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Weevil

Month 6: Maybe pregnant :)

Hello Everyone,

Today is 6 months, 21 days since I started Dan's Regimen. Here's an update:

-I had my 3rd IUI (w/6 clomid + 2 shots, no trigger shot, using ovulation kit), and I think I might be pregnant. I had a positive test result this morning. I'll take another test tomorrow morning, and then call the doctor to confirm with a blood test. I've only told my husband, obviously, but I'm too excited to contain myself, so here I am :redface:.

-I tried applying the benzoyl peroxide only in the mornings, and the AHA only at night, for about 1 month: didn't work, I broke out and my pores got large again, so now I'm back to BP morning + night, for about another month, and everything is back to normal again: clear skin, smaller pores.

-I haven't been using the hydroquinone for 3 months now (since I'm trying to get pregnant), and my skin got blotchy almost immediately and the melasma is back, so So I tried instead:

-CliniqueEven Better Dark Spot Corrector (not the clinical one): barely made a difference after 1 month

-IQDerma SkinTensive xCel -High Potency Anti Wrinkle Serum: It's wonderful. works like a charm on light wrinkles, looks like it's making a difference on melasma -not as good as hydroquinone, but it's based on Hyaluronic Acid, which is safe for pregnancy (the body even naturally produces more of it during pregnancy). But it's very expensive ($60 on sale at dermstore), so I'll try the clinique clinical dark spot corrector next (cheaper), or go back to AHA...we'll see.

-My skin is much dryer lately, so I've had to start using Dan's moisturizer (the old version). Doesn't work as well as chanel's moisturizer, so when both run out I'll get dan's new moisturizer

Wish me luck on the pregnancy!

Weevil

Month 4: 1st IUI

Hello everyone,

It's been 4 months, 7 days since I started the regimen. I haven't broken out at all for about 1 month (so I haven't had any pimples tempting me to pick). My face is so clear now, I've stopped wearing makeup as of a week & a half ago. I've used up 4 tubes of hydroquinone 4% and that has gotten rid of most of my acne & non-acne related PIH. I look OK, in terms of complexion, but I'm still noticeably red & shiny by midday (I still also have big pores on my nose and cheek area around my nose, but they seem to be getting smaller). So if Almay 0.5% BHA makeup produced a shade that matched my skin tone, I would still use it. It's truly great makeup -aside from Chanel which costs a fortune- the best I've ever tried. It helped prevent breakouts, healed them, concealed them and balanced out my skin. Looked great all day, did not cake or collect in my smile lines, I never looked shiny (not even on my nose!). So why did I stop using it? My skin cleared and calmed down so much (thanks to Dan's regimen), that you could tell the difference between skin tone and makeup under my eyes (I don't wear makeup around my eyes at all...my skin is perfect around my eyes, I wear contacts and I don't need shadows or mascara because I have big almond eyes with long, curly black lashes...I gotta have something good, don't I? :rolleyes:. My husband told me I look yellow under my eyes! I realized this is because the Almay makeup has a red undertone, and I have an olive undertone (I'm of spanish background). None of their colors seem to have an olive undertone, so nothing matches! I'm reluctant to try anything else, because I feel I've tried almost everything else and I don't want to break out. Plus, no makeup saves me 15 min. in the morning. Plus I just don't like the concept of makeup in general (men don't wear it...why do we have to?????)

So I need to find something that will control the shine & redness without breaking me out. I'm going to try Aveeno's 30 spf daily sunblock because it has good reviews on acne.org (not shiny, not white-looking, doesn't break you out, even helps with acne...we'll see). At least until Dan comes up with a sunblock.

I've also switched from Dan's cleanser to Clean & Clear's sensitive skin cleanser. I've been on it for 1 month...so far perfect (cheaper & easier to buy then Dan's).

And I stopped the hydroquinone and the Almay BHA makeup 2 days ago because both ingredients are not recommended for pregnant women, and I had my first IUI yesterday (intrauterine insemination). I'll know in 2 weeks how it goes...keep your fingers crossed for me!

So my regimen is very simple now: Dan's BP in the morning, Dan's AHA at night. we'll see how it goes.

Best of luck to everyone!

Weevil

Month 3, Day 3

I forgot to mention yesterday: I'm not treating my chest & back anymore with anything because all acne & related problems are gone. This for like the last 1.5 months. I don't even have any PIH on my chest anymore...perfectly healthy and awesome (still some PIH on my upper back, but I have long hair, so no one sees that anyway, so I don't care...it'll fade with time).

As far as my face is concerned, I will continue with Dan's regimen & products religiously forever, for as long as have occassional breakouts (which I definitely get around my period, on my chin).

So I'll only post if there's any change (if I break out again, or if I get pregnant). Good luck to everyone!

Weevil

Month 3

Hello everyone: it's exactly 3 months & 2 days since I started Dan's regimen. Couldn't be happier. My skin's not perfect yet, but has completely gotten back to normal, which for me is big pores confined only to the nose and about 1.5" around the nose area on my cheeks. The rest of my face has miraculously gone back to invisible pores, smooth skin. I went to vacation in Oregon, and the humidity did not affect me. I do however continue to breakout around my period on my chin area, but a little extra BP + AHA usually takes care of zits overnight (really. amazing).

One thing to report: I stopped taking the spironolactone for 20 days because we are trying to have a baby, we didn't get pregnant so I started taking it again until my next ovulation period, and I broke out on my cheeks. Deep white clogs inside open pores. I squeezed all of it out and right now it's dry and healing, but that will cause hyperpigmentation that will set me back at least a month. Kiddies, if you can possibly resist, don't pick. I attribute this breakout to my skin clearing out the hormone effects of the changes in spironolactone intake because there were no other changes in regimen, diet or exercise during that period

Another thing: I didn't use makeup at all during my 1 week vacation, because I was outdoors all the time so I used Neutrogena's 70 SPF sunscreen, which really is too thick to use under makeup. It didn't make my skin any better, nor did it affect it negatively. In fact, I think the Almay with 0.5% BHA actually improves my skin because it keeps it matte. Totally controls excess oil production all day long. I don't even need powder. It can be over-drying, specially on my forehead and fine-line areas around my mough and eyes. But Dan's moisturizer and or jojoba oil usually takes care of that. So I'm back on Almay and still using it every weekday and when I go out on weekends.

Wish me luck on the whole pregnancy thing!

Weevil

I've only been using Dan's AHA in liu of moisturizer nightly, and nothing in the daytime because my almay makeup felt like enough, but just this week my skin has been feeling dry, so I'm going to start using Dan's jojoba oil tomorrow morning, under the almay. I'm almost clear enough of the PIH that maybe soon I'll be able to go makeup free -and then I'll use sunblock over the BP. We'll see how it goes

Another update: last week (Day 38) I started using Almay 220 - a shade lighter than 240- because my complexion has lightened up so much, it's now matching my neck! So no more redness at all, and almost all the PIH is gone. I love you Dan!!

Weevil

Research on pregnancy & Dan's regimen: so far the concensus seems to be that AHAs and azelaic acid creams are the only safe products for both acne and melasma; but just recently it was posted on Acne.org that the FDA has reclassed BP as a category 1 drug, "safe & effective" so BP should be OK too (I confirmed this online...here's the official article link: http://govpulse.us/entries/2010/03/04/2010...drug-facts-form

But I probably will give up the BP if I do get pregnant, and use organic, raw, unpasteurized Apple Cider Vinegar as a toner, along with the AHA, just to be safe.

-webmd.org:Pregnancy Acne: What to Do

Even if it's been years since you've seen a zit, don't be surprised if pregnancy brings out a bumper crop, particularly around your mouth and chin.

"These are the most common areas for acne to occur during pregnancy, and if you don't treat it right away, it will continue until you deliver, and sometimes even after baby is born," says Marmur.

Although some over-the-counter preparations can help, dermatologist Sumayah Jamal, MD, PhD, says you must choose wisely.

"You should not use any products that contain benzoyl peroxide, salicylic acid, or any of the retinoids. They are not safe to use during pregnancy," says Jamal, an assistant clinical professor of dermatology and microbiology at NYU Medical Center in New York City.

What you can try, she says, are sulphur-based topical products, as well as those containing glycolic acid or alpha hydroxy acids, or any at-home microdermabrasion treatment.

If these don't help, says Jamal, there are topical prescription drugs that offer good results. "These include erythromycin cream and azelaic acid -- both very safe to use during pregnancy."

And while Jamal does not advise using oral antibiotics for acne during pregnancy, Marmur says for patients who don't get results with topical treatments, prescription oral erythromycin is considered safe to use.

"It should not cause a problem, and if your acne is really making you miserable, this can help," she says.

What also works: switching to a foundation for oily skin, or using loose powder mineral makeup. Both have oil-blotting properties and won't irritate skin with acne.

"You can also use a mattifying product underneath your makeup to soak up excess oil, or dab your face with blotting papers during the day to help remove excess oil," says Jamal.

-babycenter.com:

Is it common to be more prone to acne when you're pregnant?

Pregnancy can trigger acne or make existing adult acne worse. (On the other hand, some women with acne-prone skin report a decrease in breakouts during pregnancy, so you never know.)

Higher levels of hormones called androgens are at least partly responsible for pregnancy breakouts because they can prompt the sebaceous glands in your skin to get bigger and boost production of an oily substance called sebum.

This extra sebum, combined with the shed skin cells that line your hair follicles, blocks your pores, creating an environment in which bacteria can rapidly multiply. All this can eventually lead to the inflammation and skin eruptions of acne.

Acne during pregnancy can be mild, moderate, or even severe, and it can occur at any time during the pregnancy. It may come and go, or it may last the entire pregnancy, says Andrea Cambio, a dermatologist in Cape Coral, Florida.

Is there anything I can do about pregnancy acne?

There's no way to prevent the problem, but here are some tips that may help:

Wash gently with a mild soap or cleanser twice a day.

Don't scrub your face with a washcloth, since that can irritate the skin and make the problem worse. Instead, use your hands to gently wash your face.

Pat your skin dry rather than rubbing it.

If you use moisturizer, make sure it's oil-free.

Don't squeeze, rub, or pop your pimples – it'll aggravate the problem and could lead to scarring.

If you wear makeup, use products that are water-based rather than oil-based and that are labeled "noncomedogenic" or "nonacnegenic," meaning they won't clog your pores and cause breakouts. Be sure to wash your makeup off thoroughly before going to bed, too.

Ask your doctor or midwife before using medicated gels or lotions. A number of over-the-counter and prescription products help clear up acne, but some of the ingredients aren't safe for pregnant women or haven't been well studied in pregnancy. If your acne is severe, you may need to see a dermatologist.

Are all prescription acne medications off-limits to pregnant women?

It's particularly important to avoid the oral prescription drug Accutane (isotretinoin), which can cause serious birth defects. Also avoid tetracycline, doxycycline, and minocycline – sometimes prescribed for acne – which can cause teeth and bone abnormalities in the fetus.

Cambio says it's considered safe to use topical prescription antibiotic creams containing erythromycin or clindamycin, but she always recommends that a pregnant woman check with her caregiver first, just to make sure.

Keep in mind that your pregnancy isn't all bad for your skin! While you may have to put up with some new blemishes, as you circulate more blood and retain more water you may find that your complexion is more radiant than ever before.

-babypartner.com says BP OK: "Benzoyl peroxide during pregnancy

Benzoyl peroxide is a keratolic and antimicrobial medication. That means it promotes the softening and removal of the outer layer of dead cells from the surface of the skin and has antibacterial properties.

Benzoyl peroxide is used in many topical acne treatments such as lotions, creams, gels and masks. In some preparations it is combined with other medications including antibiotics, retinoic acid and sulfur or salicylic acid.

How benzoyl peroxide works

Benzoyl peroxide works by slowly releasing oxygen that helps to fight bacteria, a primary cause of acne. It also contributes to the peeling and drying of the skin which helps to reduce blackheads and whiteheads.

Benzoyl peroxide and pregnancy

Only trace amounts of benzoyl peroxide is absorbed by the skin when applied to the face. Many doctors consider benzoyl peroxide safe to use during pregnancy and there have been no recorded problems by women who have used the medication during pregnancy.

Common brand names

Benza W

Benzagel

BenzaShave

Clear By Design

Clearasil

Cuticura Acne Cream

Del-Aqua

Desquam

Fostex

Neutrogena Acne Mask

Noxzema Clearups

Oxy 10

Oxy 5

PanOxyl

Stri-Dex Maximum Strength

Theroxide

Common side effects

dry skin

peeling of the skin

Manufacturers of benzoyl peroxide products remain more cautious and recommend that benzoyl peroxide should not be used during pregnancy unless it is considered essential. If you have any doubts about using benzoyl peroxide during your pregnancy you should consult your doctor.

Benzoyl peroxide may pass into breastmilk and if you are using benzoyl peroxide you should consult your doctor before breastfeeding.

There are no side effects unique to children over the age of twelve. Studies of the effects of benzoyl peroxide on children under the age of twelve have not been completed.

Known food interactions

An allergy to cinnamon or foods containing benzoic acid may increase the risk of developing an allergic skin rash when using benzoyl peroxide. You should consult your doctor.

drug interactions

Consult your doctor before using benzoyl peroxide if you are taking any of the following drugs, medications or supplements, since excessive skin irritation and other problems may result:

abrasive skin cleaners

medicated cosmetics

oral contraceptives

prescription or non-prescription acne medication

resorcinol

salicylic acid

sulfur

tretinoin

Reasons to consult your doctor

Contact your doctor immediately if you experience any of the following:

blistering

burning

crusting

severe redness and swelling of the skin

-americanpregnancy.org says BP OK: "When choosing over-the-counter medicated acne cleansers and treatments, it is advised that you consult with your health care provider first. There are products that contain benzoyl peroxide, which have been recommended safe for pregnant women to use. However, there are over-the-counter medications that you may want to avoid such as products containing salicylic acids. Always consult your health care provider before taking ANY medications during pregnancy, whether prescription or over-the-counter"

-safefetus.com says BP is a Category C drug and "Studies on animals show adverse effect and toxicity on fetus. No adequate and well controlled studies done on pregnant women. Drugs should be given only if the potential benefit outweighs the potential risk to the fetus.

-fetalexposure.org says yes to BP, and contradicts safefetus.com. It's the most complete article I've found, but it's dated Feb/2000:

"Acne and Pregnancy

Vol 7#5, February 2000

Kathleen O’Connell, BA; Megan Shepard, BA; Kelly Ormond, MS, CGC; Eugene Pergament, MD, PhD, FACMG

A variety of medications are prescribed for the treatment of acne, some taken orally, others topically. When assessing the possible risk of these medications during pregnancy, the route of the exposure is important to consider. Topical creams and gels are less systemically available than medicines taken orally, ultimately meaning that the fetus is exposed to less of the medication. As with any decision about medication during pregnancy, the potential risks must be weighed against its benefits for the patient. Since there are various acne medications available, it may be possible for a woman to find a combination of medications that is both effective and does not put her pregnancy at risk for major malformations. This newsletter examines various medications used in the treatment of acne.

Common medications

Benzoyl Peroxide (Benzac, Benzamycin, Beroxyl, Desquam, Triaz, Vanoxide)

Benzoyl peroxide is a topical treatment for acne that has antibacterial effects and induces skin peeling. About 5% of each topical dose is absorbed sytemically. There are not any animal or human reproductive studies on benzoyl peroxide, and therefore its potential teratogenic risk is undetermined. However, benzoyl peroxide is commonly used, and there are no case reports about benzoyl peroxide and birth defects in the literature. This, combined with its topical exposure, provides some reassurance that the risk of malformations is likely to be low.

Hydrocortisone (Vanoxide-HC; w/ benzoyl peroxide)

Hydrocortisone is a corticosteroid used topically to treat acne and other dermatologic conditions. There have been no reproductive studies on topical exposures to hysdrocortisone specifically, and as such its risk in pregnancy is undetermined.

A literature review of oral cortisol exposures during pregnancy did not find an increased risk for malformations in the exposed group, but it was found that the exposed group did have an increased risk for prematurity and other complications for the mother and fetus (Aron et al., 1990). The doses in the studies reviewed were presumably much larger than a dose from a topical exposure. Fraser et al. (1995) surveyed 468 women exposed to all corticosteroids in general, and noted no significant increase in birth defects. However, this study did note an increase in cleft palate versus that expected (2 vs. 0.2). Because an increase in clefting has been observed in mice exposed to corticosteroids (Fraser et al., 1951), this finding is of potential concern.

Most other studies of oral and inhaled corticosteroids have not found a significant increase in birth defects or in clefts specifically (Czeizel and Rockenbauer, 1997; Fitzsimons et al., 1986; Rodriquesz-Pinella and Martinez-Frias, 1998; Schatz et al., 1997). Finally, a retrospective study by Czeizel et al. (1997) followed 191 women exposed to topical cortisone during pregnancy and found no significant increase in birth defects. In summary, although there is a potential connection between oral corticosteroids and cleft palate identified in the human and animal studies by Fraser et al. (1951 and 1995), it is unlikely that a topical exposure to hydrocortisone significantly increases the risk of birth defects, including oral clefts.

Salicylic Acid (Sal Ac)

Salicylic acid is used to treat acne, warts and other dermatological problems. There are no studies specifically looking at topical salicylic acid in pregnancy. Oral salicylic acid (aspirin) has not been associated with an increase in malformations if used during the first trimester, but use in late in pregnancy has been associated with bleeding, especially intracranial bleeding (Rumack et al., 1981). The risks of aspirin late in pregnancy are probably not relevant for a topical exposure to salicylic acid, even late in the pregnancy, because of its low systemic levels. Topical salicylic acid is common in many over-the-counter dermatological agents, and the lack of adverse reports suggests a low teratogenic potential.

Antibiotics/Anti-infectives

Erythromycin (A/T/S 2% acne gel, Benzamycin, Emgel, Erycette, T-Stat, Theramycin)

Erythromycin is an antibiotic that is commonly prescribed in pregnancy. Although often taken orally to treat infection, it is also used topically for acne. Erythromycin crosses the placenta minimally; the fetal blood concentration is only 2-10% of the maternal serum concentration, and the medication is quickly metabolized by the body.Takaya et al. (1965) found no increased malformations in mice exposed to 1-20 times the human dose. Human studies on erythromycin have all examined oral exposures. Retrospective studies of 79 and 6972 women exposed in first trimester had no significant increase in birth defects (Heinonen et al., 1977; Briggs, 1998). Jick et al. (1981) examined the prescription records of women exposed to erythromycin during the first trimester and also found no increase in birth defects (n=100-200). Because of these studies and the fact that this medication is commonly prescribed, it is generally assumed that topical erythromycin does not pose a significant increased risk for birth defects.

Clindamycin (Cleocin)

Clindamycin is an antibiotic related to erythromycin and available both orally and topically for the treatment of acne. It has been studied in both mice and rats at doses up to 180 mg/kg/day without teratogenic effects (Weinstein et al., 1976; Philipson et al., 1976).The retrospective Michigan Medicaid study identified 647 women exposed to clindamycin in the first trimester (both oral and topical exposures) and did not note an increased risk for major malformations. Furthermore, a study of 104 women exposed to clindamycin in the second and third trimesters did not suggest an increased risk for prematurity or placental complications (McCormack et al., 1987). This medication is unlikely to significantly increase the risk for birth defects in either its oral or topical form.

Tetracycline

Tetracycline is an antibiotic taken orally to treat acne. This medication belongs to a family of antibiotics that includes minocycline and doxycycline. The half-life of tetracycline is 11-22 hours, so most of the medication is removed from the body in 5 days.Two retrospective studies found no increase in the incidence of major malformations when women were exposed to tetracycline in the first trimester (Heinonen et al., 1977; Briggs, 1998). However, discoloration of deciduous teeth and the crowns of permanent teeth was seen in children who were exposed to tetracycline after the fourth month of gestation. Studies performed by Cohlan et al. (1961), Kline et al. (1964) and Kutscher et al. (1966) established that infants exposed to tetracycline in utero after the fourth month of gestation may have discoloration of deciduous (â€babyâ€) teeth, cavities, and enamel hypoplasia in their teeth. It is believed that tetracycline causes dental discoloration and bone depression because it acts on the calcification process in development. The critical period for calcification begins at four months’ gestation and ends twelve months post-partum. Therefore, tetracyline should be avoided after the sixteenth week of gestation and throughout lactation.

The degree of dental staining appears to proportional to the dose of the medication (Egerman et al., 1992). Cohlan et al. (1961) also found that tetracycline caused long bone growth depression of 40% which normalized when the use of the medication was suspended.

Doxycycline and minocycline, two medications structurally-related to tetracycline, are also used to treat acne. These medications have not been as well-studied as tetracycline; it is, however, generally assumed that doxycycline and minocycline similarly affect the fetal calcification process. Therefore, these medications should also be avoided after the first trimester of pregnancy through the breastfeeding period.

Sodium Sulfacetamide (Sulfaset, Klaron, Novacet, Sebizon)

Sodium sulfacetamide is a topical anti-infective medication used to treat acne and seborrheic skin conditions. It belongs to the class of medications termed sulfonamides, and most reproductive studies examine sulfonamides as a class and in oral dosages, making it difficult to extrapolate the potential risk for a topical medication such as sulfacetamide.

The maternal use of sulfonamides near delivery can lead to newborn toxicity, resulting in anemia and jaundice and, theoretically, kernicterus, although this has yet to be documented in the literature. (Briggs, 1998). There have been two large retrospective studies of sulfonamide exposure, which involved 1445 and 3465 women exposed in the first trimester; neither study found an increased risk for malformations from the class in general (Heinonen et al., 1977; Briggs, 1998).

In contrast, other case controlled studies raised concerns about sulfonamide use in pregnancy. A 1971 case-control study by Nelson et al. determined the pregnancy exposures of 1369 patients, 468 of whom had babies with congenital malformations. They observed that significantly more mothers of the babies with birth defects took sulfonamides than the control mothers (Nelson et al., 1971). Saxon et al. (1975) looked retrospectively at 599 children born with oral clefts. The mothers of children with malformations in addition to the oral clefts were more likely to have taken sulfonamides than mothers of children with isolated oral clefts.

Because topical sulfacetamide has never been specifically studied to determine its potential teratogenic risk, one cannot definitively conclude that it does not cause birth defects. However, because it is topical and, for the most part, sulfonamides as a class do not appear to significantly increase the risk for birth defects, it is unlikely that topical sulfacetamide causes a significantly increased risk for malformations.

Breastfeeding while using sulfonamides is probably not a risk to a healthy infant. At most 1-2% of a maternal, oral dose of sulfonamides enters the breastmilk (Adair, 1938; Hac, 1939). However, sulfonamides can potentially cause anemia and jaundice in stressed, premature or hyperbilirubinemic infants. In addition, if an infant has G-6-PD deficiency breastfeeding should be avoided while taking sulfonamides , as sulfonamides act as oxidative stressors and can result in a hemolytic crisis.

Retinoids Isotretinoin (Accutane, Roaccutane)

Isotretinoin is an oral retinoid used to treat cystic acne. A known teratogen, this medication is contraindicated during pregnancy due to the characteristic malformations it causes. The pattern includes defects of the CNS, thymus, craniofacial and cardiovascular systems, as well as conotruncal malformations. Isotretinoin is thought to affect initial differentiation and migration of cephalic neural crest cells, and the critical period for this medication is 2-5 weeks post conception. Because the teratogenicity of Accutane is fairly well-known, we have chosen to focus upon other common acne medications in this review, rather than summarizing the literature about isotretinoin (for more details, see RISK/NEWSLETTER 3/96). Despite the half-life of approximately 1 day (manufacturer insert), due to the teratogenicity of this medication it is recommended that isotretinoin be discontinued at least one month prior to attempting pregnancy (Braun et al., 1984; Benke, 1984; Rosa, 1983; McBride, 1985; Rizzo et al., 1991).

Tretinoin (Avita cream, Retin A)

Tretinoin is a component of various topical acne creams. Because this medication is related to isotretinoin, there is concern that tretinoin could potentially have similar teratogenic effects on the fetus. Two case reports have described infants born to women using topical tretinoin during the first trimester of pregnancy. The infants had malformations that mimic the birth defects associated with isotretinoin (Camera et al., 1992; Lipson et al., 1993). In contrast, a prospective cohort study failed to find an association between birth defects and 215 women exposed to tretinoin in the first trimester (Jick et al., 1993). Shapiro et al. (1997) did not find a significant increase in number of livebirths, SAB’s, low birth weight, major malformations, duration of pregnancy, and cesarean sections in 94 women exposed to tretinoin versus controls.

A dose-response relationship potentially could play a role in the effects of tretinoin; it is of note that 5-31% of tretinoin is absorbed sytemically, depending on whether the skin is healthy or dermatitic. Although prospective studies have shown no increase in congenital anomalies, the case reports and biological plausibility of the anomalies raise concern about this medication. While such risks are likely to be low given the low topical absorption, health professionals should encourage women to weigh the risk and benefits of tretinoin during pregnancy.

Adapalene (Differin Gel)

Adapalene is a retinoid used in a topical gel form for the treatment of acne. As such, there are theoretical risks for retinoid embryopathy. However, the manufacturer reports that only trace amounts of adapalene are absorbed from the skin (trace is defined as less than 0.25 ng/ml). The manufacturer’s studies on pregnant rats and rabbits using doses 120-150 times the maximum human topical dose did not show an increased risk of adverse outcome or malformations. There has been one human case report of adapalene use during weeks 4-13 of pregnancy; the fetus had IUGR, anophthalmia and agenesis of the optic chiasm, and the pregnancy was aborted at 13 weeks (Autret et al., 1997). The anomalies seen in this pregnancy are not typical of those seen with other retinoid exposures. In addition, as with any case report, the malformations could be coincidental and unrelated to the adapalene. There have not been any other human studies or case reports to date. The overall risk of adapalene is undetermined because there have not been any human studies. However, because only trace amounts of the gel are absorbed into the skin, it is unlikely that doses large enough to induce malformations could reach a fetus.

Other medications

Azelaic Acid (Azelex)

Azelaic acid is a topical cream for acne. The manufacturer’s studies in animals do not show an increase in malformations at doses much higher than the maximum human dose. There have not been any human reproductive studies to date. While it is reassuring that animal studies do not show teratogenicity and that the fetal dose is small because the medication is topical, the risk of azelaic acid is undetermined because there have been no human studies.

Conclusions/Summary

In summary, acne medications present a range of risks during pregnancy. Because of its proven teratogenicity, it is well known that isotretinoin (Accutane) should not be taken during pregnancy. Additionally, tetracycline and its derivatives should not be used after 16 weeks gestation due to its effects on calcium-containing tissue, particularly teeth. The risks of other medications such as tretinoin are less certain, while some commonly used medications, like benzoyl peroxide, do not appear to pose a significant risk for malformations. Because of the widely known teratogenic effects of isotretinoin, many women are wary of acne medications in general during pregnancy. However, there are a wide variety of medications available for the treatment of acne, many of which pose a minimal risk if applied topically during pregnancy.

-babycenter.com says that BP & AHAs are OK:

Most pregnant women know that what they put (or don't put) in their bodies is important to the well-being of their growing baby, whether it's the right kind of protein, too much caffeine, or certain types of fish. But many pregnant women might not know that what they put on their bodies is just as important.

Most of us slather on oceans of lotions every day, but we don't think about what might be passing the skin barrier and being absorbed into our bodies. With a developing baby in your belly, this is a vital concern.

"Everything you eat, apply, or come into contact with may affect not only you but also your baby," says Sandra Marchese Johnson, a dermatologist with Johnson Dermatology in Fort Smith, Arkansas.

"Because some topical ingredients get absorbed into the bloodstream, there are some you want to avoid," adds Leslie Baumann, a professor of dermatology at the University of Miami and author of The Skin Type Solution (Bantam, 2006).

The more powerful and targeted products get, the more we need to be careful about what we have in our skin-care regimens during pregnancy. While most commonly used products are completely safe, there's a handful of ingredients considered potentially harmful to a growing baby. Below, see our guide to what to look for when shopping the beauty aisle.

If you plan to breastfeed, adds Johnson, continue following the guidelines noted below until you stop nursing.

Retinoids

These powerful substances, found in some antiaging moisturizers, are lauded for helping reduce wrinkles and improve skin tone. Retinoids are a type of vitamin A that speeds up cell division (quickening your skin's renewal) and prevent skin collagen from breaking down.

But retinoids are one of the skin-care ingredients that experts, including Baumann, recommend that expectant moms stay away from. Some studies have shown that high doses of vitamin A during pregnancy can be harmful to an unborn child. And oral retinoids, such as isotretinoin (Accutane, an acne treatment), are known to cause birth defects.

If you've been using a skin cream that contains a retinoid, don't panic. Retinoids have not been shown to cause problems in their topical form in pregnant women.

"There is no data to show these retinoids ingredients are harmful when used on the skin — doctors are just being extra cautious," explains Baumann.

On the label:

Differin (adapelene)

Retin-A, Renova (tretinoin)

Retinoic acid

Retinol

Retinyl linoleate

Retinyl palmitate

Tazorac and avage (Tazarotene)

Bottom line:

Best to avoid

Salicylic acid

This mild acid is used to treat certain skin disorders, including acne, and you can find it in a number of skin products, such as cleansers and toners. It can penetrate facial oils to get deep into pores and clean out dead skin cells. Salicylic acid is in the aspirin family, so it can also help reduce inflammation or redness. BHA, or beta hydroxy acid, is a form of salicylic acid and is used in some topical exfoliants to reverse signs of aging.

But salicylic acid is another no-no for pregnant women. High doses of the acid in its oral form have been shown in studies to cause birth defects and various pregnancy complications.

Again, doctors are being cautious by recommending that pregnant women avoid the topical use of salicylic acid. Small amounts applied to the skin — such as a salicylic acid-containing toner used once or twice a day — are considered safe, says Johnson.

But the concern is stronger about face and body peels containing salicylic acid. "This kind of 'soaking' in the ingredient is similar to taking one or more aspirin when pregnant," she explains.

"More product used equals more absorption into the bloodstream," adds Baumann. Always check with your doctor before having a peel treatment. Better yet, she advises, if you must have a peel, have it done professionally at your dermatologist's office. A dermatologist will know how to do it safely during pregnancy.

On the label:

Salicylic acid

Beta hydroxy acid

BHA

Bottom line:

Best to avoid

Note: Alpha hydroxy acids, sometimes listed as AHAs, glycolic acid, or lactic acid, are safe.

But if you prefer to avoid yet another doctor appointment, Baumann recommends using a facial wash that contains no more than 2 percent salicylic acid (look for the percentage on the product label). This small amount is considered safe.

If you want to be doubly sure, ask your obstetrician or midwife before use. As for what to avoid when it comes to treating acne, stay away from leave-on acne lotions, gels, and creams, as well as at-home peels, which can contain salicylic acid or retinoids, says Baumann. And, of course, steer clear of the oral form of the retinoid Accutane.

On the label:

Beta hydroxy acid

BHA

Differin (adapelene)

Retin-A, Renova (tretinoin)

Retinoic acid

Retinol

Retinyl linoleate

Retinyl palmitate

Salicylic acid

Tazorac and avage (Tazarotene)

Tretinoin

-laboroflove.com says BP is OK:

"Can Benzoyl Peroxide Be Used During Pregnancy?

During pregnancy, a woman’s body is going through a variety of radical changes. Many of these changes are due to the changes in hormone levels that occurs during pregnancy. Some of the side effects of these hormone levels may be relatively harmless, such as a change in sex drive. Other side effects can be severely annoying. Few are more annoying than acne. As hormone levels change, your skin may produce more oils. This, in turn, can lead to an outbreak of acne. If a woman is prone to acne or if she has a history of acne, she might find that pregnancy only serves to multiply her acne woes. In addition, acne during pregnancy may occur anywhere on her body, not just on her face.

Over-the-counter acne treatments are generally considered to be safe to use during pregnancy. Most of these treatments contain benzoyl peroxide. Benzoyl peroxide has been proven in clinical studies to be safe to use during pregnancy. There are a few anti-acne medications, such as Tetracycline, Salicylic Acid, Tretinon, and Isotrentinoin that either are known to be harmful during pregnancy or have not been fully tested as to their effects on pregnant women. Of course, you should always check with your health care provider before using any medications while pregnant, whether they are over-the-counter or prescription. There may be circumstances that are unique to you or to your pregnancy that may affect whether or not you should use them.

There are other things that you can do to help address the problem of acne during your pregnancy, that don’t require medications such as benzoyl peroxide. You should keep your skin clean by using an oil-free facial cleanser and avoiding soaps that contain oils or other irritating substances. You should avoid picking your pimples, which can cause bacteria to spread or create scars. You should also maintain a regular regimen of moderate exercise, which can increase the flow of blood to the skin and help your body to stay more toned and healthy. Finally, you should avoid stress. In addition to causing acne, stress can cause problems for both you and your unborn baby."

-from wynne, a moderator on acne.org: "Please realize that Dan's statement above is the final word from acne.org on the safety of any of the products during pregnancy. Please do not just consider what other posters say about the safety of ANY products in pregnancy. Please talk to your doctor.

Benzoyl peroxide is a category C medication. A category C medication means that no studies have been conducted in pregnant women (for obvious reasons as Dan states above.) A Category C medication has however caused effects in pregnant animal studies. Thus the medication should not be used unless the benefits far outweigh the risks, and THAT is a judgment reserved for the woman herself AND her doctor, not any of us. "

-From Jentalkin2u, a member of acne.org: "I researched this topic online because I'm currently trying to conceive. What I found was it's OK to use:

BP

AHA

Clendomycin

Erythromycin

Do NOT use:

BHA (salicylic acid)

Retinoid / Vitamin A products

"

Weevil

-from babycenter.com: soy products can cause melasma!!

Soy

Some moms-to-be seek out natural ingredients such as soy in their skin-care products, thinking that they're free from harmful effects. But that's not necessarily the case, says Baumann.

While soy-based lotions and facial products are generally safe to use, "Soy can make the 'mask of pregnancy' (dark splotches on facial skin) worse, as can oil of bergamot, which is in many organic products," she says.

Soy has estrogenic effects, which can make those dark patches, also known as melasma or chloasma, worse, Baumann explains. "The 'active soy' found in some product lines is okay, however, because the estrogenic components have been taken out."

On the label:

Lethicin

Phosphatidylcholine

Soy

Textured vegetable protein (TVP)

Bottom line:

If you have dark skin or melasma, avoid these products, or choose 'active soy' products instead. Otherwise it's safe to use.

Pregnancy Mask and Other Pigment Problems

Among the most frustrating pregnancy skin problems is melasma, also known as chloasma or "pregnancy mask" - patches of dark, pigmented skin that appear on the face.

Pregnancy mask is related to pregnancy hormones and sunlight exposure. The American Academy of Dermatology says women with darker complexions and dark hair are at greatest risk.

But regardless of your complexion, Marmur says, other areas of darker skin can also develop on or around your nipples and between your thighs. "Many women also experience linea nigra or 'line of pregnancy' -- a darkened area of pigmentation that runs down the center of the belly," she says.

While there is no specific treatment for pregnancy pigmentation problems, staying out of the sun can definitely diminish the amount of discoloration you experience, so can wearing a sunscreen anytime you are outdoors.

While the jury is still out on the safety of traditional skin-lightening ingredients such as hydroquinone during pregnancy, Jamal says there are others with an established safety profile you can safely try.

"You can use azelaic acid, which is good for pigment, as well as any topical vitamin C product, which helps suppress pigment naturally," she says.

She also recommends Phytocorrective Gel by Skinceuticals, which she says safely suppresses pigment, as well as the Aveeno soy-based products. "They have a photo-stabilized sunscreen that contains soy and has been shown to lighten pigmented lesions on the skin," says Jamal.

if all else fails, you can safely cover pregnancy mask with a high-pigment concealer or foundation. For best results, choose the color closest to your complexion and resist the urge to go lighter.

"If you select a light shade of concealer, you're not going to get better coverage, plus you're only going to draw attention to the mask by highlighting that area," says Holly Mordini, director of global artistry for Smashbox Cosmetics. Another tip, says Mordini, is to always use a good moisturizer before putting on your concealer. "This will help give better, more even coverage over large areas," she says.

If your mask does not clear after pregnancy, Marmur says a chemical peel "works like magic" to remove all traces.

-Another alternative to hydroquinone: Mother of Pearl cream (at CVS) or Concha Nacar de Perlop #3 bleach...has salycilic acid, so works to heal blemishes and bleach PIH

Description from Amazon.com: A one of a kind cream uniquely formulated to bleach, cleanse the pores, remove impurities, aid in fading spots and blemishes, and generally beautify the skin. Contains Genuine oyster shell powder. Concha Nacar is an anti-aging ingredient for the skin. It has been used since ancient times, and in China it used to be claimed that this product could stop the formation of acne scarring. Concha Nacar de Perlop is particularly very common in Latin America and its proven success is making its way to America. If you are looking for a better deal, we recommend you try Madre Perla. It contains twice as much cream: Bleach Cream , Day Cream and Night Cream . Directions: Wash face with warm water. Apply cream and rub in well, avoiding areas around the eyes and the mucous membranes. Allow cream to remain on skin for 1/2 hour to one full hour. Wash off with cold water to open skin pores. Use daily for best results. Minimize exposure to direct sunlight and use sunscreen during the day to avoid recurrence of spots. Tips and Tricks: Don't over wash or use harsh scrubs. Two gentle washings a day is sufficient. Too much cleaning can leave skin irritated and dry, triggering glands to produce more oil, increasing the likelihood of pimples or blackheads. Use oil-free or non-comedogenic products (those that won't clog pores) on your face. Size: 2 oz.

It's like a mask, so you can't leave it on for more than 1 hour

Weevil

I woke up with one red bump on my right cheek bone today. I PROMISE THE UNIVERSE, I'M NOT GOING TO TOUCH IT. It's going to be very hard, peoples. I'm just going to put on the BP + AHA tonight instead of the hydroquinone, until it goes away (the other pimple on my left lower cheek I experimented with last week, went away in 2 days with the same treatment & no touching, so I'm hoping for the same thing).

Other than that, my skin is progressing very nicely on Dan's regimen. The pores on my chin and the sides of my face have gone back to normal (they are not visible & plugged up anymore). And the hydroquinone + AHA are fading my PIH quite fast.

I'm very happy & hopeful I can stop wearing makeup really soon!

I wish everybody tried Dan's regimen...it would have saved me sooooo many years of bad skin!

Weevil

Note: Diet & exercise

I'm posting a lot today because I don't always have the time, but I want to log systematically everything I'm doing just in case it helps anyone out there (since Dan has helped me so much without even knowing), and for my own record.

This post might not be what people want to hear, but diet & exercise really haven't made any difference in the 25 years I've dealt with my problem skin. For most of those years I ate very healthfully but didn't exercise (I was skinny until I turned 27), then for 6 years I ate horribly, was under a lot of stress and gained 37 pounds, because all I did was sit in front of a computer in a corporate executive job. My skin was no better or worse than before. Then for the last 8 years I've had no stress because I changed careers. No change in my skin. For the last 3 years I've been perfect: no stress, eating as healthfully as humanly possible, and I exercise one and a half hours a day. I've lost almost all the weight I gained and I'm wonderfully happy in most every aspect of my life. But guess what. My skin got worse than ever just 2-3 months ago.

Clearly my problem is hormonal and genetic, and I make it worse because I pick (nervous tick).

Having said all that, I'm not saying that you shouldn't eat healfully, exercise & minimize stress. Everybody should, just so you live a happy, healthy and long life (what's more important than that?). What I'm saying is: don't stop eating healthfully, minimizing stress and exercising, just because you don't see your skin improve. The benefits of these 3 things go far beyond good skin. And who knows? you might be one of those lucky people whose skin does benefit also.

Here's what I usually eat, just in case anyone is curious:

Breakfast: whole-grain oatmeal + 1/2 cup of blueberries , 1 mug of coffee+ a little bit of fat free creamer

Snack: 2 low fat high density string cheese + 1 cup of carrots

lunch: veggie stir fry: olive oil, 1 cup of broccoli or 1 cup of green beans + 1 cup of red, yellow, & green peppers+ 1/2 cup of tomatios +1 medium potato or 1/2 cup of beans or 4 oz of turkey or 1 cup of whole grain pasta+ 1 oz of cheddar cheese

snack: 1 cup of yogurt + 1 cup of fruit (rasberries, cherries or blueberries), or 1 apple + peanut butter, or 1 whole wheat muffin with peanut butter/jelly

dinner: I don't eat after 6pm, so usually it's just 2 squares of dark chocolate, or if I'm very hungry, I'll add a banana

I also drink 32 OZ of water in the morning, and lately another 32 OZ of water + juice of half a lemon in the afternoon

I used to drink a lot of green or black or white tea at night, but I became anemic after my recent surgery so I can't do that anymore until my iron count is back up.

In the weekends I eat 2 eggs (omega 3 fortified) + veggies for breakfast, same snacks as above, tuna or salmon salad for lunch, and whatever my hubby wants for dinner (small portions because it's usually pizza or chinese food or restaurant food).

So I have excellent overall health, I never get sick, I'm fit, I look younger than most people my age. But my skin sucks. Can't have it all, I guess.

Weevil

According to Paula Begoun's website:

"Benzoyl peroxide negates the effectiveness of most retinoids (i.e., Retin-A, Tazorac) and therefore cannot be used at the same time. To get both benefits, you can use benzoyl peroxide in the morning and the retinoid in the evening. However, Differin (adapalene) has been shown to remain stable and effective when used with benzoyl peroxide (Source: British Journal of Dermatology, Oct. 1998, page 139). "

Just for the record, I've been prescribed Retin-A, tetrinoin and Differin...Differin was much, much too irritating, and really seemed to make my skin worse, even after at least 6 weeks of use. Tetrinoin worked very slowly but was not irritating the first time I tried it 1 year ago, but when I tried to use it again recently (3 months ago), it didn't work at all and was very irritating. I didn't like how shiny Retin-A made my face when I used it...

So I'm just sticking with Dan's regimen and products because they work better than anything I ever tried before

Weevil

-I'm copying part of blogger "Duane"'s regimen for future reference (sorry Duane, I hope this is not innapropriate...I'm not sure how to use message boards properly, so I couldn't figure out how to tag your posts...the computer acumen part of my ego is severely damaged)

"DKR REGIMEN

morning

dessert essence jojoba oil, purpose gentle cleansing wash, paula's choice 1% BHA gel (to unclog pores), acne.org 2.5% benzoyl peroxide gel, complex 15 moisturizing lotion"

night

dessert essence jojoba oil, purpose gentle cleansing wash, paula's choice 1% BHA gel (to unclog pores), acne.org 2.5% benzoyl peroxide gel, cetaphil moisturizing cream mixed with jojoba oil"

Duane recommends using BHA gel to unclog pores, because BP doesn't unclog pores that are already too clogged (definitely my problem). He says BHA is more effective then AHA for this. Once I finish my AHA tube (Dan's product), I'll try BHA.

-Paula Begouin's website (very informative) says that if you are allergic to aspirin, you might not be able to use BHA (which is salycylic acid)...I am allergic to aspirin, so it might be why if I use the 0.5% BHA Clean & Clear toner on my whole face, it seems to make my pores worse. However, this toner has been effective for me when applied with a Q-tip as spot treatment (only on an active blemish).

I will experiment with Paula's 1% BHA when Dan's AHA runs out, because, per my research, BHA is oil-soluble (and AHAs are not), so it can penetrate the oil in the pores and kill the bacteria

-Here's a salycylic acid product to keep in mind for later:Neutrogena Rapid Clear 2-in-1 Fight & Fade Gel

It has BHA and AHA, but the BHA may be too high (2%) and it doesn't say how much AHA it has...

-should not use BHA during pregnancy

Weevil

So my research has revealed that: yes, it is OK to use hydroquinone with AHA, in that order (1st hydroq., then AHA). It should be good for you because the hydroquinone lightens the skin, and the AHA exfoliates. I've already tried it one night, and everything seemed OK.

Two options for when my prescription runs out are:

-Obagi Nuderm (complicated website...don't really know which products to get, but one of them is 4% hydroquinone, which is my prescription strength)

-Palmers Eventone Fade Milk with 2% Hydroquinone and alpha hydroxy acids. also has a sunscreen; but it doesn't say what the AHA concentration is. no matter, I suppose I can add Dan's AHA. This might be good for when I'm pregnant, since it's OTC and less hydroquinone. But I really think I'm just going to quit the hydroquinone altogether during pregnancy...

Weevil

Day 30: DO NOT PICK

Hello everyone,

Here's my latest confession: I picked Friday night, and made it worse, so I spent all weekend at home trying to minimize the damage. People, if you can possibly control yourself, I have now proven to myself beyond any reasonable doubt that picking comedones that are under the skin surface just makes them worse. They get inflamed, infected and then scar worse. Sigh. Now if I could just control myself, I would make my life a lot easier.

Here are the gory details:

-My doryx prescription ran out on Tuesday (it was a 90 day prescription), and I"m not going to renew it because we are going to start trying for babies again in July. So by Friday I had 3 little areas on the right side of my face where I felt comedones under my skin (each area is about 1/3" in circumference, and every pore in that little area was filled with gunk under the skin). So I picked, and got the "gunk" out, but all 3 areas got inflamed and looked much worse after I picked than before. I'm an uncontrollable idiot.

-Saturday & Sunday I applied Dan's BP and then his AHA morning and night, and nothing else (no makeup, no hydroquinone).

-This morning everything had dried out, so now it's back to just scar & PIH control. I only put on the BP under my makeup (AHA is mildly irritating...only to be used at night or when not going out in public), and I don't look too bad today.

-So on the plus side, Dan's products rock. Nothing I've ever used works this fast or this gently.

-On the minus side I have new scars to deal with, and 1 new bump that appeared yesterday on my left lower cheek. This is a true pimple in it's early stages, not like the comedones I got Friday, but I'M NOT GOING TO TOUCH IT.

-My skin is still a little red & sensitive this morning so tonight I might repeat the BP & AHA treatment instead of getting back on the hydroquinone (which is more irritating to me than the AHA, and can't be used in conjunction with BP).

-My goal is to clear my skin as much as I can before I get pregnant so that I can limit my treatment to BP & AHA (and maybe BHA) and nothing else during the pregnancy.

Wish me luck! Good luck to all of you!

Weevil

Day 25: AHA research

Hi everyone,

I'm trying to figure out when to use AHA, and if it's bad in combination with hydroquinone, because I must confess: I haven't been really using any moisturizer since my skin got soft again (on Day 15, I think), but all recommendations say that I should, so I'm hoping the AHA will moisturize + exfoliate + clarify PIH.

(I've only continued using Dan's moisturizer on my neck & chest -which have COMPLETELY healed from any and all acne, thank the gods- but still feel like they need it).

The questions are specifically:

-Do I use AHA after hydroquinone at night? (BP with hydroquinone is contraindicated, according to the hydroquinone literature). Haven't dare to, because the hydroquinone seems to be working well by itself, and it has not dried my skin out yet.

-Do I use AHA after BP instead of moisturizer in the morning? Haven't dared to yet because a)my face hasn't felt like it's needed any extra moisture, b) MY PIH is too pronounced to avoid wearing the almay 0.5% salycylic acid makeup, and I'm afraid the AHA + the salycylic acid may irritate me (meaning all day I'll have to deal with an irritated face AT WORK!)

By the way, today I was running late, and I forgot to apply Dan's BP!! God I hope 1 day doesn't hurt me. I'm going to apply the BP tonight instead of the hydroquinone just in case.

-Note: I read somewhere on the message boards that Lily of the Desert 99% Organic Aloe Gel w/ Vit A, C, E (Whole Foods) works well to get rid of shiny oil from the AHA, which I do get from Dan's AHA when I've experimented with it in the daytime (without makeup).

If anybody knows about the AHA/Hydroquinone combo, please feel free to comment.

Thank you!

Weevil

Hi everyone,

I cannot believe how well my skin is doing on Dan's regimen & products. Dan, you are the man. I don't know how to thank you. Here's a summary of my progress:

-my pores are 90% back to normal

-I only have 3 healing blemishes right now, that I caused myself because I picked my face last Friday night.

-I have not picked since then (yey...4 days in a row...lets see how long I can go)

-Saturday morning I started massaging my face with jojoba oil after washing, and then cleaning it off with the chanel toner, and then applying the BP. My skin felt really soft afterwards, with no more irritation, so:

-I started applying hydroquinone Friday night (Day 20), after washing and massaging with jojoba oil, and did not apply anything else. Saturday morning my PIH had visibly dimished and there was only very slight irritation.

-Saturday morning I did regular routine, and did not put on makeup until 5pm (to go out). I applied Neutrogena SPF 85 under the makeup since I was going to be in the sun. It didn't produce any ill effects.

-I applied Hydroquinone again Sunday night and last night. So far so good: diminishing PIH, no irritation, no new blemishes.

-I'm out of the doryx prescription. I'll see if my dermatologist will renew it without an office visit

Right now I don't know where to incorporate the AHA...after the hydroquinone as a moisturizer?

I'll see if anyone can offer advice on the boards.

I'll update my current regimen on my signature

Best luck everyone!

Weevil

Per Wynne's advice: apply to lesion at night and cover with bandaid, moisturize with vaseline (ingredient in these antibacterials) to prevent PIH. This after the BP application

Also, take Ibuprofin if inflammed (but I may be allergic, since I'm allergic to aspirin...must find out)

Weevil

Day 18

AHA really stung last night, but this morning almost all my blemishes were healed. However, I couldn't resist "cleaning" my clogged pores and scrubbing my flaking skin off, after 3 days of not touching them. We'll see if I break out. So far I think I did aggravate one blemish (it's inflamed now, and it wasn't this morning), but that's the ONLY active blemish on my skin right now. I have 2 healing blemishes left, everything else is just red/brown stains (and even these are fading, although they're still pretty bad and extensive, so I can't go without makeup yet).

So back to square one on the picking front. sigh.

I'll also try the jojoba oil massage/cleanse the way Cool as Kim Deal recommends, on the weekend when I don't use makeup, and in the mornings.

I wish I had the guts to take pix to show you all, but it's just too embarrasing. I really admire those of you brave & generous enough to bare your skin for our benefit.

Good skin to all!

Weevil

Day 16: Great so far

Hello everyone,

So far I'm loving this treatment: I can really see tangible progress. Here's what I've done since my last post:

-Friday 5/21 (Day13) I did pick my face (I squeezed all clogged pores and scrbbed all dead skin off), but I don't think I did too much damage

- I did not wear makeup either Saturday or Sunday

- I wore chanel moisturizer on Saturday, but no moisturizer on Sunday because I didn't think the daytime moisturizer helped

-I applied Dan's AHA on Sunday night instead of moisturizer, to no ill effects this morning (did seem better than the moisturizer)

-Monday 5/24: I scrubbed all dead skin after long shower. my skin showed marked improvement.:I don't have any "active" blemishes anymore, only 5 healing ones, my pores are getting back to normal, I still have a lot of red/brown stains from all the old acne, but better than Day 1. And my skin is soft and almost not irritated at all. I did wear the almay makeup today, because there's still too many stains to go without. My chest is 99% healed and not irritated, but over the weekend I went back to Dan's BP + moisturizer because the AHA seemed unnecessary & was mildly irritating. Dan's moisturizer is the only thing I'm using on on my neck.

So from Monday thru Friday this week, my regimen will be:

-Night: wash gently (no picking, no scrubbing), Boots sensitve skin toner #7 to clean off makeup residue, chanel precision toner to close pores, Dan's BP gel + AHA on face. Chest: Dan's BP & moisturizer on chest Still sleeping on my back.

-Morning: NO PICKING, I'll try to minimize the scrubbing, boots toner before shower, chanel toner after, Dan's BP gel on face, back & chest, AHA on forehead & around mouth (where my skin is getting wrinkles), almay's 0.5% salycylic acid makeup, Dan's moisturizer on neck & chest.

We'll see if I can get through the week with minimal pickin & scrubbing...

Good luck to all!!

Weevil

Wed 5/19/10: Day 11

Hello everyone, this is just going to be a straightforward journal, where I keep track of my progress with the treatment, so please forgive any lack of writing flourishes.

I found acne.org on Sunday 5/9/10 (Mother's Day), when I was feeling really desperate about my skin. I'd just turned 39, was 7 weeks into recovering from surgery (to remove a fybroid and endometriosis), and my skin was worse than ever. I've always had mild/moderate acne, I've tried every treatment, nothing worked permanently, but my skin felt totally out of control this time: I was breaking out where I never had before: my temples, the sides of my face, my neck, my chest. Mostly giant clogged pores, a few whiteheads, lots of melasma and red/brown spots from previous breakouts

I started Dan's Regimen that night, because I happened to have maxclarity's 2.5% BP foam on hand. The 1st week my skin dried out completely, but got extremely red and flaky. Some of the BP cleanser ran down my neck while washing and dried my neck so severely I had to put cortaid on to stop the cracks and itching. But I was amazed at how fast most blemishes all dried out. I used chanel's precision moisturizer, until Dan's products arrived. That worked very well for my face, not enough moisture for my neck though. I realized my main problem is that I pick and I scrub my face too hard with towels to get rid of the flaking skin (I can't stand the sight of clogged pores, and they are so easy to "clean" I can't help myself), but I've managed to significantly reduce the amount of picking & scrubbing this week (not completely, though). I've also been using Almay's blemish clearing makeup 0.5% salycylic acid, because I can't stand the sight of my skin right now, and it does seem to be helping with the drying and clearing. I've also continued using Neutrogena's non-alcohol toner because washing gently and pat-drying was not cleaning all the makeup off at night. And finally: I'm sleeping on my back to minimize any skin irritation.

On Friday 5/14 Dan's products arrived and I switched. His gel is amazing. A lot easier to apply than the foam, and a whole lot less irritating. My irritation pretty much went away over night. I used Dan's moisturizer for 3 days, but switched back to Chanel because it just feels better and seems to control oil and reduce pore size. I'm still using Dan's moisturizer on my neck though, because it's more moisturizing than Chanel.

I also switched to Dan's AHA for my chest because it seems like it's all I need now!

I'm now using Chanel's Precision toner instead of Neutrogena's before applying the BP gel (much, much better than any toner I've ever used, although ridiculously expensive...maybe when I stop having to wear makeup, I can give up the toner)

In summary:

-After 1 week of Dan's regimen, but not Dan's products: 90% of blemishes dried out, but extremely dry, red and irritated skin. I'm very hopeful

-Week 2: After 4 days on Dan's products (cleanser, BP treatment, moisturizer on neck, AHA on chest) except for chanel cleanser & toner: 95% of blemishes cured, skin irritation GONE, pores VISIBLY REDUCED), this is awesome I'm thrilled. I'm still wearing makeup though, because I have many many discolorations from previous blemishes and my melasma seems to have gotten worse since I stopped the hydroquinone (they so seem to be clearing slowly however). I'm still picking and scrubbling a little (but much less than before).

Can't wait to stop wearing makeup! (I hate it and until this latest crisis hit, I only wore it rarely, to parties or interviews and such...not on a daily basis like I'm forced to now).

Will keep posting...

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