Question
Face
Hi,
I am 21 and have never had a problem with acne before in my life. Back in October I got a bad inner ear infection and needed to take steroids. About two weeks after that I broke out really bad all over my forehead. Since then about every two weeks I would break out on my forehead. But for about the last month It hasn't gone away and I am starting to break out on my cheeks below my cheek bones. The rest of my face is staying clear though. I have no clue what is going on! The pimples are more just bumps though most will go away and new ones will form but some will turn into white heads. And the skin on the bad areas is usually light red/pink.
I am on yaz birth control and have been for a couple of years now. About three weeks ago I started using proactiv to see if it would help and nothing has happened yet. In fact after I use the toner my skin will burn a little but after I use the green tea moisturizer it goes away. I have very pale sensitive Irish skin. Any idea about what is going on would really help!
AnswerHi Ali!
You have likely identified the source of the breakout problem - the steroids. Steroids are known to create this issue in a considerable number of people. How long this acne continues to remain a problem, however, varies by the person.
In some cases breakouts will clear up very quickly after discontinuation of steroid treatment. In other (and more extreme cases) the breakouts actually worsen after discontinuation of steroids and some people require extremely strong prescription drugs like Accutane to finally clear the problems.
Typical steroid acne will result in a large number of small pink bumps (papules) and occasionally these may turn into pimples/whiteheads. The breakouts are often confined to a specific area and may affect the face or body.
From your description and the photo you've shared - the breakouts definitely seem to fit the above descriptions. It is important to note that although I am a licensed skin care professional, I am not a medical doctor. Any advice I offer you is intended to improve the appearance of your skin and is not intended as healthcare advice or to diagnosis any illness. Don't ya love the disclaimers!?
Moving along:
Steroids appear to increase a specific type of yeast (pityrosporum) in the hair follicles. This yeast is naturally found in the follicles and isn't typically problematic. It's only an issue when there is an over abundance of the yeast. Excess amounts of this yeast in the skin can cause breakouts as well as mild itching and sensitivity.
The fact that you're using Proactiv and not seeing a result is also indicative of a possible yeast problem. Proactiv is a benzoyl peroxide product. Benzoyl peroxide is primarily antibacterial rather than antifungal. If your problem is yeast, antibacterial agents will not be effective - you'll need antifungal agents to address the problem. Benzoyl peroxide products can be very drying and when overused or used improperly they may dehydrate the skin and remove healthy, beneficial oils. This can result in damage to the skin and worsen problems. If you experience any increased sensitivity or feel that your skin is drying out, definitely remove benzoyl from your skin care line up. There is no real reason to continue working with it if it is not producing a positive result with your breakouts.
What to try:
Specifically - try antifungal agents. You can do some research online to find out about a whole host of acne fighting antifungal treatments both over-the-counter and prescription. A few ingredients that come to mind are clary sage and tea tree oil. Keep in mind that essential oils can be extremely strong - so be cautious and don't apply an essential oil all over your skin. If working with the oils directly, they'd need to be properly diluted. There are a number of products on the skin care market that contain these ingredients so you may want to look for skin care regimens that include them. Another powerful antifungal and anti-inflammatory agent is azelaic acid. There are professional (but non-prescription formulas) available from various skin care companies and there are prescription strength versions available through your doctor.
Speaking of doctors: There are many, many antifungal agents available by prescription. I would definitely consider looking into a prescription strength antifungal medication.
I hope this offers some insight into what may be happening within your skin. I wish you the best of luck in clearing up your breakouts - I know they're NO fun!
Casey Durrett, LEI
www.skinphd.com
skinhints.blogspot.com
P.S. Ali, I've updated this entry just to add a word I accidentally left out in my orginal message! In the section where I've mentioned the essential oils, it's important *not* to put them all over your skin!!! I left out the "don't" in my original message! Oops!
