Acne.org Products
First and foremost, I haven't been formally diagnosed with KP, but I am 95% sure that's what I've been dealing with for the past year. Now that I think I'm on the right track of treatment, I'm hoping to see some progress, and maybe my story can help someone else!
Relevant info:
23 year old female
Skin history--
Pale with freckles, burn fairly easily. No problems with pimples leaving marks or scars. Oily forehead and nose, normal to dry everywhere else (used to be oily T-zone, normal elsewhere)
Acne: Never considered it bad; I had some wicked forehead problems from about age 15-17, which I think my softball helmet contributed to. My back/shoulders were the worst from about 18-20 (late bloomer). Nothing that would've been classified as more than mild. Some problems with pustules near my ears and on my chin, on and off since about age 17. All of this has reduced DRASTICALLY in the past 2 years; back is almost completely clear, and used to be my worst.
Eczema: Problems around nose and corners of upper and lower lips. I used to use Elidel, but now it's under control with some OTC Neosporin cream
Sensitivity: CRAZY prone to heat rash; I also sometimes get heat-induced hives on my neck or upper arms (often from working out). Somewhat sensitive to scrubbing and certain products, but nothing too terrible.
Family: Just about every skin condition in the book. We have crazy sensitivity, eczema, psoriasis, moles, skin cancer, etc. etc. etc. Not much history of acne.
Story:
Almost exactly 1 year ago, I noticed my facial skin getting a bit dry (not surprising, since I was FINALLY past the oilier stages of puberty and I live in a cold winter climate). I decided to try out some face lotion (Neutrogena naturals) after never using a face lotion before. Around this same time, I also tried messing with some masks and stuff, just for fun.
About 2 weeks later, I broke out in what looked like a rash on my cheeks and neck. It was quite red, but not terribly itchy. I stopped using the lotion thinking it was an allergic reaction, but symptoms did not go away. The "rash" stayed, and I started to think it was acne, and began treating it as such. I used SA and BP products with mild improvements, but never anything great. I also noticed my skin was progressively getting red and blotchy, almost chapped looking, and that these marks were not going away.
I finally made a derm appt in April, but couldn't get in until mid-July. By the time I made it to the derm, the rash on my cheeks was much better, but was still on my neck under the jaw. Derm diagnosed it as acne (as I had myself), mainly based on location (which was more or less confined to the neck at this point). Sent me on my way with a prescription for tretinoin .1 and clindamycin, plus advice to use a BP wash. He looked at me for maybe 2 minutes.
Needless to say, this did not work at all. I jumped right into all this as well, as I was given few instructions. Irritation wasn't too bad at first, and I did not experience a "purge" as most people on tretinoin do (probably because I don't actually have acne). I dropped the BP wash, as it left my face red, and stopped the Clindamycin after a couple months. I noticed my face becoming more red and much more fragile, although the texture did improve. I couldn't stand the hypersensitivity I seemed to develop, however, and stopped everything after my follow-up at the derm in November. I told him the problems I was having, which had now progressed to some strange swollen areas on my neck possible lymph nodes) and he more or less brushed me off and just said I would get used to it. Yep, never going back to him. The weird swellings went away within about a month of stopping all of this, and have not returned.
I then tried to self-medicate. I got some Paula's Choice BHA, which worked well for a few weeks before it started to dry me out. I then tried using just Dove to wash, which dried me a little, but didn't make things worse.
I then started to self-diagnose; what I had did NOT behave like acne AT ALL. First, I thought it might be folliculitis, but the itching was not intense enough. Also, zinc soap had little effect (nothing bad, but no improvement either).
I went to a PA at my GPs office to get her opinion after a bad flare, and she was more helpful than the derm, by far. She spent about 45 minutes with me, talking, looking, and actually FEELING my skin. Her consensus: It looks like acne, but my skin is so DRY, and the bumps are SO. TINY. Neither of these is characteristic of acne at all. She gave me samples of cetaphil gentle wash and lotion, as well as recommended a mild BP wash (AcneFree, 2.5%) to help clean out the pores. I have a prescription for a much milder, .025 tretinoin cream if I would like to try it for skin texture, but she recommended trying a glycolic acid lotion first.
Back to my own research, and I kept coming back to the same thing: Keratosis Pilaris. I have always had this mildly on my chest and upper arms, and VERY mild on my thighs (gets worse with shaving), and I realize now this is probably what I've had on my forehead for years. It's much less red in these areas than it is on my face, probably because it is not exposed to the weather and is treated with fewer irritants. It's commonly misdiagnosed as acne, especially when it appears on the face. Here are the symptoms that match for me:
1. sandpaper skin texture: yes, yes, and more yes
2. Flesh-colored to red bumps that are localized around a hair follicle: I have a mix of flesh-colored and pink bumps, and they are always pin-prick sized
3. Bumps appear in clusters: I have TONS of bumps. TONS. And I can run my hand across my cheek, I can hit a patch that feels like sandpaper, followed by a silky smooth spot, followed by more sandpaper, and on and on and on
4. Bumps can become inflamed: I occasionally get these teeny, tiny pimples, almost like pustules. Unlike an acne pustule, these have no underlying inflammation or deep clogged pore. They are also never bigger than a pin prick.
5. Mild itching, especially in the winter
6. Worsens in cold, dry air (My cheek bumps cleared up about 70% last summer, before my derm appt.)
7. Dry skin
8. KP on the cheeks often causes a chapped appearance
9. Red patches of skin that don't go away
10. I can literally PULL tiny little plugs out of my skin with a tweezers sometimes. I can also "scrape" the pores clean by using a needle parallel to my skin (rather than perpendicular, like you would have to do with a zit). What comes out it either a whitish clump of what looks like dry skin, or a tiny, waxy plug; I have never had anything like this come out of pimples. It is very distinct
11. No comedones. I don't have clogged pores, anywhere other than by my ears. None. Zero. Everything is on the surface.
12. STUBBORN TO TREAT.
Sorry this is so long, but I just wanted to share and track my progress! Hopefully I can help someone out. Here is my current regimen, and my plans. I have to work into products VERY slowly, because I do have some sensitivity issues, which have been worse after my skin started getting dry in the winters. Tretinoin didn't help, either, but I feel like I've recovered since stopping a few months ago.
Plan: Use a BP an AHA lotion combo treatment, as SA tends to dry me out. BP will act as a mild keratolytic and will fend off the little tiny whiteheads from the infected bumps. AHA will help with texture. I am sticking with Cetaphil for both wash and lotion. I know the wash has SLS which some people swear against, but I've never had problems with it, and I seem to be responding fairly well to the wash.
Current regimen:
1. Wash, twice daily. Cetpahil gentle when I get up or after my first workout, Cetaphil-AcneFree 2.5% rotation at night (just upped using the BP 4 times per week, after using it 3 times per week for 2 weeks).
2. Moisturize after washing with Cetaphil cream
3. Control eczema with OTC Neosporin Eczema Essentials
4. Spot treat any pimples with Paula's Choice BHA (I only get about 3-4 actual zits per month, and they clear up very quickly for me).
5. I don't wear any makeup, ever. Never have.
After doing this for 2 1/2 weeks, all of my mild itching has stopped. About 2 weeks in, I noticed my bumps and red patches look a little more pink than red. Some bumps have flattened out a bit, particularly on my forehead. Lesser change on the cheeks, but still an improvement and a little less inflammation.
Plan:
1. Work up to daily BP wash
2. Gradually add in AHA lotion after another 2 weeks. I'm thinking either Dan's AHA or a Paula's Choice product.
Here are some pictures!!! These are SUPER zoomed in so you can actually see the bumps. None of these bumps are larger than a needle point. Also, the flash makes them look a bit more red. In "real life," they are a mild pink right now.
The first 2 are my right cheek. The first one shows the sharp difference between my cheek (bumpy) and jawline (smooth). The second one shows the difference between my bumpy cheek and my smooth eye/inner cheek area. The last one shows the spots under my jaw, and you can see how they do not look like those few blackheads back by my ear; sometimes these bumps will flare up down the front and sides of my neck as well (you can also see all my neck crinkles and funny pores on the front of my neck, but I feel like everyone looks like this haha!) The last picture is one I found online of someone's arm, and this is EXACTLY what I look like, but on my cheeks and neck.
Needless to say, this is crazy frustrating to treat! I will update every couple of weeks, hopefully with good things!
OK update #1 (now that the boards are working again!)
It's worth noting that I'm at the tail end of about a 2-week cold/bronchitis fest right now (working in a school is a complete germ fest haha!), and being sick always wreaks havoc on my skin (dry, irritation from constantly have a Kleenex on my nose and face, inflammatory response from immune system, etc. etc.) In any case, take any of the "bads" in this update with a grain of salt.
I attached a picture of my right cheek in the same lighting, same time of day as the first picture in my original post (this one is a bit more zoomed in). Not a big difference here, but you can see that the number of larger bumps has reduced quite a bit. You can also see how some of the bumps are just SCREAMING to be scraped off!!! Even if I can't see the difference so much in pictures, I can definitely feel how much smaller the bumps are.
So 1 month after the new regimen of BP wash and moisturizer (JUST worked up to daily BP wash at the 4 week mark), and here are the changes:
GOOD:
Bumps are less inflamed (my cheeks and neck feel more like 100 grit instead of 50 grit sandpaper...still very rough, but definitely more "fine" than coarse).
No more itching!!!! This is HUGE. All of the itchiness on my cheeks and neck has completely stopped, which I think I owe mainly to consistent moisturizer use. Less scratching also means less inflammation, so yay!
Seemed to smooth out the center of my chin. I didn't even know I had major clogs here, but apparently I did.
Mild "purging" of those pesky KP clogs (I lovingly call them "skin bits"): at about the 3 week mark, I could brush a ton of these little dry skin balls/clumps (same stuff I can extract from my pores) very gently off of my skin, particularly on my temples, forehead, chin crease, and jawline near my ears. I got a fair number of larger clumps off my cheeks as well, but these involved the gentle use of a needle to scrape; the ones on my cheeks tend to cling a bit more (maybe because the skin is thicker there?)
BAD:
Nothing major, but I do have some irritation bumps around my lips and "nose wings;" this was definitely at its worst one week after I added the BP wash, and seemed to flare up a bit after I bumped up to daily use. I am very prone to irritation in this area, so this is nothing out of the ordinary. Ever since I was a kid, just about anything that touches my face here poses a risk of irritation. Just some teensy tiny, but bright red, bumps. Nothing a little aloe or eczema cream can't soothe right up.
Dry chin and between eyebrows, slightly dry on nose and near ears. Nose and eyebrows seem OK now, but my chin is still flaky. I also can't put too much moisturizer here to combat this...seems to clog me up.
I hate having to use face lotion. Blegh. I'm getting used to it, though.
New plans!
I decided to use the acne.org AHA (seems to be more formulated for dry skin with its lotion texture than Paula's Choice, plus it obviously is formulated for the face) and my bottle arrived on Friday! I did the patch test below my jaw the first night and combo below the jaw/on forehead the second night. I felt ZERO reaction from it....some people in the reviews noted a tingling or burning, but I did not. Maybe the thickness of my KP-filled skin protected me from this haha!
Anyways, I used it full-face and neck for the first time last night (it's been about 27 hours). Obviously it's too early to tell anything (seems like people notice an improvement somewhere between 2-4 weeks after using). THAT BEING SAID...I do have a patch of dry skin clearly peeling off of my chin (trying not to pick at it!!!). I also have one random smooth(ish) spot smack dab in the middle of my forehead that I know was not there (plus, I used it 2 days in a row here with the patch test). I also have one oddly smooth spot (I'm talking BABY soft) on my right cheek that's amidst a sea of crappy little bumps. Maybe it was here before and I'm just noticing it since I'm looking for changes. Or maybe this AHA is crazy fast, and the BP/moisturizer combo has loosened a bunch of shit out of my skin for easy exfoliation. I mean it's legitimately like an inch-long smooth patch, not just one tiny spot.
Anyhoo, here's the plan:
Continue to wash with Cetaphil in the mornings and AcneFree BP at night; moisturize morning and night with Cetaphil cream except for the following addition:
AHA instead of Cetpahil cream, alone at full strength, every third night (1 on, 2 off pattern) for a minimum of 2 weeks. I would like to work up to every other day by 4 weeks time.
I know Dan says to use the AHA at full strength only 2-3 times per week (as I'm planning to start), but since the root problem of KP (beyond constant overproduction of protein) is just shit exfoliation of the outer layer of the skin, I think I should be doing it more than this. Also, I'm not using NEARLY the amount of BP that his regimen calls for, so I don't have that additional irritant. It also seems from reviews that a lot of people who don't have that tingly, burning initial reaction to AHA are able to use it even DAILY without problems.
Chemical exfoliation seems to be the first line of treatment (combined with moisturizing) for KP, and I'm been doing none of that for over 3 months now. Whoops. Soooo it stands to reason that I have my body's weight in extra skin protein built up in all these pores, so I'm not expecting to see any results for maybe 4 weeks. Lots of gunk to dig through, and my sensitive skin makes me start out slowly with any new treatment!
I'm optimistic about this AHA though, since it felt quite soothing to me. I even saw an overnight decrease in the redness of some of those irritation bumps around my nose. Time will tell!
Hi my dear, my goodness that looks eerily similar to what I've recently gone through!
Mine was pityrosporum malassezia fungus, and it was hell for a month.
If you're brave enough to step away from your regime and try mine for a week, it might help?
I used:
Dr Cynthia Bailey's zinc calming soap (alternate with Dr Bailey's zinc foaming soap every other day)
Then for ONE WEEK STRAIGHT, I applied Lamisil Dermgel on my face day/night.
Nothing else.
By the 5-7th day, you will see the bumps flattening and skin clearing.
After that, you can either continue using it daytime (I do!) and then if you use makeup - put makeup after it...
OR you can use it nighttime before you go to sleep and layer it under other mosturisers, BP, acne products you have.
It really worked for me - because my problem was fungal.
Lamisil dermgel is gel-based, it goes right into the skin and leaves little residue - great for oily skin like mine!
The facewash from Dr Bailey contains Zinc Pyrthione - a fungal killer, and her products are made SPECIALLY for facial fungus. I would highly recommend getting it from her website.
And LAMISIL is basically found in any pharmacies.
Oh... and please stop ALL Antibiotics, Anti-Histamine and Steriods medication immediately!! And continue eating plain yoghurt daily!
All the best! Do update!
Hey thanks for the reply! I actually did try a zinc soap very similar to Dr. Bailey's for about 2 weeks, as I suspected fungal as well. Absolutely zero change. I also don't think my itching is intense enough for it to be fungal. I don't use any antibiotics of any other medications for that matter, so we're all good there!
I am actually starting to investigate the possibility of a food allergy/sensitivity! It seems like a similar "rash" to this is quite common with dairy allergies (we do have a family history of milk allergies), so I am starting there. I also was getting hives at an increased rate, popping up around my mouth and neck. I was also getting eczema flares around my nose and mouth again, which has been an ongoing battle with me since childhood. Definitely both signs of food allergies. I also think that my limited success with topicals suggests a more holistic approach. Also, this rash starting to appear not too long after I was on a an antibiotic for a sinus issue, and I know antibiotics can royally mess with digestion.
I have officially finished 8 days of dairy-free, and I have not had a hive pop up for 3 consecutive days. After my 6th day of this new "diet," I came downstairs and my mom looked at me surprised and said, "your face looks so much less red!" I went to look in the mirror, and you know what? She was right. When someone who has seen you almost everyday for 23 years notices a difference, you know it's true. It looks like a lot of the transient inflammation in my face has gone down in a very, very short time. It is also worth noting that the little eczema bumps and dry patches around my nose are 100% gone at the moment, and the dry patches around my mouth are 50% improved. Plus, I started this about a week before my period, which supposedly increases skin inflammation inherently; I never really have any major breakouts with my period (maybe 1 larger zit in my typical problem areas), but it certainly would not be a time that things would look more clear.
Supposedly, dietary changes make a bigger impact after about a month (milk proteins can live in the system for upwards of 3 weeks), so I'll be giving this AT LEAST another 23 days. I am considering visiting an allergist to rule out any other possible contributors, but we'll give this the full month first. I am very, very optimistic, however, and I am certainly enjoying having less transient redness in my face, woohoo!
Hives and fungal are two different things!
In my case, I had food allergy (damn shrimps!) and I had hives popping up all over my body for one week. It was red and itchy and absolutely hideous. After some useless steroid and anti-histamine injections (which later caused my fungal infection), the hives didn't subside. So my mom resorted to smoking me with frankincense resin and THAT completely cured my hives!
Remedy for HIVES (those itchy welts) is FRANKINCENSE. You can buy the resin and smoke your naked body (in the bathroom of course) OR you can buy the Frankincense essential oil and dab it all over the hives.
For the FUNGAL infection itself, I would highly recommend LAMISIL dermgel. I applied it religiously for 7 days straight (day and night) and it really worked for me. After 7 days, I applied on/off on the remaining little devils that didn't subside and I am pleased to say 2-3 WEEKS later, my fungal is completely gone.
Just try that for 7 days (and nothing else - but wash your face regularly of course, preferably with zinc pyrthione soap) and see if it makes a difference.
All the best!
PS: Oh yeah, I didn't even need to change my diet (I'm a junk food girl!) and yet my face is completely clear. You don't have to 'inconvenience' yourself just to get clear skin. As long as you have products that work!
This will be my last update here!
After close to 2 weeks cutting dairy, I have seen a DRASTIC improvement that has been noticed by people who see me regularly. I can feel a dramatic improvement in the texture of my skin when washing, especially on my cheeks. I also no longer have that gritty sandpaper texture along my jawline for the first time in MONTHS. There is still a long way to go and possibly some more experimenting for me to do, but I know I am on the right track. I haven't seen any clearing like this from product use alone (and I've tried A LOT of stuff), and it feels amazing to finally have something make a difference. After having skin that has been somewhat inflamed for over a year, I know it will take time to fix all the damage. Luckily, no pitted scaring or anything like that, but there is still certainly some redness, dryness, and bumpiness to be solved. All of that has improved, though!
While some people may not have a dietary component to the quality of their skin, it seems to be a contributor to mine. It also seems to be common enough that it should be noted (especially if, like me, you developed a problem after antibiotic use). If you are someone with a rash-y skin condition that does not respond to topicals well, I would encourage you to experiment with your diet. Best of luck, everyone!