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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18462
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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Since age of 16, my skin has never been great... not severe

Customer Question

Since age of 16, my skin has never been great... not severe acne but lots of blackheads on nose and cheeks. Also, it gets quite oily. I tried antibiotics when I was sixteen but didn't complete the course properly for some reason - I can't remember why and have always regretted this because it’s a ‘what if’ scenario. I’ve noticed that my skin doesn’t heal as quickly as other peoples… any spots / marks take ages to fade.

Anyway, I’ve tried all types of washes, creams etc. and nothing really works but I’ve just got on with it as part of my life… I’m now 33 years old.

Last April, I had a skiing accident and fell onto my face removing many layers of skin and causing slight scarring. To be honest, I was very lucky to get away with what I did. With this event, I saw an opportunity to sort my complexion out once and for all. Post 8 months of the accident I had some dermabrasion to help remove some of the scarring. It did help a bit and to be honest, I was back to normal with my skin and it’s quite tame acne problems; still lots of blackheads and oily skin. With this still bothering me, 3 months ago I’d thought I get hold of some retin-A and try this. I’d heard a lot about this topical treatment and starting using it (0.025 and sometimes 0.05 strength) every night. I did the usual daily routine of wash face, apply at night and then wash in the morning. It had a drying effect on my skin and the blackheads started to come to the surface where they could easily be picked off. I felt it was working and was happy with the initial results...

However, very soon after, my face started going really shiny and looked like leather underneath i.e. drying out. I was applying moisturiser to try and combat this but the oil production and shine on my face was getting excessive and became unbearable so I stopped using it 6 weeks ago. However, my face is still producing more oil than what it normally used to and I’m torn as to whether I should continue with the retin-A cream, stop altogether, get antibiotics, have skin rejuvenation or another option. I mention the skiing accident as I am wondering whether it was too soon to use such a topical treatment when the skin layers on my face were already very thin (i.e. damaged).

I am depressed and emotionally tired with my complexion and feel I must do something about it; I can’t continue this battle for the rest of my life.

Please can you advise on both short term & long term solution if any?

Much obliged.
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. D. Love replied 3 years ago.
It will help if you could provide some further information:
Do you remember which antibiotic was used?
Have you also tried benzoyl peroxide?

Customer: replied 3 years ago.
It was called something like minocyclin or similar. I really don't think I took the whole course....
As for benzoyl peroxide, yes but for a very short period.
Expert:  Dr. D. Love replied 3 years ago.
Thank you for the additional information.

There is usually a stepped approach to this problem.

Benzoyl peroxide is the most commonly used first step, so I assumed that you may have already tried it, although if you only used a short course, it would be an option to use benzoyl peroxide.

The Retin-A is the usual next step, such as you have been trying. However, it may work better for the Retin-A (and the benzoyl peroxide) to be used as a gel rather than a cream. The creams are frequently used for persons with dry skin, but persons with oily skin will more often do better with a gel formulation.

The minocycline is a common antibiotic that is used for acne. When antibiotics are used for acne, though, it is typically given for much longer than when antibiotics are used for most other indications. For most indications, antibiotics are prescribed for about 10 days, but for acne, it is given for much longer, such as for 12 weeks.

If I can provide any further information, please let me know.

Customer: replied 3 years ago.

Can you please advise on whether trying the antibiotics could be a possibility.

Will the benzoyl p dry up the oil on my face?

Aren't the topical treatments just covering up the core issue?

Do I have to worry about my skin layers being very thin at the moment?

Expert:  Dr. D. Love replied 3 years ago.
All of the options that I noted above are a possibility, including the antibiotics, although as I noted, they are usually tried in a stepped approach, taking one step at a time.

Yes, the benzoyl peroxide may decrease the oil on your face, although the gel is typically more effective than the cream.

Each of the medicines are treating an underlying factor that causes the acne. These medicines either increase cell turnover in the skin or kill the germ that contributes to the acne. None of these are permanent cures, but they are not just covering up the problem.

A thinning of the skin is usually not a concern at this age.

Dr. D. Love and 3 other Medical Specialists are ready to help you
Customer: replied 3 years ago.
Sorry - 2 last questions

If my face gets more oily with use of retin a should I keep using it? - does it eventually get better? At moment it just seems to get worse and now I've stopped using it the oil production seems to be worse than before I started using it

Expert:  Dr. D. Love replied 3 years ago.
Is this the cream or the gel?

Customer: replied 3 years ago.
The cream
Expert:  Dr. D. Love replied 3 years ago.
Then it would be reasonable to switch to the Retin-A gel. As I noted above, the gel formulations typically work better for people with oily skin, while the cream formulations typically work better for people with dry skin.