Dealing with Severe Acne: Over-the-Counter Solutions and Skin Reactions

Severe acne problem?

I started getting acne in middle school, and it fluctuates between good and bad.
Although I've heard that not staying up late can prevent acne, I still break out regularly.
Most of my acne appears on both sides of my cheeks and is quite red, making it very noticeable, almost like a large cluster of pimples, which is quite frightening.
I rarely eat fried foods, and I've seen both dermatologists and traditional Chinese medicine doctors, but nothing has really worked.
Whenever I stop taking medication, my condition worsens.
I would like to know what over-the-counter medications are available that I can apply or take myself, as transportation is not convenient for me.
Additionally, I’m curious if doctors have heard of the acne gel produced by Mentholatum.
My skin is quite peculiar; it used to be fine when I applied it, but recently, my face turns red, it itches, and there’s some swelling.
However, when I tried it on the inside of my arm, I did not experience any such reaction.
I would like to know why this is happening.

Juzi, 10~19 year old female. Ask Date: 2005/12/22

Dr. Jiang Zheen reply Dermatology

Sometimes the skin on the face is not exactly the same as the skin on the arms, so I suggest you may want to stop using it.
As for stubborn acne, the most effective treatment is oral isotretinoin, as it can maintain remission for about 1-2 years.
However, this medication requires a doctor's prescription.
Wishing you peace, Jesus loves you.

Reply Date: 2005/12/22

More Info

Dealing with severe acne can be a frustrating and challenging experience, especially when you have tried various treatments without significant improvement. It’s important to understand that acne is a multifactorial condition influenced by hormonal changes, skin type, diet, and environmental factors. Given your situation, let’s explore some over-the-counter (OTC) solutions, potential skin reactions, and why you might be experiencing redness and irritation with certain products.

Over-the-Counter Solutions for Acne
1. Benzoyl Peroxide: This is a common and effective OTC treatment for acne. It works by killing bacteria that contribute to acne and helps to unclog pores. It is available in various concentrations, so starting with a lower concentration (2.5% or 5%) may be advisable to minimize irritation.

2. Salicylic Acid: This beta hydroxy acid (BHA) helps to exfoliate the skin and unclog pores. It can be found in cleansers, spot treatments, and lotions. Salicylic acid is particularly effective for treating blackheads and whiteheads.

3. Retinoids: While stronger retinoids are prescription-only, there are milder OTC options like adapalene (found in products like Differin). Retinoids promote cell turnover and can help prevent clogged pores, making them effective for both acne and acne scars.

4. Alpha Hydroxy Acids (AHAs): Ingredients like glycolic acid can help exfoliate the skin and improve texture. They can be beneficial for post-acne marks and overall skin tone.

5. Tea Tree Oil: This natural remedy has antibacterial properties and can be effective for mild acne. However, it should be used with caution as it can cause irritation in some individuals.

6. Moisturizers: It’s crucial to keep your skin hydrated, even if it’s oily. Look for non-comedogenic moisturizers that won’t clog pores. Gel-based moisturizers can be a good option for oily skin types.

Understanding Skin Reactions
You mentioned experiencing redness, itching, and swelling when using a specific acne gel (from Mentholatum). This could be due to several reasons:
- Allergic Reaction: Your skin may be reacting to one of the ingredients in the gel. Allergic reactions can manifest as redness, itching, and swelling. It’s important to discontinue use if you suspect an allergy.

- Irritation: Some acne treatments, especially those containing strong active ingredients like benzoyl peroxide or salicylic acid, can cause irritation, particularly if your skin is sensitive or if you are using multiple products simultaneously.

- Skin Sensitivity: Your skin may have become more sensitive over time, possibly due to environmental factors, changes in your skincare routine, or even hormonal fluctuations.

Recommendations
1. Patch Test: Before using any new product, perform a patch test on a small area of skin (like your inner arm) to check for adverse reactions.

2. Consult a Dermatologist: Since you have had ongoing issues with acne, it may be beneficial to consult a dermatologist who can provide personalized recommendations based on your skin type and condition.

3. Avoid Irritants: If you experience irritation from a product, stop using it immediately. Look for products labeled as “hypoallergenic” or “for sensitive skin.”
4. Maintain a Consistent Routine: Stick to a simple skincare routine that includes cleansing, treating, and moisturizing. Avoid switching products too frequently, as this can exacerbate irritation.

5. Lifestyle Factors: While you mentioned that you avoid fried foods, consider other lifestyle factors such as stress management, adequate hydration, and sleep, as these can also impact acne.

In summary, while there are effective OTC treatments available for acne, it’s essential to approach your skincare routine with caution, especially if you have experienced adverse reactions. Consulting with a healthcare professional can provide you with tailored advice and help you navigate your acne treatment journey more effectively.

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