40 Years With Acne and How I Keep My Skin Clear

I have defective skin. I suppose I should be thankful more than anything else for this problem. The skin is the largest organ of the human body, and it is, at least, visible. And except for possible skin cancer, nothing will ever happen on my skin that threatens my life.

I have defective pores. To be specific, I have acne, a disease I have suffered with for over forty years. From the time of its initial appearance at age sixteen, I have consulted many dermatologists, read numerous articles and books, and sought the most cutting-edge treatments that I could afford. I'm still not cured, and probably never will be. Oh, I've learned a lot about how the symptoms of acne can be controlled, and my complexion looks good most of the time. And for the last ten or fifteen years, an acne flare-up has become a minor annoyance, something to shrug off after making a mental note to start treatment. But how did I get to this point?

Background

It's no surprise that I developed acne. Most experts agree that there is a genetic predisposition to acne. But, even without a family history, approximately 85% of teenagers develop some acne. Acne happens when young people entering puberty begin to produce increasing quantities of male sex hormones that signal the sebaceous glands to make more oil. At the same time, cells within the follicles begin to slough off and clump together, which blocks the pores. A skin bacteria called p. acnes then causes inflammation within the follicles, and when the follicles get irritated enough to burst, you have pimples. Many young people who have acne during their teens outgrow it by the time they are in their early twenties. But some of them continue to experience problems for many years. Their condition may be constant, it may wax and wane, but it nearly always costs them their self-esteem. If it were socially acceptable for them to wear a paper bag over their heads, they could put their best foot forward - if they could see through the slits.

As a teenager, my mother had experienced the emotional turmoil caused by having severe acne and, understandably, she became concerned when I first broke out. It wasn't long before she took me to see a dermatologist. I remember undergoing treatments featuring dry ice, sunlamps, lesion draining, birth control pills, oral antibiotics, spironolactone, benzoyl peroxide, and Retin-A. A couple of these typical 60's and 70's therapies were very effective, but probably dangerous over the long run. In the early 80's, I even took Accutane, but found only temporary results.

So, when I was about 30, I began to do my own research. I found my best resource at the public library. A dermatologist had written a book, aimed at the consumer health market, on how to manage the symptoms of acne using topical drying and peeling agents. The topical products, available over-the-counter at any drug store, weren't new to me, but the doctor's philosophy of treatment was. So what was the big revelation?

The Process

I learned that acne is a 24/7 process. The cell shedding and clumping inside the pores, the sebum production, the inflammatory response - they all take place at a microscopic level, all the time. The key is to understand just how long it can take from the time a plug forms in the follicle, until the time it explodes into a pimple on the surface of your skin. Sometimes the process takes 24 hours, sometimes it takes three months. This is why it is important not to miss a treatment, and especially, to continue treating your skin indefinitely with the products each day. Yes, this means even if the benzoyl peroxide (BP) is making your skin dry, flaky, and itchy. Just soldier through. I made it past the worst points, and I think it's worth a try for anyone with the disease.

By the time I learned this regimen, I had been treated by approximately eight dermatologists. Many of them advocated the use of BP, or a combination of BP and Retin-A, but not one doctor ever explained the necessary discipline, the constant watchfulness of the whole disease management cycle. But I never wasted time blaming dermatologists for their lack of follow-up; rather, I put my knowledge into service.

I can't guarantee the results I had, and I am only relating what long experience has proved true for me. There are always alternatives out there; in fact, there are a couple of relatively new medical treatments that might be worth investigating. However, the regimen below is surely one of the safest, most economical treatments available.

Daily Routine

Put as simply as possible, use benzoyl peroxide each day. It comes in several strengths. I recommend starting with a 5% solution. Know that there are many BP products on the market. You can experiment and discover the brand which is the easiest to apply, but they all work the same way. BP kills the p. acnes bacteria in the follicles while suppressing the fatty acids which encourage inflammation.

  • Step 1. Wash your face with lukewarm water and a mild soap. Be gentle with your skin and avoid scrubbing it.

  • Step 2. After drying your skin, apply BP over any area that has the potential to produce pimples. Don't just dab the cream or gel over existing bumps. Use your BP gel in the morning and at night, but add one more thing to your routine.

Freeze water in cup for a handy ice applicator
Freeze water in cup for a handy ice applicator

Ice

I've found that icing my face at night is the single most helpful thing I've ever done to get to a 100% improvement level with my acne. The consistent use of BP will do wonderful things, but wouldn't you rather have perfection? Ice is recommended to reduce any kind of swelling, including acne, and your BP will work better on cold skin.

  • Step 1. After washing in the evening, rub an ice cube over the problem areas for at least 60 seconds. That's it. Apply your BP, let it dry, and go to bed.

Other Tips

  • Avoid oil-based makeup foundation.
  • Avoid hot showers, as these increase inflammation within the follicles.
  • After playing sports or working out, use ice on your face or apply cold towels.
  • Remember that benzoyl peroxide bleaches many fabrics, so be careful with clothing choices.
  • Do not add other products to your regimen, unless they are part of the same skin care line.
  • Use a non-comedogenic sunscreen.

Be Persistent, Get Results

Be consistent, be patient. You will likely see a big improvement in your acne within 6-8 weeks, if not complete clearing. You can keep a slight peel going on your face at all times that is hardly noticeable after a few weeks. If you find you just can't tolerate BP, you can get a prescription for one of the retinoids (Retin-A, Differin), which were designed to work the same way.

Perform these steps without fail for the foreseeable future. After about a year, you can try giving your skin a break, but if you're like me, the acne will come back eventually.


One More Thing to Consider!

If anyone reading this has had a long-standing problem with acne, I can offer one ray of hope.

Your acne will get noticeably better when you have accomplished most of your life goals. It's that simple. When you have nothing left to prove, stress tends to fade, and that's a very favorable thing for someone with acne.

The teen years and young adult years, where everyone is looking for a mate, working on career advancement, and planning a family can be very stressful years.

But later on, you won't worry nearly as much, because you'll be more confident and less concerned about what kind of impression you are leaving. I can only speak for my own gender, but this happy occurrence sort of coincided with the arrival of menopause for me. And it is true that acne is primarily a disease of the reproductive years.

If you quit having acne in your teens, but started breaking out again in middle age (it happens sometimes), the above paragraph might not apply to you. In speaking with Barbara Strickland, the founder of Sage Skin Care, she told me that older adults many times freak out when they suddenly see pimples on their face. This is because they had many long years with no real skin problems, and understandably, they are upset. Each case is unique! But these people still have many options for treatment.

I speak from experience. I don't throw up my hands anymore and stress out because my skin still breaks out occasionally. Take it from me.


Useful Links

A great site with very active, helpful forums

http://www.acne.org/

My favorite skin care line. Has the best benzoyl peroxide and sunblock around. Offers lots of free information.

http://www.zerozits.com

Image Credits

Graphic of the dermis from the Mayo Clinic.

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Comments 28 comments

Zithead 3 years ago

52 and have battled acne since a teenager. Nothing severe but have occasional breakouts. Embarrassing and it affects your self esteem. I used a BP product for several months 2 years ago and I have not had much acne since then. Not sure if it was the BP or just age, but finally it has stopped. If you are in your 30s 40s or 50s hang in there your acne will go away before you die.


gracenotes profile image

gracenotes 3 years ago from North Texas Author

Pizzalover, I no longer eat anything with flour in it, or wheat, but my reasons don't have a lot to do with acne. Some people find that dairy products, in particular, increase skin break-outs. You'd have to experiment with this, and see if it's true. Using an ice cube will not give you frostbite. If it were dry ice, that is different, and that is something usually applied as a treatment by a doctor. I never had the blackhead problem, but I have heard good things about going to a clinical esthetician and having skin treatments there, if you can afford it. They are very knowledgeable and can provide a lot of advice. At your young age, only 13, you would have to try different treatments and see what is effective. Not everyone is going to respond the same way. Lots of new treatments out there for acne. Hope this helps you, and glad you stopped by.


Pizza lover 3 years ago

Does pizza increase chances of having acne? Just 3 slices? and by the way I am 13 years old and I have terrible acne! I am so tired of it! It's not all over my face. I mean I have blackheads all over face, but only a few big fat red pimples(ew! yeah I know gross). Help me please!!!!!!!!! Ice was the most effective remedy for my pimples, and yeah you're right - it works best at night (I wonder why) Do you have anymore suggestions for me? I eat healthy and do exercise everyday. Oh and can you tell what type of skin I have? it's not very oily and it's not very dry. Is it possible to get frostbites from using ice directly on my pimple? Please reply! Thanks!


Mava 3 years ago

Hi! Thanks for this wonderful advice! Is it okay if I don't use benzyl peroxide?


gracenotes profile image

gracenotes 4 years ago from North Texas Author

DianeA,

I am so glad you found a product that is working for you. It's especially difficult when you have skin that is reacting differently depending on what part. I will check out the recommended products.

I seem to have more red spots and tiny bumps, but every time I use ice on my face, the problem is very minimal. I still use Sage Skin Care for the most part, and recently switched back to their BP product after using Retin A for months.


DianeA 4 years ago

I have acne-prone skin (even as an adult, *sigh*) coupled with dry, flaky parts and over the past two weeks since I started using the Shielo Complexion Products (Both the Shielo Complexion Moisturizer & the Shielo Complexion Scrub) this morning and night after I wash my face, my skin has really evened out. The flaky parts are gone. My pores are smaller on my cheeks. Acne scars and hyperpigmented areas have started to fade. I have not had a single zit for the past two weeks. This is insane. And my skin is so smooth! I noticed the smoothness after the first day.


gracenotes profile image

gracenotes 4 years ago from North Texas Author

Christie, I am glad you liked the article. I don't have combination skin, so it's difficult to recommend a moisturizer. If I ever used one, I know mine was oil-free. If you have areas of your face that never break out, I'd guess you could use anything you please.


christie 4 years ago

hi, nice article. question...i deal with combination skin (sometimes oily, sometimes dry). what do you recommend as far as moisturizers go in combination with daily BP use?


gracenotes profile image

gracenotes 4 years ago from North Texas Author

Thanks for coming by.


mathira profile image

mathira 4 years ago from chennai

Very useful, gracenotes.


gracenotes profile image

gracenotes 5 years ago from North Texas Author

Injured lamb, I hope some of these suggestions will help you. If not, there are some new treatments out there.

Thanks for your contribution.


Injured lamb profile image

Injured lamb 5 years ago

Really appreciate much for the sharing gracenotes, would try this for my elder son...


gracenotes profile image

gracenotes 5 years ago from North Texas Author

Hubbswriter, thanks for your comments. Trying to keep stress at a minimum is always good for acne, I think. As far as diet, I experimented quite some time back, and I found that a low-fat diet, AND leaving off refined carbs (a very important piece of the puzzle) reduced greatly the oil factor in my pores. This is only good, of course, but one must keep up the motivation for such a diet. Right now, I really don't do this, although there is very little room in my diet right now for sweets and desserts. That's the one thing I did subtract from my diet. I really like wheat products, though, so I still indulge my appetite for bread, and perhaps too much.

I've always, always had good results from BP, and I have one of the best BP solutions I can find on the market. It's made by Sage Skin Care. However, salicylic acid made into a solution or gel, while expensive, is also very good for acne problems, as are the retinoids. One can switch off, as necessary.


Hubbswriter profile image

Hubbswriter 5 years ago

I've used BP for years, and though it helped at first, I feel like it's lost its effectiveness. Lately, I've been moderating my diet and lifestyle, and it's had great affect for my acne. Have you tried this?


gryphin423 profile image

gryphin423 5 years ago from Florida

Very informative, thanks for sharing your advice and experience.


gracenotes profile image

gracenotes 5 years ago from North Texas Author

Thanks for your comments, homemadeacnecure. I would also like to add that each individual experiences this disease differently! Different stressors can make things worse.


homemadeacnecure profile image

homemadeacnecure 5 years ago

very informative, great!


gracenotes profile image

gracenotes 5 years ago from North Texas Author

vdelarosa, I hope you and your dermatologist find something that works for you. Upon his retirement last year, my 67 year old dermatologist was still treating his skin for acne. That's probably why he chose his field. He always listened to me and my suggestions, mainly because I knew the disease as well as he did. Frankly, I'm closing in on my 6th decade.

There is a lot more available for acne now, although some of the treatments are expensive and inconvenient. Best of luck in your search for help, and thanks for commenting.


vdelarosa profile image

vdelarosa 5 years ago from Denver, CO

Thank you for this hub! I am in my early twenties and my acne has been the worse it's ever been. I have an appointment with a dermatologist next week, but I'm not to hopeful to be honest. I love to hear your suggestions. =) You are also a very organized writer!


gracenotes profile image

gracenotes 5 years ago from North Texas Author

Andrew,

Thanks for the tip. I might also try the zinc supplement.


andrewwilliams63 profile image

andrewwilliams63 5 years ago

Interesting idea about the ice, i will have to give it a go. I also fond a zinc supplement useful for acne control.


gracenotes profile image

gracenotes 6 years ago from North Texas Author

RTalloni, how many years did it take for me to have this knowledge..... makes my head spin! I appreciate the sentiments.


RTalloni profile image

RTalloni 6 years ago from the short journey

What a well written bit of good advice you have here. Very encouraging!


LizzyBoo profile image

LizzyBoo 6 years ago from Czech Republic

I so admire you Grace and I love your name Grace! I never give up!


gracenotes profile image

gracenotes 6 years ago from North Texas Author

Oh, LizzyBoo,

I do understand. Believe me.

Some of the things I recommended didn't work for my nephew, age 20. He is undergoing light treatments and responding well. Everybody is different.

Sometimes a drastic change of diet seems to work for people with long-standing acne. They get rid of dairy, or something else that is causing trouble.

I've even received lots of help from squeezing out a tablespoon of fresh lemon juice every morning, putting it in a glass of water, and drinking it down. I have heard that this helps your liver work better, and thus eliminates toxins.

Don't give up, Lizzy. I look forward to reading your hub.

Thanks for your comments!


LizzyBoo profile image

LizzyBoo 6 years ago from Czech Republic

I have a very bad skin and I really mean really bad. I have a acne from 12yers. I still have the kind of acne which leaves a scar on the skin. I have a dermatologist for 18 years now and not feeling any better. No one understand where it comes from as all my medical results are good. Thank you for the informative hub. I am working on a hub about my tipe of acne. Well done Grace


gracenotes profile image

gracenotes 7 years ago from North Texas Author

Thanks! I hope the ice tip makes a difference for you.


Gaget Girl profile image

Gaget Girl 7 years ago from UK

Good hub! Ive had acne most of my adult life and it certainly puts a dent on your self esteem. I'm keen to try your ice trick before going to bed!

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