Acne, medications, pregnancy—“I need your help!”

I have acne on my chin area and have struggled for years to address it. I don’t eat a lot of sugar and don’t eat dairy and eat very little wheat. My dermatologist has me on Oracea, which is an oral antibiotic that is 40mg doxycicline. It’s supposed to act as an anti-inflammatory and it has reduced my breakouts. He also has me using a benzoyl peroxide 4% wash once a day, and a clindamycin topical. I still always have about 2-3 breakouts on my chin at all times, and when some heal, others form. They tend to be puss-filled.

I read your book and had read many entries on your blog, and I know that all of this is contrary to what you recommend. Yesterday I got a facial and started using Yonka Gommage, which already feels great. I also use a clay mask. I plan to use the gommage and clay mask regularly. 

What I’m wondering is how I can smoothly transition away from the oral and topical antibiotics to a more natural skin regimen without creating major disruptions. I have a few events coming up this summer and I don’t want to make a radical shift that will cause my skin to get worse. Do you have suggestions for how to make this transition? For example, should I stay on the oral medication for another month while weaning off of the topical?

First, if you have a special event coming up, I recommend staying on everything you are using since it sounds like it does have a positive effect. You can always quit using it, but you might not get you skin back in control if you go off. There’s no reason to cause extra stress, wondering what your skin will do if you go off the medications before your events. You have the rest of your life to change things! Stay on the meds from your derm, and do use the gommage and mask—frequently.

With that said, the medications are probably just keeping things at bay. The real issue to me is why are you breaking out in the first place. Without finding out this crucial piece of information, you are just mopping up the mess every time something spills—but you want to find out why the spills are happening in the first place. (Is it the cat?!) Answering that question is where time and experimentation will come into play.

I agree that I don’t want to disrupt things if the meds are keeping things at bay. One thing that really concerns me is that I’d like to try to get pregnant in the next 6-12 months, so I know I need to get off the meds but don’t know how to make the transition.

Have you talked to your pediatrician? Are topical antibiotics a no-no for sure? Even tho you said you don’t eat much sugar, I’d like to know about that part of your diet. What, how much, and any other specific information you can give me.

I think topical antibiotics are okay but the oral is definitely not okay.

Opps, sorry. I misread and didn’t see one is oral. Yes—not while pregnant!

Another question in my mind is how the gommage works with the benzoyl peroxide wash. My doctor wants me to use the 4% wash once a day, but since it’s an exfoliant, can I use the gommage in addition to that? I think the BP and clindamycin are supposed to work in concert. Can I incorporate the gommage into my regimen with all of the other things I use or will my skin be confused?

I don’t eat any processed sugar but I do eat dried fruit. I eat LÄRABARs, which I think are high in sugar. I usually eat one or two apples a day as well. I sometimes eat raisins or dates or figs, but always in moderation. I wonder if that is contributing to the problem?

I looked up “a” LÄRABAR. Unfortunately they contain a whopping 23 grams of sugar, which is not only a lot, it is almost more than the recommended daily allotment of sugar. If you are sensitive to sugar, and you probably are, that alone can cause problems.

I always say anything grown and eaten as it is grown in nature is fine. Apples, even grapes, which are high in sugar, won’t be the culprit in a breakout condition. But dried fruits—not as nature really intended—are high in concentrated sugars and obviously void of water. As you might have read in this post (Sugar in your precious Frappuccinos!) although raisins are obviously not the big offender with that client in that article, they may have been contributing—well they were contributing to her daily intake of sugar.

All of this is extremely helpful and I welcome any more information you might have! Thanks again. 

If you want to see if (how) sugar is affecting your skin, stop ingesting any and all sugar for a month at least (longer would be better) and see the effects. Anything that comes in a package would be out. Dried fruit, because of the concentrated sugars, is out. Apples, or any fruit that is in its natural state is (always) fine. Without quitting sugar for a considerable time—at least a month or more—it’s hard to see the effect. But this is a huge commitment and not one I would go into when fairly soon you will be pregnant and your skin may go haywire anyway.

Probably a more relaxed approach is needed here. If you weren’t planning on having a child soon, my advice would be more proactive. But it’s almost futile to do a lot of sugar abstinence when in a few months or so you are hopefully pregnant and then your skin and how it reacts to the hormone surges is unknown.

With all changes going slowly sometimes is the best idea vs. being in a rush. Perhaps the fact you have some important events coming up will end up be a blessing in disguise. Although you will probably stay on the medications until you’re ready to try going off them (with your doctors advice, as well, of course), going off sugar or at least lessening your intake can be done now and that alone will probably help with your skin problems.

For more information, see:

• “I’m pregnant! How will my skin change?”
• Hidden Sugar: Sugar in Unsuspected Places
• Doing The Next Best Thing