Acne: all links so far

acne

• Accutane: Jennifer’s story

• Acne and imbalance—What to do

• Acne, medications, pregnancy—“I need your help!” (new!)

• A confused client needs help: “Dry? Acne? Rosacea? What is going on with my skin?”

• Acne Q & A—“How long does it take to clear up problem skin?”

• “Adult Acne” explained

• Azelaic acid for acne, hyperpigmentation, and rosacea: does it work? (new!)

• Getting rid of BACK BREAKOUT: facials, nutrition, and client questions (new!)

• Is Accutane good for acne?

• MYTH: Sun clears up acne (new!)

• Problem skin? ASK YOURSELF THESE QUESTIONS & become a skin care sleuth—updated

• Tetracycline—does it help with problem skin or is it just a temporary fix? (new!)

• Treating acne is twofold (new!)

• What is acne? Acne explained

Acne can definitely be a balancing act

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

Problem skin? ASK YOURSELF THESE QUESTIONS & become a skin care sleuth

I am always telling my clients who have skin issues that something is causing their skin issues—they are not “just happening,” although the cause may not be apparent right now. I encourage them as well as you to be a sleuth into your own lives and lifestyles and to try to break down the different elements  to find possible causes for your breakouts.

• If it’s a new breakout, what is new in your life? 
• Are you using new skin care products, shampoo, even laundry detergent? 
• Have you eaten new or unusual foods you don’t normally eat? 
• Have you eaten more sugar than you ordinarily eat? 
• Is it Halloween or your birthday? 
• Have the Girl Scouts been coming around? 
• Has your monthly cycle changed? 
• Are you going through puberty? 
• What about the amount of stress in your life? 

Try to break down your lifestyle habits to see if there is a correlation between something you’re doing, eating, or not doing, and how this may be affecting your skin. Breakout usually has multiple causes, but eliminating the ones you think might be contributing to your skin problems is a good start to clearer skin.

My skin has been a daily task to keep clear for the last ten years. I have a very mild acne problem, and it bothers me. I have tried everything in creation to keep my skin clear, but there always seems to be a spot or two at any given time. I have very sensitive skin that does not respond well to AHAs or other acid products, and most oils found in many products bother my skin.

I use Cetaphil to cleanse with and it works wonders (I love that product). I need an exfoliator to use before I wash with my cleanser. I have also used your gommage and was happy with the results and how it didn’t bother my skin. I appreciate any advice or comments you may have for me.

Since her breakouts are ongoing, she is definitely doing something on an ongoing basis to encourage her problem skin. Her use of the term acne may be an overstatement, but that is my own opinion. The acne I call acne is the full-blown cystic type.

AHAs and other strong acid products don’t work for many people. And if you have any sensitivities and especially if you have redness in your skin, I don’t recommend them.

Cetaphil cleanser works well for many people. It is inexpensive and easy to find. I need an exfoliator to use before I wash with my cleanser. You actually want to cleanse before you exfoliate. Cleansing first gets the debris off the surface of the skin, giving your exfoliator a better chance to do its job. The gommage is a great way to get rid of a lot of dead skin while not irritating or otherwise causing problems for sensitive skin. She could use this product several times per week.

I would advise her to really take a long, hard look at her diet and see if she has hidden or even obvious sugar that she may not be counting as contributing to her ongoing problem skin. Many people just haven’t yet come to this realization about diet (especially sugar) and how it affects skin, which is why I talk so much about it.

For more information, see:

• Gaining control of problem skin—important recommendations
• What is causing your breakouts?
• “I don’t eat much sugar”—really?

Getting rid of BACK BREAKOUT: facials, nutrition, and client questions

I get a lot of breakout on my back. It is practically impossible for me to reach this area. What can I do to help the problem, and why does my back break out in the first place?

First off, because we are dealing with skin, its location is less relevant than you may think. As long as you are producing infected blemishes, you want to essentially treat them the same no matter where they appear on your body.

When it comes to treating the skin on your back, it can be challenging. But there are ways you can get to that skin, even if you have to employ another person in the process. The answer to why you are breaking out there is the same as if you were having breakouts on your face. Internally something is out of balance, and in my opinion, diet is most likely at the root of the problem.

Watch your sugar intake. As I have written about in many articles, this (sugar) is a common ingredient that can and does cause a lot of problems with skin—namely breakouts. Water is one of the best things for your body. If you aren’t currently drinking enough (or any) water each day, start now to drink more water, which helps to rid toxins from your body. If you sweat a lot, are you able to rinse it off your back? Or does the sweat just sit there on your skin for long periods of time? This can be a source of irritation and potential breakout, especially if you are sweating during workouts. Rinse the sweat off your entire body before it has a chance to dry on the skin. 

If you can afford it, get a back facial at a salon or spa. Call first to be sure they offer this service and if you have the time, go by the establishment and see where you will be receiving the treatment before you even make an appointment. Why? Some facial chairs just don’t translate into good tables for back facials. You want a versatile chair that will ensure your comfort during the process. The salon may have you lie on a massage table, which is fine. Ask them to prop up your feet if that makes you feel more comfortable. They probably have a bolster to put under the tops of your ankles for this very purpose.

If a professional facial is out of the question, I have written a comprehensive article on how to tend to back breakout at home, which also relates to any problem skin you may have on your chest as well (listed below). You can give yourself a back facial, but for obvious reasons much of the surface area of your back will simply be left untreated. You really need another person’s help in order to get to the entire back area. 

What is the most effective way to get rid of acne on the chest and upper back? Do you have any practical tips on how to take care of that area? It seems that it’s easier to take care of acne on the face, but on the chest it’s a lot harder. The only time I can really cleanse in these places is when I take a shower in the AM.

In one way, breakout is breakout. How you’d treat problem skin on your face is just about the same as how you’d handle chest and/or back acne. The biggest difference, of course, is location and simply put—your face is much easier to reach than your back.

As I’ve said over and over again—problem skin, be it acne, simple breakout, or the occasional pimple, is a multifaceted process when it comes to clearing things up. Without evaluating your diet (what you put into your body, both eating and drinking) as well as looking at your age (hormonally, where are you at?) then of course how you are taking care (or not taking care) of your skin—both face and body— on a daily basis, it is doubtful you will be able to tackle the problem skin you are experiencing with much success.

There are many medications to be taken and I have written about that here on this blog. In the case of chest and back acne (true acne, not just occasional breakout), sometimes taking an oral and/or a topical medication is the only way to treat the problem in these locations. I’m definitely an advocate of proper everything else before leaning on mediations, but sometimes doing something short-term (taking a pill) can help jumpstart a new lifestyle program that, if you have acne, will no doubt need to happen.

I understand the frustration with not being able to reach these areas and treat them as easily as you can your face, but give the suggestions in this and other articles on breakout a try, look for that trusted helper, and continue reading on how to treat breakout that will give you more guidelines and helpful hints and will hopefully make it easier for you to have clear skin all over.

For more information, see:

• A DIY At-Home BACK FACIAL—with a friend’s help of course!
• Dermatology, skin care & 2 sets of belief systems
• NO SWEAT: What happens when sweat dries on your skin?
• Geranium (or lavender) essential oil—spot remover for breakouts: How to use it and how NOT to use it

Tetracycline—does it help with problem skin or is it just a temporary fix?

Linda is a client of mine. Her son, Michael, has had problem skin his whole teenage life and has been on tetracycline* for years. Now, at age nineteen, his skin is a mess. The antibiotics have long-since stopped working and his dermatologist is suggesting Accutane. His mother is, to say the least, disappointed and unsure of what to do.
*Tetracycline is a grade of antibiotics under the heading of tetracyclines.

    

Linda has told me Michael eats a diet rich in poor-quality foods. She insists he doesn’t drink sodas and juice at home, but I told her I bet he does at his friend’s houses. Teenagers and soda pop pretty much go hand in hand. And you can best bet if his friends drink cokes, so does he. So although she makes sure to keep her own house as sugarfree as possible, the world is a huge candy store just waiting for a teenager’s sometimes questionable judgment to come partake.

I told Linda that her son can go on and stay on drugs his whole life, but until he stops feeding the problem—literally—his skin troubles will continue. Due to his age, his hormones may still be surging and will settle down with time, but in the meantime it would be great if he could learn to change his eating habits.  

        

The challenge with teens especially is not only are their hormones kicking in, but they haven’t for the most part learned the relationship between action and consequence. They don’t have the responsibility thing down—at least not when it comes to diet. For those of you who are responsible or who have responsible kids, please don’t be offended. I’m not saying all kids are irresponsible in all ways. But even adults have a hard time with understanding that what they are eating may be affecting their bodies, their health, their skin. And in my experience (plus I was a teenager once), I find teens haven’t made that connection yet.

    

One positive thing about Michael is he is coming to Linda and expressing disgust with his skin. That’s actually a good sign because it means he will be open to some degree to changing his ways and listening to helpful advice. Here is a fact that has repeated itself to me over and over again: If someone sees improvement after making a change (like cutting back or quitting sugar), they are more prone to continuing to change. If no improvement is seen (like after buying expensive products, for instance), then they are less likely to continue doing the new change.

The point to this story is to say that taking antibiotics won’t necessarily clear up your skin. It may be a temporary fix, but unless you change your eating habits (or just grow out of the teenage hormonal years), antibiotics definitely are not a cure-all. And they can actually affect your body’s immune system by weakening it. Start at the source and see what positive changes you can make that will surely result in positive changes in your skin’s health—and of course for the health of your entire body.

As far as Michael going down the Accutane road, I have many articles on the ills (and sometimes positives) of taking Accutane. Like any and all of these skin care “remedy” medications, they are serious drugs and they can and do have consequences. If taking a drug seems an easier fix than changing your diet and being careful about what you put into your body, then I guess that is the road you’ll choose. But without taking stock of your diet and other incidentals that could also be affecting your skin’s condition, in my opinion that is a road I don’t recommend taking.

For more information on Accutane specifically, see:

• Accutane: all links so far

For other helpful information, see:

• Sodas, sugar, your skin & breakouts
• Teenage Skin Problems Q & As
• Medications Oral & Topical: all links so far

MYTH: Sun clears up acne

There are books published in the late ’70s into the early ’80s that actually have chapters on “safe suntanning.” Other chapters suggest lying out in the sun to help clear acne. And although this mindset isn’t as prevalent today, I still find people feel free and unrestrained to get a tan and that it is healthy for their skin. Well, no amount of sun is really good for your skin. And certainly, as this myth reveals, getting sun on your skin does not control acne.

What sun exposure can do is put some skin problems in a dormant state, only to have these trouble spots reactivate at a later date. Sun will dry out the outer skin, which has a temporary effect of drying, as well as a psychological effect of clearing. But as far as being a treatment for problem skin, sun exposure won’t do the trick.

Heat actually activates your oil glands. If you have an oilier skin type, haven’t you found that your skin gets even oilier in the summer months? I see this in my facial room all the time and I’ve heard it from clients for years. And back when I had oily then normal to oily skin it was true for me as well.

When it comes to myths about anything, and in this case skin care, you have to be logical and think things through a bit. Sun exposure can cause all kinds of things to melt. And heating up oil certainly makes it more “runny” if you will. So lying out in the sun to “clear up acne” is probably, in the long run, only going to increase any existing problems.

For more information, see:

• Acne and imbalance—What to do
• Acne Q & A—Part 2
• Skin changes due to sun exposure

Azelaic acid for acne, hyperpigmentation, and rosacea: does it work?

Azelex and Finacea are brand names for prescription topical antibiotic creams containing azelaic acid that is used for treating acne as well as rosacea. It is said to be less irritating than other topical blemish medications derived from vitamin A like Retin-A, which can cause a lot of redness and flaking. This, of course, is imperative for anything addressing rosacea, which is red, irritated skin.

If you google “azelaic acid,” something like this will come up: Azelaic acid is most frequently prescribed for rosacea sufferers, because it’s crazy-effective at decreasing the inflammation that causes rosacea’s trademark redness. The ingredient is also antibacterial, making it helpful for decreasing acne. It also helps fade the dark spots acne leaves behind.

Azelex contains 20% azelaic acid, which comes from wheat and grain. It helps to decrease inflammation and is an antimicrobial, which means it kills bacteria. Azelaic acid’s antibacterial abilities are similar to essential oils, and I happen to be a fan of essential oils. They are easy to find, inexpensive, and do not require a doctor’s prescription. I also think essential oils work better than most topical medications used to diminish blemishes.

One of the more interesting benefits listed for azelaic acid and specifically Azelex is its reported ability to lessen pigmentation. It doesn’t have a bleaching action, but helps to disrupt the melanocytes’ activity, inhibiting melanin production wherever the product is applied. This theory is not absolute, but it might be one way to help lessen hyperpigmentation.

Some topical medications, however, can have the opposite effect, causing photo or sun sensitivity, which actually increases pigmentation. It just goes to show you nothing works for everybody. Rosacea is another skin condition this antibiotic cream is reported to be beneficial for.

All of my writing is experience-based—either personal or from my clients’ experiences. To date, I haven’t had enough clients using this treatment cream either for rosacea or acne issues to give you anything other than the facts available on this product’s label. When I have more information from my client’s experiences, I will include it here.

For more information, see:

• Acne: all links so far
• Hyperpigmentation: all links so far
• Rosacea: all links so far

Treating acne is twofold

Treating acne or any constant skin care problem is a twofold process. If you do one step but forsake the other step, it’s doubtful you’ll see long-term results. As I read skin care books and articles in magazines and even listen to skin care experts on TV, I am always amazed that the treatments for problem skin usually recommend doing only one thing: treating the breakout. The question in my mind is always “What is causing the breakout in the first place?”

Here is one analogy. You are driving your car down a street with nails all over the place. You drive, and lo and behold, you get a flat tire. You fix the flat tire and keep driving down the same road. Later, you get another flat, and you fix it. What you don’t realize is until you get off the road with all the nails in it, you will continue to get flat tires. Translate this to your skin. You may not even realize you are doing things that are contributing to your problem skin.

Until you become more aware, you will probably continue to have problems—even if you’re using topical (or oral) medications. You must go to the root to find the cure. And even then there are no guarantees. But causal treatment (treating from the cause or root) will surely help you get a better hold on why you are breaking out.

If you alter your behavior in order to stop contributing to your breakouts, hopefully then you will have clearer skin. You may not be able to afford to eat so much (or any) sugar—or whatever it is you may have in your diet that is a major contributor. But you have a choice. You can choose to continue to be frustrated with your blemishes or decide to do something about them, which usually includes discontinuing items currently found in your diet.

For more information, see:

• Sugar & Skin Problems
• What is causing your breakouts?
• Gaining control of problem skin—important recommendations

Acne Q & A—“How long does it take to clear up problem skin?”

Can you provide any referrals for products that treat severe acne?

Severe acne will not be totally eradicated by using products, even with an exceptional treatment product. True acne is a sign of an internal imbalance that needs to be attended to more than just topically. However, treatment products that employ essential oils, which are antiseptic and antibacterial, are perfect for helping to calm down infected skin. Again, nothing used topically is going to fix a problem that stems from the inside, but these types of products can definitely help. 

How long does it take to clear up problem skin?

There is no definitive answer to that question. It is totally individual and depends on numerous factors. “Why is my skin not clear?” would be a good first question to ask yourself. If you continue to do things that contribute to poor-quality skin, then your skin may never clear up. Improper cleansing, sleeping with makeup on, using products that are drying, eating sugar or junk food, disregarding constipation, and not drinking enough water are just some of the factors that help to create unhealthy-looking, unclear skin.

Then there is the genetic component that cannot be overlooked. You can have all the unhealthy habits in the world and still (perhaps) get away with it due to inheriting miraculous genes for good skin. On the other hand, the opposite can also be true. You can do all the “right” things to support internal and external health, and having clear skin still may be a struggle if you have a genetic makeup that predisposes you to having problem skin.

So my answer to the question “How long does it take to clear up problem skin?” is: Good question!

What are you willing to do to improve the balance of health inside and out? Perhaps adopting a life philosophy where you see you are either contributing to your healthy mind and body or contributing to the destruction of health, incluidng your skin. This, by the way, can apply to any and every area of your life—not just your diet and how you are taking care of your skin.

Ask yourself these questions: How are you contributing to or contaminating your skin? Your body? Your health? I bet the answers you come up with will not only be interesting, but will help you understand how you could be causing your skin problems. And also (here’s the good news), how you can be the creator of healthy skin.

For more information, see:

• What is acne? Acne explained
• A confused client needs help: “Dry? Acne? Rosacea? What is going on with my skin?”
• Problem skin? ASK YOURSELF THESE QUESTIONS & become a skin care sleuth

A confused client needs help: “Dry? Acne? Rosacea? What is going on with my skin?”

I have dry, scaly patches on my cheeks, but my dermatologist said I have acne. He gave me a topical ointment plus oral antibiotics. Is my skin dry or is it acne? It’s all so confusing! Help! Plus an aesthetician said I have a little rosacea on my cheeks. I’m so sensitive and have spent so much money at the dermatologist and having different treatments—what should I do? What is my skin type?

I love this person’s remarks. She exemplifies the confusion so many people face when it comes to their skin. “A doctor said this, and I am taking a prescription medication, but with little or no results. I don’t understand my skin.” Sometimes clients even say “My skin is confused.” Your skin isn’t confused; it is simply reacting to its environment (internally and externally). Your skin, in fact, knows exactly what to do—and is doing exactly what it needs to do. It is the consumer who gets confused, and for good reason. I will break down her comments to see if I can make better sense of what is going on with her skin.

I have dry, scaly patches on my cheeks, but my dermatologist said I have acne. Dry and scaly skin does not equal acne. If your skin feels dry and looks scaly, you probably need to exfoliate. True scaliness could mean your skin is having an allergic reaction or perhaps an intolerance to a product, especially a new product. Dry and scaly skin could be eczema, a common dermatitis. Dry and scaly could also be your skin’s reaction to harsh and drying products you may be using to decrease oiliness or problem skin. Remember: your skin is reacting to something when it becomes dry and scaly. Look to your skin care habits and the products you are using, even extreme weather conditions, to find out what may be causing these reactions.

He gave me a topical ointment plus oral antibiotics. A topical product for acne may help with breakouts, but it also may be causing the dry and scaly condition of your skin to continue or even get worse. Many times dermatologists prescribe creams and ointments that are meant to dry things out. This, as you know (or will find out), is not how I would go about treating an acne or problem skin condition. If your skin seems drier and more scaly or red and irritated after the prescribed treatment products, don’t use them! Monitor your skin and let it be your guide, but do contact your doctor about any reactions.

Regarding antibiotics, taking anything orally affects your entire body. Constant or repeated use of oral antibiotics can cause several problems. First, it can create a healthy environment for unhealthy bacteria to flourish in your large intestines. Your colon is set up with a particular balance of both good and bad bacteria; antibiotics kill both the bad and the good bacteria. Second, your immune system can weaken from constant use of antibiotics. If and when you really do need to produce antibodies to fight off bacteria, your system is less able to do so, which makes you vulnerable to getting sick. Antibiotics—long term—set up imbalance.

Is my skin dry or is it acne? It’s all so confusing! Plus an aesthetician said I have a little rosacea on my cheeks. I have found acne and rosacea to be the most misdiagnosed conditions or at least the two most overused words to describe skin problems. You may very well have rosacea, although the description of your skin didn’t necessarily indicate that. I would suggest reading about rosacea so you can see if the symptoms match your skin’s condition. The treatment for rosacea is miles apart from acne treatment. Perhaps you truly do have acne or even rosacea, but you may just have problem skin that has been adversely affected by the actual treatment of your problems. Now that is confusing. You may simply have problem/dehydrated skin.

I’m so sensitive and have spent so much money at the dermatologist and having different treatments—what should I do? What is my skin type? If you take away all the treatments and medications that could be causing problems, it might be easier to determine your true skin type. Your skin’s condition is what you need to treat first and foremost. It is the immediate need, secondary to skin type. Once your skin has normalized, you can better determine what products would be effective for your actual type of skin or skin type.

It’s difficult to treat skin conditions yourself if you don’t know what is going on. That is the purpose of my writing—to help you determine for yourself what the problems are and how to go about solving them. I want to give you the knowledge and the tools to help you help yourself. If you have acne and cannot get rid of it by changing your lifestyle habits (or because you refuse to), then absolutely, go see your doctor. Medications may indeed help you, but in this person’s case, it didn’t help her and seemed to cause her skin more problems.

For more information, see:

• What is acne? Acne explained
• Sensitive Skin: Q & A
• Dermatitises (skin inflammations) explained

Is Accutane good for acne?

The answer to this question is not as straightforward as you may think. Accutane has helped hundreds and thousands of people with acne. Some people can go through one round of the drug and be cured. Others find little or no relief. There are also what I call serial Accutane users; people who continue to go back to this medication after its effects have worn off. 

In defense of Accutane (or any other treatment for problem skin), if you do not take away the cause of problem skin, then Accutane or any other treatment is compromised as to its efficacy. If you keep bumping into a door, you can treat the bruises with ointments to help them fade, but unless you determine that bumping into the door is causing the bruises in the first place, you can see how ineffective any treatment might be.

Do some investigation and try to find out the source of your problem skin. This can take time and definitely requires patience. You may not have either of these to spare. But if you decide to go on Accutane treatments, or any medication, please be well-versed in the side effects and take whatever precautions recommended by the drug company. That information will be found on the long list of contraindications and drug interactions provided with all prescription medications.


Although Accutane is supposed to be prescribed for stage IV, nodular acne—the most severe cases—I have found that many of my clients who didn’t have such severe cases were readily given a prescription. From the experiences of my clients coming in and relating their stories to me, I have also found many people have been on Accutane more than a few times, without even having major problems with their skin.

There is a lot of information about Accutane on this blog. I hope these articles provide you with sufficient information to make an informed decision on whether or not to go on this drug yourself or to have your teenager start taking Accutane. Do more research, find as many answers to your questions as you can. If you’ve read anything here, you know I am not in favor of using Accutane to “cure” problem skin. There are many who are believers, I’m just not one of them. Good luck on your search!
 
To understand how going on Accutane isn’t always a cure for your problem skin, please read:

• Accutane: Jennifer’s story

Here are a few articles you could start with to understand the relationship to food and skin issues. There are many more articles on this blog that can help you understand why you are breaking out as well as help to keep the breakout to a minimum:

• Problem skin profile: Donna—constipated with problem skin 
• Help for Breakouts
• Sugar & Skin Problems 
• YONKA Problem Skin Helpers + more

Acne and imbalance—What to do

Acne is an exterior sign of internal imbalance. If you have acne, look at your diet, any hormone fluctuations you may be experiencing, and how you are taking care of your skin (or not). All of these have to be in balance in order to control and eventually clear acne.

If you have acne, products and facials—although helpful—are not the sole answer. I believe you must also look to your diet. Please don’t discount the possibility that what you are putting in your mouth is having an effect on your skin. I highly recommend getting in touch with a clinical nutritionist or someone who really understands the relationship between food and skin. I believe you have to go to the source of the problem (in this case, food being a potential contributing factor) rather than merely treating the symptom, which is problem skin. Hormones are the primary cause of skin problems, but food does have a secondary effect.

For those of you with acne, I recommend following The Basics (cleansing, toning, and hydrating with a moisturizer specifically made for problem skin), along with diligent exfoliating with a gel peel (gommage), plus a clay mask. Whenever there are problems with the skin, exfoliating and masking should be done at least two or three times per week.

I also recommend taking a good look at your sugar consumption, something that a lot of people tend to disregard as an issue with skin problems. I can tell you as a practicing aesthetician for more than 30 years and also someone who is sensitive to the sweet stuff, sugar is a major contributor to many peoples’ skin breakouts and also acne. (Although this photo depicts blood sugar issues from sugar, the problems I’m talking about is skin breakouts and oilier skin. But blood sugar issues are certainly caused by ingesting even a little sugar.)

In order to really treat acne, I truly believe you must get your entire house in order. Don’t just look for topical or oral medications from your dermatologist to work miracles on your skin. It really takes a commitment to proper eating habits, a good skin care program, staying away from picking at the skin, and sometimes using prescription topical or oral medications to further reduce the lesions on your face.

I also want to say that if you are a teenager with acne, the element of time is another important component to helping your skin issues to disappear. Sad but true, sometimes you just have to get through the hormone surges your body is going through over time before your skin will clear up. All the other items I’ve talked about in this article will definitely help your skin, so don’t give up!

For more information, see:

• MYTH: Food doesn’t affect skin
• Sugar & Skin Problems  
• The Basics 1-2-3 Program for proper skin care

What is acne? Acne explained

Acne is something you wouldn’t wish on anybody. Yet many of us will have to contend with it sometime in our lives. It can be debilitating and embarrassing and can cause real psychological scars that stay with us for a long time. Unfortunately, the scars can be physical as well. Here, I am not proposing a cure or some miracle program to stop acne from occurring, but I will explain what acne is and provide some suggestions for coping with this disease.

As a teenager, I had (what I remember to be) perfect skin. It wasn’t until I was 23 that I developed a case of acne that lasted for a few years, a time period that I will never forget. It doesn’t matter when it hits you, if it does it is devastating. So I hope you never have to go through what we acne sufferers have gone through. And if you have acne now (or know someone who does), hopefully there will be some information here that you find helpful, which can lead you to a path of healthier skin—for a lifetime.

What is acne? The following has been reprinted with permission from a Johnson & Johnson, Inc. pamphlet on acne. They so clearly explain how acne develops, I wanted to pass the information along to you as it was written.

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Long before blemishes appear on your skin, trouble has been building up beneath the surface—in the hair follicles and their attached oil glands. Each follicle contains a number of sebaceous or oil glands. The oil you see on your skin is sebum, which comes from these glands.

Cells that line the follicle surrounding the hair are being constantly replaced. The mix with sebum and work their way to the surface of the skin. Eventually they are washed away. Sometimes, however, this process goes haywire. For reasons not completely understood, the follicle begins to produce cells that stick together so tightly that they are not shed. Accumulated cells, bound up in sebum and mixed with other skin materials, including pigment and bacteria, stick together and form a plug. This plug clogs up the pore, obstructing the opening to the skin. But the sebaceous gland keeps producing sebum, and this is how acne begins. The initial buildup is called a microcomedo. It lies deep within the follicle and starts forming many weeks before you notice any disturbance on your skin.

The sebaceous gland continues to put oil into the blocked system, and the follicle begins to swell and forms a closed comedo or whitehead. A whitehead is usually visible as a slight bump on the skin. If the follicle doesn’t break, the whitehead may turn into an open comedo or blackhead. The familiar blackhead is like a whitehead except that the exit to the skin surface is open. Some of the materials in the follicle cause it to darken. This material, and not dirt, gives the blackhead its dark color. Often the follicle bursts or leaks from the pressure in the plugged system. A papule or pimple forms when the follicle begins to release its contents into the surrounding tissue, causing inflammation. That’s why the skin surface surrounding a pimple usually appears reddened and swollen. 

The white cells in the body attack this material and pus develops. These pus-filled inflammations are called pustules and in about 10 days will usually disappear by themselves as the body disposes of this material.

You might suffer from whiteheads, blackheads, papules or pustules or a combination of all of them. Keep in mind that these blemishes are just expressions of acne at different stages of development. But every one originated from a microcomedo hidden within the follicle—which is why we say acne is a problem that works against you from the inside out.

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Acne is certainly no fun. If you’re a teenager, it is probably just a matter of time (although this could mean years) before your hormones balance out and your skin problems go away. If you are a teenager or an adult and have true acne—or even just simple breakout—you must look to your diet and lifestyle to find out how these areas of your life are contributing to your skin woes.

For more information, see:

• What is causing your breakout?
• Problem skin profile: Donna—constipated with problem skin
• MYTH: Food doesn’t affect skin

“Adult Acne” explained

I have many clients who have been diagnosed at their dermatologists as having “adult acne.” When these clients are in my treatment room for a facial and upon further examination, many times it turns out they simply have a minor breakout. Usually it is caused by improper diet, stress, or perhaps a hormone imbalance. Their breakout certainly needs to be addressed, but I dislike the term adult acne, although it is widely used nowadays to describe problem skin in adults.

Technically, even a blackhead has the potential for acne. But it is rare in these individuals diagnosed with adult acne that I see true acne, as opposed to a small breakout. It is all a matter of degree, but the kind of acne I use the term acne for is the full-blown type. An adult can certainly have true acne. But I don’t like overusing the term adult acne when it makes a minor breakout sound much more intense than it really is, lessening the weight of having true acne.

Regardless whether you have true acne, “adult acne,” or simply breakout, please read through this blog to find helpful hints and tips for solving or at least managing your problem skin.

Here are a few more articles that might help clarify what type of skin you have along with helpful information whether you have acne or just occasional breakout:

• Determining Skin Type
• What is acne? Acne explained
• Help for Breakouts

Accutane: Jennifer’s story

Jennifer came to me years ago for a facial and has been a loyal, monthly client ever since. She is a lovely, conscientious woman in her late 20s. By her own admission, Jennifer is overweight. She doesn’t drink alcohol or smoke cigarettes, but she does have a wicked sweet tooth; something she has “no control” over.

Throughout our years together, I have seen Jennifer’s skin go through many ups and downs. She has attempted to lose weight many times, unable to find a way to drop the unwanted pounds. The same holds true for her attempt at eliminating sugar from her diet. Jennifer’s skin is now and has always been broken out—sometimes severely. She truly has an acneic condition—comedones, milia, pustules, and cysts. I am not saying that sugar is the sole reason for her skin problems, but sugar is a top factor in how her skin appears and how her skin is indeed functioning, or rather dysfunctioning.

After trying all the different routes to “curing” her acne and without changing her lifestyle habits and dietary choices, Jennifer decided to take the leap into Accutane. Because her acne had become so severe, I actually was in agreement and thought this would make an interesting case study.

Jennifer’s skin improved on Accutane—temporarily. It was definitely helping with the large cysts under her skin as well as helping to stop new cysts from developing. If new problem areas did come, they were smaller and less noticeable. Both Jennifer and I were encouraged with her progress and she surely thought her skin problems were over.

Jennifer’s treatment course ended, and eventually so did her clear skin. Within a six-month period, her skin was right back where it started, and Jennifer was depressed. And no doubt her emotions were also fueling her food intake. She was gaining weight along with her skin breaking out again.

Talk and counsel her as I did, I couldn’t get Jennifer to stop eating sugar and other foods even though she knew they were huge contributors to her skin problems. It’s true that you can lead a horse to water, but you can’t make her drink. Jennifer went on to take several rounds of Accutane. All helped for a period of time, but then her problems would always return.

My point in sharing Jennifer’s story with you is to illustrate how denial and reliance on drugs and medications will not necessarily get you clear skin. Maintaining awareness and making conscious choices are always the best ways to achieve a goal. And if your goal is clear skin and you have an acneic condition, before taking medications, ask yourself what you may be doing to contribute to your circumstances. Acne is happening for a reason. It is up to you to decide how you are contributing to your problem skin.

For more information, see:

• Sugar & Skin Problems
• I’m sensitive to sugar—are you?
• Going on Accutane—right or wrong?