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Anyone have unusual advice for salvaging bad skin?
I have had terrible, borderline life-destroying bad skin since high school. I've fought it for over a decade with every treatment option under the sun (including copious amounts of SPF to block out the sun), and it's still awful, albeit in a more "beat up, scarred, leathery" way now than a "covered in pimples way" it used to be.
I think I'm totally fucked and just have to accept that. But might as well ask if anyone has any unusual or hail mary methods for improving skin texture/quality, fighting acne, reducing scarring, reducing redness, etc.
Just for the hell of it, here is a list of skin treatments I currently or have formerly used:
Niacinamide
Retinoids (Accutane and Tretinoin)
Azelaic Acid
Urea repair
Vitamin C (topical and oral)
SPF (million sunscreen variants, applied every day, applied every two hours outside)
Snail Mucin Power Essence
Oral collagen supplements
Fish oil supplements
Vitamin D supplements
Daily cleansers
Hyaluronic Acid
Ferulic Acid
Toothpaste (actually a pretty good short term pimple reducer)
Glycolic Acid (exfoliator)
Korean facial masks
Slugging (putting a layer of vaseline or a similar substance on at night to trap in moisture)
Eliminating hot showers
Silk pillowcases
Claritin (to reduce general inflamation)
Rhofade (weird, controversial short-term treatment for redness that restricts blood flow to the face)
Ivermectin (fight skin mites associated with rosacea)
No sugar consumption
No dairy consumption
Black head removal tape
Botox
Dysport (similar to Botox)
Microneedling
Radiofrequency microneedling
Fraxel non-ablative laser
And I'm sure there's a whole bunch of random smaller treatments from when I was young that I forgot
I have become something of an amateur expert on this shit, feel to ask anything if you're curious.
Have you tried any corticosteroids class skin creams? I didn't see any on your list. I use them daily to keep my skin in decent shape. I found a nice strength chart here for all of the specific types. The weakest - hydrocortisone - is available OTC at pretty much any drug store. I was prescribed a class 6 on that chart for a while, but I eventually discovered that the OTC hydrocortisone worked just as well for me.
Dermatologists really don't like prescribing the stronger variants long-term, but it might be worth a try to see if it helps if the OTC stuff doesn't help much. It helps if you find a friendly one who is willing to experiment with unconventional things.
I have used OTC corticosteroids on my hands and have found it very effective. But the reputation of corticosteroids in the face is that they work in the short term at the detriment of the long term. They thin your skin, and thin skin is already the reason why facial skin tends to be so much worse than regular skin.
Have you been prescribed facial corticosteroids by a dermatologist?
Yes I was, and I have kept using it and getting fresh prescriptions for I think like 15 years. They kept talking about "skin thinning", but nothing noticeable happened to me. They kept making me try other things, but nothing else worked (I don't remember most of the things they got me to try unfortunately). Personally, I'd rather take my chances with "skin thinning" than live with terrible itchy flaky skin on my face. I actually found that chart I linked when I was thinking about trying to order some prescription stuff from one of those sketchy overseas places that doesn't need prescriptions because I was getting seriously tired of them trying to push other things that didn't work on me. I didn't go through with that because all I could find was the ridiculously strong class 1 ones that might actually do something bad, but it did give me the idea to try the weaker OTC class 7 stuff since it's basically the same thing, just less potent. That seems to work, so I figure I both solved my problem of keeping my skin decent without dealing with annoying dermatologists and also somewhat went along with their fears by going with a weaker non-prescription version.
Obvious disclaimer, I'm not a doctor at all and haven't examined you, if you follow my example you're doing it at your own risk. I'd say try it for a week though with the OTC stuff. If it doesn't work, you're no worse off. If it works a little, consider trying to get some of the stronger versions by prescription. If it works great, then you get to decide if having something that actually works is worth possible long term risks of skin thinning. It sounds like mainstream medical advice hasn't exactly served you that well anyways.
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Based on the extensive list of treatments the obvious "See a dermatologist" I suppose has already been covered? I only mention this at all because you did not. Some of what you've listed appear to be treatments for acne rosacea.
Usual medical treatments for acne vulgaris include benzoyl peroxide, azelaic acid, erythromycin, clindamycin, or dapsone. None of these are over-the-counter, at least as far as I know, depending on where you are. There is also systemic therapy, such as the use of minocycline or doxycycline. These are oral antibiotics with an anti-inflammatory effect. There is also the synthetic retinoid isotretinoin, which is highly regulated due to all sorts of possible side-effects. None of this is relevant information for the skincare hobbyist, however, unless you see a specialist, which I recommend if that route hasn't been taken--though I suspect it has. If it has, consider seeing different doctors until you attain a therapy you are content works to greater degree than what you've done tried so far.
What's up with the hot showers? Cholinergic urticaria is when you break out in hives from contact with hot water (but also an increase in body temperature and sweating), but is that what you experience? I imagine any real dermatologist would be eager to have you as a patient (This is not meant as a slight in any way).
None of this may help in the slightest, but I wish you luck.
I've been to many dermatologists, as well as two plastic surgeons, one of whom is considered one of the best laser surgeons in the world. On the whole, my experiences with them have been fairly negative. Not that their advice is bad, just that it tends to be very typical (retinoids + sunscreen + moisturizer), and they seem to lack the means or inclination to seriously deal with extremely bad cases like mine.
I don't really blame them, dermatological responses to treatments are incredibly varied on an individual basis, and there isn't really much derms can do about it at a certain point.. There are people who have dry skin and put on an OTC moisturizer for a few weeks and then they're fine. Then there are people with dry skin who will spend literally years juggling multiple moisturizers, toners, cleansers, and serums trying to find the right combo that properly protects the skin barrier without causing break outs.
I've used azelaic acid and dapsone, both work decently well, but always seem to loose effectiveness for me, and of course, both cause irritation for me. I've considered oral antibiotics, but I'm scared of their long-term side effects, IIRC there isn't a lot of good research on what happens when people take daily antibiotics for months and there are plenty of horror stories of people developing IBS from them.
The experience is exactly that. If I take a hot shower, I get hives on my chest. If I put my head under the water of a hot shower (which I haven't done in years), my face turns red and swells up. Even with lukewarm showers, I get some redness in my face and chest, and if I make the water a little too warm, I get hives.
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You could consider using a hyper realistic silicone mask. You could try Adapaline Retinoids. See this.
Lol, reminds me of Vanilla Sky - https://youtube.com/watch?v=PZ5Eab3Na_E
It didn't mean it as a Lol, as I think I would try it in your situation. Lots and lots of people get plastic surgery which seems far more "drastic" than wearing a mask that people couldn't tell was a mask.
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I didn't do it for skin problems, but a few things really helped my Rosacea:
Interesting, my current diet is 150* grams of protein per day, mostly for working out, but there is some evidence that heavy animal protein diets are better for skin due to collagen consumption. Plus heavy meat is generally better for combatting inflamation, which is linked to rosacea. What mechanism would make high protein worse for rosacea?
Collagen is good, and one reason why I supplement glycine. But most protein sources are high in branch chain amino acids, which seem to cause insulin resistance in the metabolically unhealthy. Insulin resistance increases infIamation. I am trying to reduce BCAAs to 8g a day, at least temporarily. I'm not trying to reduce other amino acids, but as a consequence my overall protein is pretty low for this experiment.
I checked Amazon and saw glycine is 10 cents per pill, but then I checked my collagen supplement and I see there's already glycine in there. But thank you for the tip.
I take about 5g a day with Bulk Supplement's Glycine Powder. It's pretty cheap stuff, but I can tell the difference in how smooth my skin gets.
I recommend checking out /r/SaturatedFat for some unorthodox health advice. They are pretty interested in eliminating inflammation, reductive stress, and insulin resistance and I think they are finally onto something.
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Can you provide more information about what, exactly, is bad with regards to your skin? Is it specifically bad acne of some kind?
This. We need way more information to understand what's going on here.
Are you 100% sure you do not have eczema, psoriasis, acne, or atopic dermatitis? If you do one of the standard treatments is phototherapy. Specifically UV phototherapy. The dose and spectrum are carefully controlled, but blocking 100% of UV may not be doing yourself any favors, given you seem to have some sort of condition. Of course UV can also damage your skin and cause skin cancer, so finding a knowledgeable dermatologist is highly recommended over blasting yourself with sun.
If you want to add another random item to your list though, some people report good results with dandruff shampoo. Like regular 2-in-1 classic head and shoulders. Just using it as body and face wash 1-2 times a week. Lather up, let dwell for 30-90 seconds, and rinse.
I have recently started to explore autoimmune issues as a causal mechanism. Reasoning: I had bad eczema on my legs as a kid, have had psoriasis in the past, and my mother has a ton of weird allergy issues (allergic to penicillin and aspirin, was on daily antihistamines for 10+ years, now goes in for monthly antihistamine shots). I went to an allergist for the first time a few weeks ago and confirmed with tests that I'm allergic to cats and tree pollen, plus based on my description to her, I'm certainly allergic to hot showers (make my whole face turn red and swell up). The doctor speculated that I was allergic to dust, but my tests were negative. Next month I'll do a skin test where they put thingys on my back for 4 days and I can't shower.
But I don't think autoimmune is the central cause. My skin looks more like it's been put through the ringer by standard acne, with underlying irritation exacerbating it.
I will look into this. I used to use Head and Shoulders daily, but due to the irritation caused by even lukewarm showering, I have cut back on my showering to once every 3ish days (I work from home, don't interact with people a lot).
What is the proposed mechanism for how it would help facial skin? Antifungal?
Looking at other Urticaria, once you get past antihistimines and phototherapy, I've seen some suggested treatments as biologic omalizumab, steroid medications, or selective serotonin reuptake inhibitors (!?).
I'm not a medical practitioner at all, but the allergy to warm water seems like something that's pretty pertinent in figuring this out. Your skin is hypersensitive and the root cause of that hypersensitivity is possibly linked to your acne.
I had stress related psoriasis once that went away after dealing with the underlying cause. Is there a possibility that the sensitivity is psychosomatic (in other words linked to stress or other mental health issues)?
I told my allergist about my hot shower response and she diagnosed me with cholinergic urticaria, but didn't say much else except recommending Claritin when I shower. On its own, it's annoying, but not a huge deal. Hell, hot water is generally considered bad for facial skin anyway, so it served as a little extra incentive to embrace cooler showers.
However, on the off chance this allergic response is connected to something bigger, I'm going to press my allergist during my next appointment. Maybe it's worth getting one of those mega antihistamine injections just to see what happens to my face. Honestly, HOPE my facial skin problems are related to my allergies, because that's so much easier to solve. Wouldn't it be amazing if the root of my problems was an allergy to some random fucking environmental thing that I can avoid or crush with antihistamines? But that's probably wishful thinking beyond the rosacea.
I won't say a psychosomatic role is impossible, but I tend to be skeptical. Besides, I beat my psoriasis with cortisone (that stuff kicks ass).
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Wait a sec, that seems a lot for a guy who has all these skin problems. I’m sorry for the ‘have you tried turning it off and on again?’ question, but have you tried using mild/no soap?
Yep, I've tried going full caveman mode where I use nothing but a light moisturizer, and I've tried going hardcore "throw everything at my face and see what happens." I'm one of those people who is constantly caught in the see-saw between the two extremes. If I go minimalist, I get back acne; if I go maximalist, my skin gets irritated and worn out. I've never been able to maintain a good balance between the two for more than maybe a 6 month period.
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Yes, the active ingredient, pyrithione zinc, is supposed to be anti-fungal. I think people are pretty sure it works for fungal acne, though I suspect it also helps with random dryness and itchiness. What causes dandruff after all, if not scalp dryness.
Edit: Personally, Head and Shoulders every day is too harsh for me. I also see you did mentioned acne in a different part of the thread. I think the other common remedy people try, not already on your list, is changing your pillow case every night or every other night. Some people use a fresh towel to wrap their pillow every night. If you have acne from oily skin, it's supposed to help keep your skin oils from clogging pores while you sleep. Fortunately I've never needed to try it, so no first hand experience on that one.
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Always bad acne (never quite sure about type, I think bog standard), rosacea, chronically sensitive, acne scarring, lots of smaller discolorations, rough textures (especially orange peel), big pores, very dry by default.
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