Trial and Error: My Acne Story

It is so unbelievable how much acne can affect your mood, confidence, and personality. When I first began to develop acne in my teenaged years, I did not pay much attention to it. My acne began as a cluster of mild inflammation on my forehead. Eventually, mild acne turned into cystic acne and spread from my forehead to my cheeks. At that point, I knew I was battling against painful, severe acne that is prone to permanent scarring. Eventually, I was taken to a dermatologist who prescribed me all the usual medications: benzoyl peroxide, salicylic acid wash, and Retin-A Micro cream. At this point, I don’t remember how long I tried each treatment, but I do know that all did little to improve my acne.


As a last resort, my dermatologist prescribed me 6 months of Accutane, a potent form of Vitamin A that acts to shrink your oil glands and decrease oil production. I was promised a permanent cure from acne with little side effects – how could I say no? Fortunately, Accutane did just that. Within 2 months, my skin began clearing up. Active lesions began to dry out and I did not notice new acne forming. I used gentle cleansers and slathered my face in cocoa butter every night to rid of my scarring. The most annoying side effects I experienced were nosebleeds and cracked, dry lips. I also had to provide blood work every month to monitor my liver enzymes since Accutane could be toxic to your liver. However, I was ecstatic at how fast Accutane was clearing my skin. By 6 months, I was acne free. By 1 year and just in time for my senior year in high school, my scarring had disappeared and my skin was flawless. By my freshman year in college, no one I met would have even guessed that I used to have acne at all.

Fast forward to a few years later – my senior year in college. Out of the blue, I noticed my skin was oilier than usual. I blamed it on the hot weather and having to be outside on campus. Soon, I began to develop clogged pores that led to mild inflammations. At this point, I felt frustrated and disappointed because I knew exactly what was happening: my acne was coming back! Except this time, I was going to do my best to fight against it. This is when I began my obsession on skin care and research on acne treatments. Here is a quick summary of my trial and error process:

• Oil cleansing method: this made my skin worse by clogging my pores (as if it wasn’t clogged enough already)
• Glycolic acid cleansers by Jan Marini: this proved to be too mild of a cleanser for my face. Glycolic acid is supposed to chemically exfoliate skin as well, but my skin quickly grew accustomed to these cleansers and did not work effectively anymore after 1 week of daily use.
• Sunscreen with liquid-consistency (Shisheido Ultimate Defense 50+ Sun Lotion): the high content of silicones in this sunscreen definitely led to pore clogging for me. However, if it works for you, I can say that it does provide effective sun protection!
• Proactiv Lotion: I only used the benzoyl peroxide lotion in this 3-step process. It worked for a few months, but I did notice it started to lose its effect after a while. It’s also a bit too expensive for my taste, especially since the main ingredient is benzoyl peroxide.
• Salicylic acid and Glycolic acid peels: I wish I knew that strong, home-based peels could result in hyperpigmentation in Asian skin. These chemical peels did little to help active acne and caused more hyperpigmentation spots on my face. Be wary of these strong peels on any type of skin!
• Corticosteroids: to this day, I still get angry with the dermatologist who prescribed me Prednisone (a corticosteroid). I came in with a mild case of acne and asked her opinion on the different solutions. When I asked her the side effects of Prednisone, she replied, “Well, everything has side effects! So don’t worry about it.” In the end, Prednisone made my acne worse which is no surprise when I found out that acne related to thickening of the skin is actually a very common side effect from taking Prednisone. Technically, steroids provide anti-inflammatory effects in the body and thus can lower your immune system. Since acne is essentially an inflammatory process, we are led to believe that corticosteroids will prevent acne. Yet, for some people, Prednisone makes acne worse by increasing androgen levels, which in turn will increase sebum production.
• Differin Gel: or also known as Adapalene, is a retinoid-like topical treatment, which is used by applying a pea-sized amount to the face every night. Adapalene acts to inhibit the productivity of sebaceous glands and the production of sebum. I had been on Retin-A Micro before Differin, and I found that Retin-A Micro was more potent than Differin. Both made my acne worse before it got better. Unfortunately, Differin made my skin oilier!
• Tea Tree Oil: there are tons of raves on this particular product, but for me, it just did not live up to the hype. Since I now suffer from mild acne, I do believe that tea tree oil could possibly keep cystic acne at bay and prevent new cysts from forming due to its natural antibacterial properties. However, I do not believe that tea tree oil will prevent mild acne related to clogged pores and excess oil production.
• Blue Light Therapy: It has been so long that I do not remember the particular product I used for blue light therapy, but I do remember that it did not work for me. Blue light therapy acts to destroy acne-causing bacteria. It made very little difference for my mild acne.

MY CURRENT SKIN REGIMEN
If I’ve learned anything from my trial and error process, it is this: you want to find the least amount of the products with the greatest benefits for your skin. So, I’ve pruned out unnecessary products to come up with 5 staple items:

1. Cleanser: a gentle water-based cleanser with 2% salicylic acid
2. Toner: an effective toner to remove excess traces of makeup and that contains either salicylic acid or glycolic acid for gentle exfoliation
3. Serum: you will want a serum that provides antioxidants such as Vitamin C. Applying a serum underneath your sunscreen could improve the effectiveness of your sunscreen!
4. Sunscreen: a broad-spectrum and non-comedogenic sunscreen specialized for your face. Sunscreen should always be applied after your serum and moisturizer, but underneath makeup.
5. Acne Treatment: whether it is benzoyl peroxide, sulfur, or salicylic acid – there are tons of acne treatments out there. My favorite is benzoyl peroxide from acne.org to use at bedtime because it helps dry oily skin. I never wear benzoyl peroxide during the day because its oxidative effects on the skin can interact with being out in sunlight.

I think the important lesson to remember is that all skin and acne is unique from individual to individual. As you can see from my list of past treatments, those that did not work for me may work perfect for you! Finally, finding your own unique regimen requires patience. Going from product to product quickly is a waste of time and money because you will never know what really worked or not. My advice is that if you do try a new product, try it for 2-3 weeks until you decide to discontinue it. That way you can get a more accurate feel of whether the product works for your or not.