How to treat acne, sensitive skin, and darkening

1. I’m a 13 year old girl, I have a skin condition, which makes my skin very irritable at times. I struggle with acne. I’ve been taken to the dermatologist and prescribed retinal. I found out the hard way that I was allergic. My skin turned red, peeled, and burned. I don’t know how to keep routine well so can you send me tips for how to keep routine and/or what I should use? (Inexpensive please) Thank you. 2. Hello! I am a 15 year old Pakistani Saudi girl. I live in Saudi Arabia and I have a very fair complexion. But whenever I visit Pakistan, my complexion darkens. After I return, it takes time but gets back to my normal complexion. This time, I am going to Pakistan for a couple of years and I am very much worried about my complexion. I want to know if it will get back to normal in some months or will it stay darkened forever? Kindly reply soon, Thank You. 3. Hi! I have no idea what to do. I need HELP. I’m 19 and I get these huge monster zits on my lower back and buttocks region. I also get them on my chest. I have tried all types of acne creams, medicated body washes, and dark spot correctors for after a zit has gone down. I never pick at them or peel off the scabs. They are often really painful and feel like the kind of the cystic acne spots I get on my face sometimes. The ones on my face only appear around the time of my period but the others are persistent and seem to always be present. I’ve been using a prescription acne medication (Epiduo) which take care of the ones on my face but not the ones on the lower parts of my body. I’ve been on birth control for about 3 years to help with cramping and acne. It did it’s job for my facial acne, but nothing for the body acne. I just don’t know what to do. It seems to be a case of folloculits to me and I have no idea of how to go about it. I would so very much appreciate any advice you could give me. Thank you!

I love all of your questions and it’s so great that you are being proactive!

1. Acne and “irritable” sensitive skin. How to treat this?

This is always a tough situation because most acne medications are developed for really oily, pretty tough skin. And you’re right of course, acne products can really irritate if you have acne and sensitive skin. Start with a gentle cleanser like Cetaphil or CeraVe cleanser both morning and night. The “acne” cleansers are usually too irritating for sensitive skin. Then add the most gentle hydroxy acid (think 2% salicylic acid or lactic acid) both morning and night. You’ll need to go to the drugstore or online and read the ingredients on the back. You don’t want anything too strong. If you are doing well with those after about a month, then you can trying stopping the hydroxy at night, and try adding the Differin cream at night instead. Just do a test area first on one cheek to make sure you’re not allergic. Please remember it takes 4-10 weeks to really see a difference with acne. Please go back to your dermatologist if you are having problems! Sometimes staying away from white sugar, white flour products and deep fried foods is helpful also.

2. How to keep your skin from darkening when you’re traveling.

If your skin is darkening when you’re traveling or living somewhere else, it’s almost always that you’re getting more light on your skin. Please remember that it’s the daily exposure to natural light, not just sun that can cause skin to darken. If you use 2 layers of sunscreen on your face and neck, and a hat then that should do it. If you wear a hajib, then it’s almost impossible to wear a hat also. So the 2 layers of sunscreen are super important plus one for the eye area, unless you always wear sunglasses. Here’s how!  Use an 18% zinc sunscreen (tinted ones are nice too) as the first layer. Then put a mineral powder over that. The two layers should really help! Also, if you do get a bit darker, it won’t last forever, once you are out of the natural light again.

3. Monster zits on the lower back and buttocks.

Here are some non prescription things to try which should help! Buy some Cln Body Wash and use it daily on the area. Cln also makes one called a Sport Body Wash which some patients like even better. Then at night before bed, apply to the whole area (not just the spots) Neostrata Smoothing Cream or some Glypro Daily Firming Lotion. These are hydroxy acids that help to prevent the pores from reclogging. After you’re cleared up up, just use the hydroxy cream on any new spots or areas. It helps to not wear tight clothing that rubs on these areas.

Hope this helps,  Dr. I



Dr. Brandith Irwin, MD

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Hi, I’m Dr. Irwin. I believe that consumers deserve a medically trained and unbiased skin care advocate.

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