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36yo F is going to kick this crap!

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I always wonder if I should just march to my derm and ask to be put back on accutane, for the third time. Isn't that where this is all going to end up anyway? Sigh. Probably.


Bad Skin Day

What else is new. I could title every entry that way. I'm having a breakout with mini red pimples all over the tip of my nose and a couple next to my nose and then just a bunch scattered all over the rest of my face. My dozens of hyperpigmentation marks look awful today, too. My skin is dry and flaky and looks extremely unhealthy and just weird. Yet, the oil pumps out, out, out.

That oil thing is a new development. I have always had really dry skin. About 6 weeks ago, my skin starting pumping out the oil like crazy for the first time in my life. It's awful! So I have this painfully flaky, rough, dry skin, with oil slick all over it. Fuck!

I started using Atopalm MLE Face Cream last night in the hopes that it could repair my skin's barrier like it says it will. My skin is just so totally out of whack right now and is sooooo uncomfortable. I can always feel it.

There is no way I feel I can start the BP with it like this. My skin is so damaged right now, and I know the BP will destroy it.

Game plan for today is to hide at work as much as possible and then tear out of here. Thankfully no plans to see anyone this weekend.

I'm so sick of hiding out, I feel like crying. I want my life back!


Just saw that the DKR products I ordered arrived today. Weee!

I'm not starting right away, though. My skin is still irritated from overdoing the Murad lotion with retinol in it. Once that calms down, it's full speed ahead.


Well, I cancelled the appointment with my dermatologist again this morning. When it comes down to it, right now, my acne is mild. I don't want to blow that up with powerful drugs right now. I want to try OTC methods for a little while longer, specifically, Dan's Regimen.

I'm terrified that BP might rip my seriously sensitive skin apart, BUT any topicals (especially retinoids) will do that to me, and I need a long term solution that will not lose its effectiveness. I have gone through all of my options over and over again endlessly in my mind and none of them are ideal. That's just the bottom line. BP seems to be the best of the worst, so to speak, so I have my fingers crossed that it will work for me.

I have to force myself to take it very slowly and to be patient with the BP. That's going to be so, so hard. I have learned the hard way, though, that even in just overdoing OTC retinol, I can burn myself and screw everything up when I'm not careful.

So, right now, I'm building up my skin's barrier. Dan's products should arrive by tomorrow. Not sure exactly which day I will start yet but sometime within the next couple of weeks...


So, I have a derm appointment scheduled for tomorrow. I had one last Wednesday but cancelled it and instantly regretted it. Yet, I'm no closer now to knowing what I want to talk with her about than I was last week. The problem is, my derm sort of lets me choose my own adventure (within reason) as to what treatment options I want to pursue.

I flip flop back and forth endlessly about what I want to do. Oral antibiotics? More topical solutions? Spiro? I seriously have no clue what to try next.

I'm going to go through with the appt, but I don't have high hopes that it will be effective since I am so uncertain about everything right now...


So, I downloaded the Skin Type Solution book by Dr. Baumann to my kindle last night. I'm pretty sure I'm a DSNW (Dry, Sensitive, Nonpigmented, Wrinkled), which is apparently just about the most complicated to treat for acne. Greeeeat. Because of my dry, sensitive skin, OTC products containing BP, SA, AHA, etc. are no good for me because the irritation counteracts any anti-acne effect.

The good news is, I was on the right track by using the sulfacetamide topical and by skipping the differin for now. I was also on the right track by starting to scale back the harsh topical products with SA, retinol, etc. I was using. She gave some recommendations for other products I can try, from drug store products to high scale cosmetic products to prescriptions.

The thing that troubles me about this, though, is if I can't use SA, BP, AHA, etc., how in the hell am I going to maintain a long term acne regimen? Maybe once I restore my skin's barrier (which is apparently my problem), maybe I can start incorporating these types of products again? She seems to think once you restore your skin's proper balance that acne maintenance products are no longer needed, but I don't know. That seems contrary to everything else I've ever known about acne being a long-term, noncurable skin disease.

So, I learned some good things, but I also have more questions.


This Weekend

This was a very social weekend for me, even though all I really wanted to do was crawl under a rock and hide as usual. Friday night I went out to dinner and a movie with my DH while our DD stayed over night with my SIL. Saturday, we went to the zoo and a kiddie amusement park with our DD and niece. It was such a BEAUTIFUL day here in the NYC area. A sorely needed break from the cold rain we've been having. Today was a birthday party for my nephew with virtually all of my inlaws.

During all of these events, all I could think about was my skin. I did my best to grin and bear the interaction and enjoy myself, but it is so, so, so, so hard. I know that I do not look anywhere near my best, and that just tears me apart. I know I need to go on and live my life, but damn. I am always so distracted about my skin. The psychological aspects of this are killer, just killer. :doh:


I drive myself crazy trying to decide what to do next for treatment. My course of action changes daily, sometimes hourly.

I currently have mild to moderate acne, depending on the week. I no longer (knock wood!) get cystic acne. It's mostly small papules and whiteheads that always leave red marks. I never pick, but the red marks last forever, so it looks much worse than it really is. I never have a clear day, ever. I always have at least a couple red marks, oftentimes many more.

Dan's Regimen sounds great. I even ordered the supplies Friday and should have them by Thursday or Friday of next week. My skin is so sensitive, though, that I don't know whether it can handle that much BP on a daily basis. My skin is already red and dry on a good day.

Ditto retinoids. I have had a tube of Differin 0.1% cream sitting in my drawer for almost 6 months now. I can't bring myself to use it out of sheer terror of the IB. and having to go through the whole "getting my skin used to it" stage.

AHA/BHA...well...is that going to be enough? I don't know. I have a 2% BHA product that's been in my cabinet for about a week that I have been wanting to incorporate into the routine, but I've been waiting for a time to test it on a day where I'm not going to see anyone. So far, haven't had any of those days. Too much going on!

Then I often think about spiro. Problem with that is, I don't know if my biggest problem is hormonal. I don't have the classic signs. My acne is not localized only to my chin/jawline. I get it all over. My acne does not necessarily flare up in connection with my period - I ALWAYS have it. It's a constant thing...

I don't want to take oral antibiotics because I know it's only a short-term fix. Besides, I tried minocycline a few years ago, and that was a disaster. I had one of the rare adverse side effects where the drug triggered an autoimmune response. Every joint in my body had searing pain. I couldn't turn doorknobs or take stairs without searing pain. I wouldn't wish that kind of pain on anybody.

And accutane. Well, I've been on it twice, so I know what it is. As much as my current acne troubles me, though, I don't think it's severe enough to warrant accutane.

Head is spinning...


I just turned 36 and am still dealing with this acne crap! I went through my first round of Accutane in 1997 and had another in 2005, after trying retinoids, antibiotics, blah, blah, blah, leading up to both rounds. Acne started creeping up again last summer, and I've been struggling with it again ever since.

Even though overall the acne this time around has been milder than in years past, for some reason, this round has been more devastating to my self esteem than ever. I constantly cancel plans, make excuses for why I can't attend family/friend events, etc. Work is torture! I hide away in my cubicle and pray that not too many people stop by to chat. I even dread having too much face to face time with my husband. It's horrible! As much as I tell myself I'm being stupid and it's not that bad...I can't help it. I hate this!!

I've been using a sodium sulfacetamide topical since last November and although it's great for my freakishly sensitive skin, I know it's not enough (I still have mild breakouts), and I know it's only a matter of time before I breed superbacteria and all hell breaks loose. My derm also prescribed me some differin 0.1% cream, but after reading all the reviews on it, I decided not to try it until I was really desperate and had nothing else to lose.

I need to come up with a long-term plan, though, because I am obviously going to be one of those "lucky" people who deal with acne into their 40s and 50s. Yay, me!

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