Struggling with Acne: Persistent Redness and Peeling Skin Solutions

Acne

Hello doctor, I've been troubled by acne for several months.
I have seen a doctor and taken medication for over a month, and I have also been applying azelaic acid for more than a month, but there has been no improvement.
Although I don't have acne on my face now, both sides of my cheeks are red, and it seems like there is some peeling as well.

Lin Bo-gang, 10~19 year old female. Ask Date: 2022/01/31

Dr. Wu Yuxin reply Dermatology

My cheeks are red and seem to be peeling a bit.
Could it be due to the irritation from the ointment itself? I should discuss this with my doctor.

Reply Date: 2022/01/31

More Info

Dealing with persistent acne and the resulting skin issues such as redness and peeling can be quite frustrating. It sounds like you've been through a lot in terms of treatment, and it's important to understand the underlying factors that could be contributing to your current skin condition.

First, it's essential to recognize that acne can lead to post-inflammatory erythema (PIE), which is the redness that remains after acne lesions heal. This condition is common and can take time to resolve. The redness may be exacerbated by various factors, including environmental conditions, skin care products, and even the medications you are using.

In your case, you mentioned using azelaic acid (杜鵑花酸) for over a month. While azelaic acid is effective for treating acne due to its anti-inflammatory and antibacterial properties, it can also cause irritation, especially if used in conjunction with other potent treatments. This irritation can manifest as redness and peeling, which may be what you're experiencing on your cheeks.

Here are some steps you can take to help manage the redness and peeling:
1. Gentle Skin Care Routine: Switch to a gentle, hydrating cleanser that does not strip your skin of its natural oils. Avoid harsh scrubs or exfoliants, as these can worsen irritation.

2. Moisturization: Use a fragrance-free, non-comedogenic moisturizer to help restore your skin barrier. Look for ingredients like ceramides, hyaluronic acid, or glycerin, which can help retain moisture and soothe the skin.

3. Sun Protection: Protecting your skin from UV exposure is crucial, especially when dealing with redness. Use a broad-spectrum sunscreen with at least SPF 30 daily, as sun exposure can worsen redness and prolong healing.

4. Limit Active Ingredients: If you're using multiple active ingredients (like azelaic acid, retinoids, or benzoyl peroxide), consider simplifying your routine. Too many actives can lead to irritation. You might want to alternate days for different treatments or consult your dermatologist for a tailored regimen.

5. Consider Anti-Inflammatory Treatments: Topical treatments containing niacinamide or green tea extract can help reduce redness and inflammation. These ingredients are known for their soothing properties.

6. Consult a Dermatologist: If the redness and peeling persist, it may be beneficial to consult a dermatologist. They can assess your skin condition and may recommend treatments such as topical corticosteroids for short-term use to reduce inflammation or other prescription medications that can help with redness.

7. Patience and Consistency: Skin healing takes time, and while it can be disheartening to see persistent redness, consistency in your skincare routine is key. It may take several weeks to see improvement.

In summary, while it’s understandable to feel frustrated with ongoing skin issues, focusing on a gentle skincare routine, proper hydration, sun protection, and possibly consulting a dermatologist can help you manage the redness and peeling effectively. Remember, healing is a process, and with the right approach, you can achieve healthier skin.

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