Skin Wars: Dealing with Adult Onset Acne

by January 7, 2013
filed under Life

Skin Wars: Dealing with Adult Onset Acne

I used to joke with my brother in our teens about how he got the thin gene and I got the good skin gene. I always felt fortunate that while I had plenty of other body image issues to contend with, my skin was never a problem for me. Sure, I got the occasional zit, but it never ran rampant. Lots of my classmates had it much worse.

In my early 20s, I bumped into a coworker in the ladies room at work and she blurted out randomly, “your skin is amazing. You’re like a porcelain doll.” She would probably have been horrified to learn that I regularly fell asleep with my makeup on and didn’t really do anything special to take care of my skin. Maybe the occasional Beore nose strip and Spectro Jel instead of soap in the shower.

When I went on OrthoTricyclen the first time, I didn’t notice much of a change in my skin, although I knew it was sometimes prescribed for the side effect of clearing acne. I was on it for many years, and when I finally went off, boy was my skin pissed. About 6 months after the Pill was out of my system, comedones started popping up all over my cheeks and chin. Not the huge inflamed cystic zits that are hard and hurt when you press on them, but lots of little pimples that made my skin look and feel rough. I was in a serious relationship by then and I was sick of my skin, so I decided to go back on the Pill. A couple of months after that, my skin cleared right up.

A few years later, after being sucked in by the amazing before and after photos in the infomercials, I decided to try ProActiv. Not really because I necessarily needed it, but I thought it could improve my overall complexion and prevent future breakouts. I didn’t follow the regimen religiously, but nonetheless, my cheeks were much smoother. When I went off the Pill the second time, I expected the blemish explosion to recur, but it never happened. I breathed a sigh of relief, and attributed it to the regular use of ProActiv.

While on vacation this summer, I noticed my cheeks were full of bumps. Initially I attributed it to using sunscreen or possibly to a new kind of foundation I’d been trying. When I got home, I immediately stopped using the foundation and stepped up the ProActiv. Only this time, the blemishes didn’t clear up.

In fact, things got worse. I started getting cystic zits frequently. I used to get them maybe once every month or two, and then suddenly I was getting two or three a week. They were usually slow to heal and often left scars. This was in addition to the constant crop of whiteheads running rampant all over my face. Every magazine article about skin care in the world instructs you never to pop a zit, but I also found this difficult. Sometimes there is so much pressure under the skin it becomes seriously painful, and the only way to relieve the pressure is to “extract” the gunk.

By now, I was freaking out. What the hell was going on? As someone who once had as close to a flawless complexion as you can get without Photoshop, this was a huge blow to my confidence. I could no longer deny that I was not just experiencing a breakout — I had adult onset acne. I learned online that up to 40% of women will experience chronic acne for the first time in their 20s, 30s or even 40s, even if they never had it during adolescence.

While the physiological process of acne formation is well-understood, the underlying root causes are a matter of debate. Anecdotal culprits include hormones, dietary dairy, carbs or sugar, aspartame, vitamin deficiency, smoking, cheap cosmetics and many more. I tried a lot of the home and over-the-counter remedies suggested online. Ever rubbed Halibut Liver Oil on your face? It stinks like the garbage dumpster behind a seafood restaurant.

Months passed. Nothing helped. I was at my wits’ end and bordering on unhealthy obsession. I constantly stared at my face from different angles in the mirror. Every single day there seemed to be new blemishes, and each one made me more depressed. So in desperation I finally made an appointment with my family doctor, who prescribed Stievamycin — a combination of Tretinoin (generic Retin-A) and the antibiotic eurythromycin. The former increases skin cell turnover rates to prevent clogged pores, and the latter kills the acne bacteria that turns clogged pores into inflamed zits.

My doctor warned me it might take anywhere from four to eight weeks to see results. This treatment requires patience, and the side effects can also be discouraging. I had redness, peeling and scaly patches on my face for the first three weeks. I also experienced what is known as the “purging” phase, where rapid exfoliation causes deep-seeded comedones to come to the surface of the skin more quickly, making breakouts seem temporarily worse.

I also had to change up my skin care routine. I ditched ProActiv and switched to a gentle citrus gel cleanser with organic ingredients. I found using a moisturizer with hydrocortisone in it helpful in relieving the dryness and scaling. I’m now 5 weeks into treatment. Things aren’t perfect, but I’m starting to notice improvement. I haven’t had a single cystic zit since I started using Stievamycin, and the comedones resolve faster. My skin is smoother, with a more even tone. A side benefit of Tretinoin is its anti-aging properties, which as someone in her mid-thirties, I appreciate.

Only time will tell if Stievamycin will help me to put my best face forward once again, but I can say for certain that this experience has given me a new appreciation for the importance of consistent skin care. It takes effort, but having the confidence that comes with clear skin is definitely worth the trouble.

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