Blog with Dr. IrwinTag >> Acne How do I sort out a complex product problem and acne?Posted in Skin Care Products, Skin Care, Acne, 2012 on Jan 08, 2012 | Permalink Dear Dr. Irwin, If you had to make the best between 2 bad choices, which would you choose? the choice is no daily sunscreen with less acne, or daily sunscreen and large horrible cyctic acne and blackheads? I am so exhausted battling acne (had accutane 2x in my 30s), every sunscreen brand makes me break out worse (ive tried dozens including some your recs.) And i figure superficial sun damage can later be fixed with lasers? I'm careful never to "bake" on the beach, i wear a wide brimmed hat, and use sunscreen everywhere except the face and chest in the summer and on sunny holidays (most of the year i live in foggy, rainy north europe). I work indoors, but enjoy being outdoors a few hours a day with my kids, regardless of weather. I'm 43, type 3 skin, some rosacea and lentigoes. Recently iv'e switched to a minimal routine which seems to control the acne: scrub (clinique), organic argan oil, plus Differin (adapalene) only on the problem areas (jawline/chin), and a multivit high in B5. Retinol facecreams and benzoylperoxide just makes the acne worse. I remember you saying, use retinol if you can tolerate it, else don't beat yourself up about it if you cant. I am hoping to hear the same thing about daily sunscreen! Or do your really think its nonnegotiable?
Also, any suggestions for fading the red/brown acne scars? I have no pitting, but though hydroquinone 4% reduces the brown age spots it dosn't reduce my postacne redness. Thanks so much for your great website, and wishing you a succesful new year!
Petra
Petra - thank you for writing and I hear your frustration on this. A couple of general thoughts that may help and then some specifics. Remember that while products can make certain... more How long do I need to wait after Accutane treatment before I can have my scars treated.Posted in Lasers, Fraxel laser, Carbon Dioxide Lasers, Acne Scars, Acne, 2011 on Dec 08, 2011 | Permalink I got off of Accutane in June. I have some acne scars and would like to use the Fraxel laser. How long do I have to wait? I don't want there to be any complications.
The short answer is this that if you are thinking full face traditional ablative CO2 resurfacing, then you need to wait a full year. If you are considering the Fraxel or the How do I know if my products are right for me?Posted in Skin Care Products, Skin Care, Acne, 2011 on Oct 31, 2011 | Permalink Dr Irwin,
What are some of the symptoms of over exfoliation? I'm 40, with very fair skin, live in a sunny climate, use Retin-A nightly and gentle facial scrub 2-3 times a week. I also use Skinceuticals Blemish/Age Defense 2-3 times a week in the morning to help with occasional breakouts. Since I've been on this routine my breakouts are gone, which is a wonder as I've had them non-stop for years. But I'm wondering if this is too much, f.e. maybe Retin-A every other night is enough... How do I know that my routine is just right? Thank you.
This is a good question because there really isn't a meter you can plug in that will tell you. Generally though, if you skin looks hydrated and not dry or irritated, and your breakouts are... more What do you think of home high frequency devices for acne?
It depends a little on which one but, in general, they can help individual lesions resolve a little faster, when used as directed. If you're someone who gets occasional acne lesions, this... more
What are these tiny bumps on my forehead, neck and chest?Posted in Lumps bumps moles, Acne, 2011 on Sep 17, 2011 | Permalink I have multiple tiny bumps all over my forehead, neck and chest from last 4 years.They do not seem like acne as they never go away and never grow in that size. I have observed that the edge of the bump is slightly red and top of the bump is of skin color. they are not visible from far but under light clearly visible. On the neck it appears as if someone has pasted skin color muster seeds. I have tired BP (5%) which keep them in control but does not go away completely. Please advise what skin disorder I am suffering from and how to treat this.
Ladies, ladies ......... please remember that to really treat something well, it's important to know what it is! This is a situation where you really need your dermatologist because... more
How can I really make good product choices for myself?Posted in Skin Care Products, Skin Care, Acne, 2011 on Sep 17, 2011 | Permalink Dr Irwin,
In your product recommendations you often say for which skin type a product is suitable, but I couldn't figure out how to tell for which skin type a certain product will work best. I live in a warm humid climate, and this makes me a bit more acne prone compared to when I used to live in dry climates. I'd love to know for myself how to make skin friendly choices of skin care products that I should use. Thanks.
You bring up a good point because the best skin care really is individual - not a clone of someone else's plan. Try thinking about it starting with 3 basic things -
Hi Dr Irwin,
My 13 year old daughter has been getting a lot of acne on her back over the past 6 months. She is an active girl, and I am wondering if maybe it is from playing soccer all day and the sweat getting trapped inside of her jersey. We have tried changing her body soap and using a wash cloth to exfoliate, but the bacne won't go away. Do you have any recommendations about how to make it go away? Thanks!
Here are the drugstore products that are helpful for back acne. If it doesn't clear in a month or two though, please see a dermatologist. Using a salicylic acid based acne wash twice a day... more Hi Dr. Brandith, My name is Katrin, I’m 26 years old and for the past years I have suffered a lot of ance, I been to many dermatologists, the first dermatologist sent me Accutane I have it for two years, after 3 months to take Accutane my skin was God and I had nothing of acne. my Dr. told me that after the two years of drinking accutane I would never suffer again with acne, I went back to another doctor and they send me again Accutane, but I do not want to take this medicine because it is bad, I’m writing to you because I need help and some advice , what you can recommend me?? thanks Dear Katrin,
I’m so sorry but your problem is way too complicated for an email response. You clearly have suffered quite a bit with this acne and seen several dermatologists. I would... more The Problems Behind Yoga, Sweating, Acne & Vitamin APosted in Sweating, RenovaRetinoids, Renova Retinoids and Vitamin A Creams, Acne, 2011 on Aug 18, 2011 | Permalink For the past seven months I’ve been practicing Bikram yoga 4-5 times a week, I love the practice but experience acne in the areas that most of the sweat occurs. I keep a very strict clean diet and have started taking Vitamin A, C, D, E, B-complex and Zinc in hopes of clearing my skin. The problem I’m having now is Vitamin A [I think] is interfering with my periods [late last month and this month]. Is there anything else you recommend me doing, should I stop Vitamin A to get my periods back on track?
Thank you! These are all good questions. Your period change could be due to many things. It makes sense to me to try stopping the vitamin A first (and never take more than 5,000 iu a day anyway). ... more When Acne Products Do Not WorkPosted in Acne Scars, Acne, 2011 on Aug 18, 2011 | Permalink I’ve been battling acne for almost 8 years now. It’s been getting worse. I have acne prone, oily, sensitive skin. I’ve tried everything from drugstore to proactiv to murad to burtsbees. Nothing has worked for me. I’ve stuck out each regimen for the recommended time and each time, my skin is filled with pimples and later, acne scars. I’m traumatized at how my skin’s behaving. I have been to a dermatologist who just prescribed benzoyl peroxide and tazorac both of which my skin is sensitive too. I’m about to try birth control pills but Do you have any recommendations of what I should do? Thank you I would recommend getting a second opinion from another dermatologist. If you have true cystic or pustular acne with scarring, you are a candidate for Accutane. A 6 month course of... more Alternative Help For Severe Acne?Posted in Finding a Good Doctor, Acne, 2011 on Aug 18, 2011 | Permalink I’ve been suffering from severe acne for the past 13 years! I’ve tried everything from Diane-35 birth control pills to Accutane. Nothing helps, the Accutane did helped when i was on it. But once i stop, my acne came back as well. Not as severe as before but my skin is not totally healed. Because of the severe ance i had in the past & now, i have severe pitted holes scares all over my entire face. I undergo laser - C02 Fractional Laser which most Dermatologist advised me to do to help smoothen my scars. I’ve already done it 8 times but i see no improvement. And now I’m starting to doubt if this laser even works. The scars are still deep & ugly. I am at the end of the knot, i don’t know what to do anymore. The acne, the scars is just tearing myself esteem down. Please advise. Thank you My heart goes out to you. It sounds like you’ve been through a lot and the acne problem still isn’t solved. I’m not sure why all the different treatments you’ve done aren’t... more I'm 25 yr old female who has tried about everything there is for acne and was on antibiotics for almost 2 yrs when i stopped and began my studies in holistic health.. i healed my candida through raw super food candida diet… i am big into raw food/ superfoods/superherbs and am considering accutane going against all my studies and career path.. after cleanse… my acne got super bad all around my chin for past yr. (basically boils it runs in my family) so i know it was not from diet… it must be hormones… i'm really nervous to get on accutane and am getting blood work done tomorrow to get a rx for accutane on monday… i've been dealing with this my whole life and is ruining my career as a holistic health coach and raw food chef… my derm wants to put me on very low dose for short amt of time…will loading up on probiotics.. superfood and superherbs help me at all with a small cycle of accutane? need some help.. so confused.. You raise good issues. One thing to remember about Accutane is that the molecule is almost identical to the Vitamin A molecule. Please don’t try treating yourself with megadose Vitamin... more Can you help with large oil glands on the chest?Posted in Oily skin, Acne Scars, Acne, 2011 on Aug 10, 2011 | Permalink --------------------------------------------------------------
I have very oily skin and even enlarged oil glands all over my chest that are embarrassing. I am 22 yrs old and considering the cosmetic surgery to melt them down. Do u thing it would be beneficial to go through with this procedure? I have tried everything and it doesnt seem to work so im desperate.
I really think you should see a good dermatologist as soon as possible. Often when the pores are enlarging on the chest like you are describing, it's really a type of acne. There are... more
I have combination acne prone skin which has become even more oily since being off birth control for about 2.5 months now and my cheeks are sensitive. I'm asian with light skin tone in the 25-30 age range living CA. Currently my derm has me on acanya for AM, and atralin in the PM for almost 2.5 mos now. For the past month, I've been having issues with continuous hormonal breakouts on my chin and now I feel like my breakouts are coming back (though not as severe) on my forehead, and sides of my face. I visited my derm 2 wks ago to address these concerns and he suggested I give the acanya more time to work and also gave me a trial of revision brightening face wash to use instead of my philosophy purity cleanser. So far I feel my acne is gradually getting worse. Also in the past i was taking solydyn but considering how it makes you sun sensitive i also stopped that about 4 mos ago. Any suggestions on what/how I should tweak my routine for better results? Please let me know as sometimes it seems you need to tell the doctor what you want! Thanks and looking forward to your response.
So many good questions from all of you!!! Again, I just wish I had time to answer all of them. I think this question brings up some good points. For example, how long is a reasonable... more Is there anything that really benefits acne scars?Posted in Acne Scars, Acne, 2011 on Jun 05, 2011 | Permalink Is there anything that really benefits acne scars? Yes, read my article on Acne Scars and Other Scars In Depth for information on what options are available to reduce the appearance of acne scars. Dr.... more
I have multiple acne scars on my chest and back. What can I do?Posted in Scars, Fraxel laser, Carbon Dioxide Lasers, Acne Scars, Acne, 2011 on May 25, 2011 | Permalink Hi,
I have body acne and over the years the number of breakouts has diminished but has left a lot of scars which of them are mostly skin discoloration. I am dark skinned. I have tried varies things like micro crystal dermabrasion, topical cremes and glycol peels. I was not sure about the peel first but then I have tried most of the stuff out there and risked it and it left a couple of very dark spots which hasn't faded even a little bit after 2 months. I am starting to feel that the only option would be expensive laser treatments. I would really appreciate if you could offer me some advice. Thanks.
I really agree with your conclusion on this. With most acne scarring, it is deep enough that superficial treatments like microdermabrasion, creams and glycolic peels won't help much. ... more
What Causes Milia?
A milia is just a pore that gets clogged with sebum/dead skin cells and then the sebum hardens under the skin. These show up as tiny white bumps under the skin that persist. They are... more Does Triluma help with scarring from picking!Posted in Skin Care Products, Skin Care, Pigment problems, Brown Spots, Acne, 2011 on Apr 04, 2011 | Permalink Hello DR.
does tri-luma help with brown sccaring from picking? I.. like to try it ty
The short answer is yes............ but only if you stop picking! So here's my question to you. I'd like you to think about why you're picking. If you have acne, please see a... more Question from the Netherlands regarding brown spots.Posted in Skin Care Products, Skin Care, Brown Spots, Acne, 2011 on Mar 23, 2011 | Permalink Hi Dr Irwin, I learn a lot from your blog and it gives me hope! Just wanted to share an observation on brown spots. I am 42, type 2 skin, dry but with monthly cyctic acne on jawline, and increasingly large lentigoes on cheeks/eye area. I tried Comet laser treatments (spots came back next summer), 4% hydroquinone (made the area redder not lighter) but whats surprizingly helped the last few months is using ROC vit A+C+E moisturizer. Why would this cream reduce the brown spots so drastically? It only seems to work on the lentigoes not red acne scars. I am resigned to them coming back this summer though, given i break out with most sunscreen including all the paula's choice ones :( And the ones you recommend are not avail. in the Netherlands. Any Euroepan suncreens you'd recommend? Thanks!
Thanks for sharing this. I'm not too surprised though that the Roc Vit A,C,E product helped because the vitamins C & E are antioxidants and the Vitamin A (probably Retinol since it's... more Hi Dr. Irwin-
I believe I either have hormonal or cystic acne along my jawline and neck? I also have scarring in this area due to the acne. Do you have any recommendations for products to use?
Thanks so much!
Sincerely,
Amy
Dear Amy - Most of the "over the counter," drugstore type products and acne care systems like Proactive, have either benzoyl peroxide, salicylic acid, alpha hydroxy acids or retinol in... more
Help! I'm confused about my products.Posted in Skin Care Products, Skin Care, Acne, 2010 on Dec 04, 2010 | Permalink Hi, I recently went to my aesthetician (referred by my dermatologist), and she recommended that I start a new routine. AM- Wash, Moisturize, Sunscreen. PM- Exfoliate, Tone (Toner includes only water, latic acid, citrix acid, aloe vera), moisturize, and use Ziana as needed. My question is, is this too much exfoliation? Would it counterproductive to use Ziana and the Toner at the same time? Also, shouldn't there be an antioxidant somewhere? I only use Ziana on a spare basis, should I use a Retinol on a more consistent basis for anti-aging?
I think many, MANY women are confused about products. So let's work through this logically. Let's think am and pm. I'm assuming you have some acne because you were prescribed Ziana,... more Do you perform needling/subcision on skin that has been scarred from acne?Posted in Lasers, Acne Scars, Acne, 2010 on Sep 06, 2010 | Permalink Do you perform needling/subcision on skin that has been scarred from acne?
Yes. Like all treatments for acne scarring no single type of treatment will take care of all the scarring. We often use subcision occasionally alone but more often in combination with... more
I am 28 female and have had trouble with acne around the area above the lips and chin area. It seems to "flare" up during the menstruation cycle each month. I've tried different products but some I can't use because it dries my skin. Is this something that can be helped if I see a dermatologist?
Yes, yes, and yes!!! A good dermatologist should be able to help you with this. Sometimes, the problem is the hormone spikes that occur in women around the time of our periods. ... more
I've been hearing scary things about the long term side effects of Accutane. Do you agree?
No, I really don't. There's no question that Accutane is a serious medication and the FDA guidelines must be followed absolutely to the letter. If they are, side effects and risks are... more
What is a good solution for deep marionette lines around the mouth?Posted in Sculptra, Fillers, Acne on Jun 12, 2010 | Permalink I am 45 and have a deep marionette line on one side of my mouth that is about ½ inch in length. I had Sculptra injected and while it did soften the line it is still very noticable. Is there anything else I can have done that will help improve this?
I'm always fascinated by how asymmetric we all are. It sounds like the line is just on the one side. Usually the side of the face with more lines is the "sleep side" where we spend more... more My 26 yr old daughter has been taking Spirolactone 100mgs for acne for almost two years and it has been a miracle for her skin. She had tried everything with no results,so this has been great. She glows now. My question for you is..is this safe long term like and how long should she wait after getting off before becoming pregnant? Thanks for your answer.
These are all good questions and you are a very nice mom for caring so much about your daughter, but she really needs to ask her doctor these questions herself! Have her make an... more
Should I use both Retin A and the Neostrata glycolic together?Posted in Skin Care Products, Skin Care, RenovaRetinoids, Renova Retinoids and Vitamin A Creams, Acne, 2010 on May 18, 2010 | Permalink It was recommended to me to use Retin A at night followed by NeoStrata Level 1 or 2. I was wondering whether it was necessary to use both a Vitamin A and glycolic product and if I should be using them together?
You didn't tell me your age or whether or not you have acne. But unless you have very tough, oily skin, I wouldn't recommend that combination to start out with. Why don't you try the... more My new skin care regimen is irritating me. What should I do?Posted in Skin Care Products, Acne on Apr 24, 2010 | Permalink Dr. Irwin,
My dermatologist just prescribed acanya gel, benzoyl peroxide wash 8% for morning use and I apply aveeno sunscreen moisturizer SPF 30 after cleansing, then for night she recommended a gentle cleanser (I use Shu uemura) and then apply differin lotion, then a moisturizer (I use Olay regenerist). I have been on this regimen for a few days and my skin has become red,flaky and putting a moisturizer hurts. Is there any oil free moisturizer you can recommend for me for both day and night that won't sting when I put it on? I have combination skin (oily T zone) and my cheeks are incredibly sensitive right now, it hurts when I put anything on it. I also live in a place where the summers can get very humid.
thanks so much!
You sound very uncomfortable!! Please call your dermatologist and let them know what happened. They should suggest a break and then a different regimen. But if you can't get through on the... more What can I do about post menopausal acne?Posted in Menopause, Lumps bumps moles, Growths, Acne on Apr 24, 2010 | Permalink Hi,
I heard you last night on Paula Begoun's web talk and was impressed with what I heard so I have been browsing your site. My question has to do with your comment on post-menopause acne. I am 54, have had a full hysterectomy at age 50, take monthly shots of Estrodial and according to my ob/gyn should stay on this the rest of my life. I also have used Retin-A-Micro since age 40. I agree that the acne that I get now is much different than as a teenager. It is deeper and more cystic as you stated. But, I didn't see anything that you recommended to help with this. Besides the Retin-A-Micro, I occasionally use a glycolic acid. Is there something else or better to do to get rid of the under the skin white "spots" that turn up. Some become bumps, some stay under the skin.
Thank you for any guidance.
I'm wondering if your acne is all month long or concentrated around when you get your monthly estradiol injection. It might be worth seeing your gynecologist and trying a different... more
My 26 yr. old daughter took 200mgs Spirolactone for a yr for hormonal cystic acne. She stopped for 3 months due to being tired and burning stomach and sometimes feeling queasy off and on.She then started back on just 100mgs. It has been a miracle for her as she has tried everything, even accutane. My question is ...this is her second year on it and she occasionally drinks wine, and caffeine drinks. Not much water and she only drinks around 4ozs of water when taking her dosage. She doesn't seem dehydrate, but sometimes get a stomach virus feeling with gurgling etc and pain. Could this be hurting her stomach and possibly causing more problems? I wouldn't want her one day not be able to take it anymore or it hurt her in the long run. She doesn't have any problems with it otherwise. I tell her not to drink wine , but she does. This is the kind of question that you absolutely must ask your daughter's dermatologist. Or, more specifically, she should ask her dermatologist!! I wouldn't dream of commenting without... more
I popped a small zit right in the middle of my forehead approximately one month ago, and it has turned into some kind of growth (almost like a skin colored mole?). I doesn't seem to have any type of fluid inside. People are beginning to notice it and it is making me very self conscious. I can't figure out how to get rid of it, I've tried popping it, putting apple cider vinegar on it, as well as just washing it with anti bacterial soap and using tea tree oil. None of these so called "remedies" seem to be working, now I'm worried that I will create some kind of scar :( What should I do? What can be done? Should I get it surgically removed? But if so, would I have scarring? Whoaaaa! Stop right there - you need to get into your doctor right away. There is a whole list of things this growth could be since it's been there a month. It could be a raised scar... more
how do you get rid of your acne that is one your; back, alittle on your chest, and your face in under a week? Well - the answer to this is you can't but....... you can make a huge improvement in it depending on what type of acne you have. You'll need to see your doctor for prescription... more
hi My name is Mary,I am 19.For about 2 years I have these tiny skin colored bumps on the right and left side of my chin.when I get warm or the weather does. they go from tiny to puffy.Then if one decides to erupt it looks like heck.The texture is like brail.There is a tiny little black dot in each one.What would u recommend? I was thinking about starting to use a glycolic face wash,glycolic atringent and cueva lotion I think thats how it spelled .My skin is caucasian and its not thin it pretty resilant in the since that its not thin.luckily....You see them the most from the side views and in different lightening. Mary - the little black dots on your chin are probably a type of mild acne (open comedones). And, if you're 19, you're probably still pretty oily especially in warmer weather. I think... more Is there a difference between Renova and Retin A Micro gel?Posted in Sun Damage, RenovaRetinoids, Renova Retinoids and Vitamin A Creams, Acne on Dec 29, 2009 | Permalink Hello Dr,
I'm using renova for awhile..what is the diff between Renova cream 0.2% and retinal mirco gel 0.4%.? Okay so there a lot of understandable confusion about creams that are vitamin A cousins (also called retinoids) because the names are all similiar. When you say retinal micro gel 0.4%, I'm... more
Hi Dr. Irwin. I love your site and it is very helpful in my time of need. I love the Menopause and your skin resource, however I didn't quite figure out how to combat my acne cysts. I am 39yrs old and had a total hysterectomy 6 years ago and have since been plagued with acne cysts. They are painful and leave awful marks on my face. What can you recommend? Thank you, Chris Thank you - I'm glad you like our site! It's really been fun. I have some ideas about your cysts, but you'll still need a good dermatologist to help you. After a total hysterectomy, you... more Can acne be improved with diet?Posted in Dry Skin, Body Treatments, Acne on Nov 19, 2009 | Permalink Dear Dr. Irwin:
My 16 year old daughter is starting to have acne problems on her face which includes alot of very tiny pimples on her forehead and sometimes larger pimples on her nose. She also has very bad kitosis on the backs of her arms. A dermatologist gave her slayic acid lotion for the arms. Im afraid to let her use it becuase she had the flu shot. Is this safe to use? There is no history of either of these problems in our family. What foods should she eat to improve the condition of her skin and what do you recommend that she use on her forehead and arms? Thank you. Marci Hi Marci - Lotions with salicylic acid in them have been around for more than 20 years and used for a variety of skin conditions including that problem on the back of your daughter's arms... more Acne Spots and SunscreensPosted in Brown Spots, Acne on May 07, 2009 | Permalink Hello. Thank you for this site. I've had acne and pitted acne scar/pigmentation issues my whole life. Currently, Ive finally gone back to a dermatologist to see if I can try something new. I'm on what is triluna essentially (6% hydrocortisone/.5% retin a/kojic acid/cortisone temporarily and so far I feel like Im seeing more spots. I feel this has to do with my sunscreen application. Even though I use a physical blocker and reapply every 2 hours, I made the mistake initially of using a sunscreen that get deactivated when also used with mineral makeup. (no one ever told me.) I refer to your site quite a bit and I think I'll buy the color science powder and the 48 sunscreen and layer every day but, wouldnt this mean that i'd have to wash my face every 2 hours in order to reapply the new layer of sunscreen and powder sunscreen? Okay - these are good questions. First of all, no one and I repeat no one should have to reapply sunscreen every two hours unless you're a professional surfer and you are spending all... more Fifty-Two and Still Oily?Posted in Skin Care Products, Oily skin, Acne on Apr 27, 2009 | Permalink I'm fifty-two and still really oily with clogged pores and acne. What can I do? It doesn't seem fair, does it? My patients always say they can't believe they have wrinkles and acne! I can't give you a specific plan without seeing you, but for someone your age with oily... more |
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