv sulfur mask to spot treat if I need to occationally.

I use the Avalon Co-Q10 toner a few days per week also.

I also started using Neutrogena's facial peel which is working really well for me. I use 2 x's per week. I had some bad red marks that are really fading. My skin is almost at the point of being "makeup optional" and I am just thrilled to finally be at this point :clap:

I also gave up cigarettes just over 8 months ago and that has made a tremendous difference in my skin. I get really red when I smoke and it makes me break out.

I hope this helps. Bottom line which helps for me, dont irritate the crap out of your face, use good hiquality vitamins and herbs, drink water everyday as your primary source of fluid, BP was able to work for me once my hormones balanced out somewhat, quit smoking if u can, and use age appropriate products, what works for 15 yr olds probably wont be the best choice for 40 yr olds.

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I was surfing around earlier and found this information on milia. Might be applicable to my condition. I'm in a hurry now but wanted to paste it in here to be mulled over later.

Q

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Milia are essentially deep seeded white heads. A thick keratinaceous material is contained within the lesion. Milia rarely come to the surface by themselves, so they need to be extracted in order to eradicate them.The formation of milia is often due to sun-induced changes as the skin ages. In addition, the use of skincare products that are too heavy for an individual’s skin type can occlude the glands and cause the formation of milia. Although some people naturally make milia, and I certainly expect everyone to have an occasional lesion at one time or another, milia are often the result of a problem that has affected the skin’s surface.

What can you do to prevent milia? Besides keeping your lifelong sun exposure limited and using appropriate skin care products, the use of topical vitamin A products such as Retin A and the use of glycolic acids such as M.D. Forte Facial Cleanser II or M.D. Forte Facial Lotion I can help minimize the formation of milia.

Audrey Kunin, M.D.

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Hormonal acne is supposed to show up on the jaw, chin, lower cheek areas.

Butterfly, thank you for that wonderful post ... lots of great info here.

Hormones are definitely at work; I have always had cyclical breakouts linked to my menstrual cycle. And I do have the jaw, chin, & lower cheek thing going .... but I also get bumps on my forehead, temples, and right in front of my ears. Plus I get big recurring zits in exactly the same places on either side of my nose every couple of weeks ... plus little pustules scattered all over my nose whenever I have a breakout.

Are you sure the bumps aren't from any of those Murad products your using?

Yeah ... the bumps predate my use of Murad products. And my scrub, Neutrogena Pore Refining cleanser, is one I've used for years with no problems. So I don't think the products are the problem.

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Bottom line which helps for me, dont irritate the crap out of your face, use good hiquality vitamins and herbs, drink water everyday as your primary source of fluid, and use age appropriate products, what works for 15 yr olds probably wont be the best choice for 40 yr olds.

I totally agree and am going to try out some of your recommended supplements to see if they help with the cyclical breakouts.

Here's my current thinking on this whole bump thing ...

Most of the time, and on most of my face, my main skin problem is the bumps. Every couple of weeks, something causes me to get actual breakouts where I have active pimples and pus coming to the surface. The pimples usually aren't severe and don't last long, EXCEPT for several recurring deep pimples on either side of my nose. Hormones are certainly a factor in causing my active breakouts. Demodex mites _might_ be a factor as well; entrenched mite colonies experiencing periodic die-offs might explain the way those recurring pimples behave.

But I believe that the root of the problem is the bumps. They seem to me to be very deeply entrenched whiteheads, perhaps with some milia mixed in. They are full of waxy white stuff which sometimes seems to form a hard cone and sometimes is just a softer blob. I am strongly inclined to think that the problem I mentioned before, where my keratin cells don't shed properly, is the main contributing factor; I'm just not sure why the problem got so out of hand when I was traveling.

Anyway, I'm going to continue with my anti-mite products for the time being because they seem to be helping and certainly aren't hurting. But long-term, I don't think they're going to get to the root of my problem. I may need to give Retin-A another shot (and see if I can get a long-term prescription so I don't have to go back to the derm every couple months!) But before I do that, I am seriously considering trying topical vitamin A. I am just starting to read about it on this board, and if I'm right about my skin condition, it just might work for me.

Q

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I've been reading about issues with hyperkeratinization, where the skin cells in the pores shed abnormally fast, causing blockages ... my constant problem.

The ironic thing is that I have the exact opposite problem on my arms and legs.

How unfair is that? My skin cells are shedding too much in some places and not enough in others?

Can I just get a complete skin transplant?

Q

NOT SHEDDING ENOUGH?

Background: Keratosis pilaris is an extremely common and benign disorder of keratinized hair follicles. The disease is characterized by grouped, horny, keratotic follicular papules located predominantly on the extensor surfaces of the proximal limbs, most commonly of the posterolateral upper arms and anterior thighs. It is usually asymptomatic except for its cosmetic appearance. Treatment is marginally effective and only provides temporary relief.

Pathophysiology: Apparently because of lack of proper desquamation of keratinocytes, the follicular orifice becomes plugged with keratin and results in a keratotic papule. A variable degree of perifollicular erythema occurs.

SHEDDING TOO FAST?

(this is a quote from Antony by way of frogprince)

"it's important to bear in mind that people with dry skin can have acne because they can have hyperkeratinization (excess skin cell shedding within pore) even though their sebum production is comparatively low; the pores will still be blocked by the excess shedding of epithelial cells, at a rate of something like every 3 days rather than roughly every 28 in the case of most acne sufferers. conversely, people with oily skin can be acne-free because despite high sebum production their keratinization is normalized so skin cells within the pore do not desquamate (shed off) so quickly and unevenly as to clump and stick together, thereby potentially blocking pores. most people with moderate+ acne appear to have both hyperkeratinization and excess sebum production. while the relative dryness/oiliness of skin isn't directly correlated with acne, the sebaceous glands do appear to regulate their secretions according to the relative dryness/moistness of the skin."

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I currently have only jawline acne. It always shifts from the right side to the left and when one side heals up, the other side breaks out. WTF.

I think it's hormonal acne as well. How can I balance my hormones? I take a multivitamin (centrum). Maybe I should increase it to twice a day?

I try to eat as clean as I can too.

I really can't do much else can I?

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Balance hormones? Try includings some EFAs in your diet... like Udo's Choice Oil Blend, do at least 4 liver flushes, and try to get to bed before 10.

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KK,

I dont think I would take Centrum 2 x's per day. The vitamins I take call for twice per day. You can check them out at www.womentowomen.com They are a bit pricey but I really like the quality. I used to get naucious when I took my vitamins in the am, but I could take these on an empty stomach with no problems. I figure that I would spend this much anyway if I were to buy all the supplements included separately. This website and product really helped me out when I was a hormonal mess after stopping the bcp.

The herbs I get either at the Vitamin Shoppe or online. Vitacost.com is a good place to order supplements from.

Queen, I dont know much about the demodex mites or milia. Im not sure if the bumps I had were milia, they seemed more like really clogged pores. I hope you find out exactly what will help eliminate the problem once and for all.

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Balance hormones? Try includings some EFAs in your diet... like Udo's Choice Oil Blend, do at least 4 liver flushes, and try to get to bed before 10.

What's involved in a liver flush, and what will it do?

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Just getting started with 2 new products: Green Cream level 6 (this is a high-retinol OTC treatment) and topical vitamin A.

Both are supposed to purge the skin, which is exactly what I think my clogged pores need. The Green Cream can apparently cause a lot of dryness and irritation, so I am using it with great caution. The topical A, on the other hand, is oil based (the formulation includes olive oil, clove oil and vitamin E) and people have said it makes their skin really smooth and soft.

So I'm hoping to increase the purging power while dodging the dryness ... we'll see how it goes ...

Q

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