I often talk about “nuking” my skin. Literally. I drop A-bombs on that sucker. I used to have regular teenage skin with super oily skin. My freshman fall semester in college, my skin exploded with mump sized balls all over my face. It could have been an allergic reaction to something, but I think my skin was reacting for the first time to super stress. I went on Accutane for the first time my freshman year in college during the spring semester. It was the start of my use of serious acne medication. As scary as the side effects were, I just wanted my skin to clear up.
I went on a 5 month course of Accutane taking 80 mg a day. The only side effect I experienced were NORMAL SKIN (oil glands shut down), invisible pores (my t-zone area looked poreless), and super dry lips. That’s it. My skin was the best it had ever been since I developed acne as an adolescent. This lasted for almost five years. My skin did gradually become oilier again, and my pores more visible, and I experienced a few occasional breakouts but it didn’t freak me out, or upset me. In the scheme of things, they were small fry.
I started experiencing problems with breaking out when I worked in advertising. It was completely stress related. And I was getting large cysts, with a smattering of annoying smaller breakouts on my cheeks and sides of my face. I went on Accutane again but it didn’t have the same effect, almost as if my body had become adjusted to it. Believe it or not, my dermatologist gave me an anti-depressent prescription and my skin calmed down again, and I calmed down too. My reaction to stress had somehow turned into silent seething anger bombs that were exponentially increasing the cortisol, or stress hormones, in my body. I know this because on one particular day I started the work day with a teeny tiny bump on my forehead, where I almost rarely breakout, but if I do, it is always stress related. By the end of the day, it had engorged itself and become massive. How do I know? I would rather not say, but it involved me running into the bathroom and spending over an hour there trying to remove evidence of the incident. Grossed out? You shouldn’t be…stress manifests itself in different ways. Sadly, it hijacks my facial skin. Since that incident I make a point not to get angry, or bottle it in, I know what it will do to my skin. And taking antidepressants for acne, just seemed kind of extreme, plus, I didn’t like feeling “muffled.” Better to develop better coping mechanisms than to alter my brain chemistry, you know?
Point being, between my super oily skin and my re-emerging acne due to stress, I went on a regiment of prescription strength retinoids. I now rely on a rotating arsenal of Differin, Retin-A Micro, and Tazorac. All are retinoids, with chemical structures similar to each other, so they operate in mostly the same way. Differin is by far the weakest of the bunch and is usually prescribed to people with sensitive skin, although it may be even too harsh for them. For me, I use Differin, when my skin is already clear and I just want to maintain it. I have no active lesions. It also helps alot with melasma. When my skin is behaving, Differin keeps it amazingly clear and even-toned. But if stress get’s in the way, I find that Differin is not that effective. I have to go up to Retin-A Micro. Retin-A can be harsh, but Retin-A Micro controls the amount absorbed into your skin, therefore, making it less irritating, although, it is still drying, even on my super oily skin. My skin will be a little dry and “powdery” after one night. A few days of this stuff and I can get rid of stress acne pretty well, and then go back down to Differin.
When I have cysts, or a large number of breakouts, thats a whole other ballgame, particularly, the cysts. These are deep nodules that can stay for days and days. I don’t tolerate these. I A-bomb them with Tazorac. Tazorac is hardcore, and even my skin can’t handle it for more than three days. It is like paint thinner stripping skin. After the second night of use, my skin is already peeling everywhere I use it. After the third night, my skin is very dry and peeling roughly. It is literally cracked. I can’t use anything else after the third day, I just have to treat it gently with any of the following in a system: Decleor Aromaessence Balms, Decleor Aromaessence Essential Serums, PCA Clear Skin, Egyptian Magic All Purpose Skin Cream, Rodial Glamtox Cleanser Balm, REN ClearCalm 3 Anti-Acne Treatment Mask, Nuxe Clarifying Cream Mask, Remede Skin Exacting Masque, Yes to Tomatoes Clear Skin Deep Pore Scrub, Exuviance Vespera Bionic Serum. But eventually my skin heals and I am left with flawless skin. However, with use of tretinoin, you do need to practice sunscreen protection because your outer layer of skin is being rapidly exfoliated allowing damaging sunrays to penetrate through faster.
Differin, Retin-A Micro and Tazorac are great prescriptions for acne, as long as it is suited for your skintype. I think these do a great job on regular acne or stress acne. Before I developed hormonal imbalance related acne (imbalance of male sex hormone, androgen, causing super-super-super oily skin and immediate thickening and instant clogging up pores at superspeeds), these were the tools I used to maintain, or retain, clear even-toned skin. Hormonal imbalance acne is another bag altogether, and I am still figuring out the right treatment for my skin, without going on birth control pills or spirolactone because I strongly believe that it was briefly going on birth control pills for over a year that created the extreme imbalance with my hormones after I went off. (My pattern of breakouts dramatically changed-never broke out on jawline, near mouth before.) So far, I am noticing that sulfur based products, higher then 2% salicylic based products, and lipo-hydroxy acid are very effective at breaking through sebum and decreasing the chances of the pore becoming blocked. But as soon as I have figured out a completely successful regimen, I will report back. Because despite the fact my pores are becoming blocked at superspeeds that don’t even make sense considering everything I am doing, my outer skin is getting drier and less tolerant to the three horsemen of the acne apocalypse (Rx Retinoid, Glycolic Acid, Masks), while still producing massive amounts of oil on select portions of my face. This is a little tricky. It’s personal now. I feel like I am way to smart to be bitch smacked by oily pores…I am not a newbie…Oddly, I feel like my pores have become my number one enemy and I am not about to let it get the best of me.