Monday, May 20, 2013

Holistic Approach To Acne

I wanted to do a post about what I've been doing lately for my skincare. Let me start by saying, if you're reading this post because you're struggling with acne of your own, I feel for you. This is something that I've been dealing with the past 10 years, and it's probably changed who I have become as an adult.

Besides the blow to my self esteem, my acne problems have caused me to do ridiculous things like: avoid the gym, not go to dance classes, pretend to be sick to skip school (while in high school), not go to the pool/beach with friends, grow terrible bangs that don't suit my face (to cover my forehead) and so much more inconceivable behavior. I'm sure some of you can relate to those things, and it's just terrible to realize missed opportunities because of bacteria in your pores on 4% of your body surface. Isn't that so silly to think about?

I have always struggled with acne, but since I turned 22, it's been more vengeful then ever: Cystic acne on my face and sooo many little bumps and whiteheads on my back as well as newfound oily skin (I have always had dry skin, and now it is completely the opposite). I have been on antibiotics since high school, and went back to the dermatologist (a different one) in Fall 2012. He prescribed an antibiotic that I had already tried years before (with no luck) and a topical retinoid. I played along, but after a couple months they hadn't worked, AND interfered with my birth control, which he assured me it would not. After trying pinocyclin, minocyclin, tetracyclin, and several non-antibiotic (hormonal targeted) oral medications, as well as a slew of different topicals, I was DONE with dermatologists. It just wasn't working and I was sick of it. So I stopped all the oral medications and reverted to the drugstore. I went to the strongest thing I could find (10% benzoic acid). It didn't really help, but it didn't really hurt, either.

I've always worked out and eaten pretty healthy, but around Jan 2013 I did my first juice cleanse, and started really caring about what I put into my body. I stopped eating processed foods to the point of about 90% whole foods only. I also upped my water consumption dramatically. After researching holistic acne supplements for a while, I decided to start a regime of Vitamin A, Vitamin E, Borage Seed Oil, and Zinc. I waited a few weeks and felt no effects.

I pushed it to the back of my mind, and kept focusing on my diet and exercise. I realized that with my new healthy diet, I should probably care enough to stop putting chemicals on my skin, as well. After some research, I decided to try the Burt's Bees Acne kit, since it has natural ingredients and is relatively inexpensive for a first try ($12 for the wash, moisturizer  and spot treatment). I didn't notice any improvement for 2 weeks, and then all of a sudden BAM acne like never before. Little tiny colorless bumps all along my hair line, big red bumps in the middle of my cheeks and forehead, whiteheads around my eye brows and on my temples, and painful cystic acne on my chin. It was unreal. On the two week mark of this new terrible acne I bought some Vitamin D3 and some "Get Gorgeous" tea. Today is the second day of this new addition to my routine, and this is what I'm going to review from now until (hopefully) some benefit is realized.

The "Get Gorgeous" indicates brewing 4 6 oz cups a day, and I'm taking 4000iu of Vitamin D3 a day. Every time I get in the sun for a few days consecutively, my skin clears up. Hopefully taking D3 will have the same effect. Last night I also made a face mask out of a used tea bag by opening it into a cup with a teaspoon of honey, warming to mix, and spreading it over my face for 25 min. I'm going to try and do that every night with my last tea bag. Can't hurt, right?

I'll keep you posted on how the D3 and tea work. By the way, I'm still taking the other supplements because they actually have improved the acne on my back. Not completely gone, but better then previously.

Day 3: So this is day 3 of the tea/vitamin D experiment and I have no new things. Aside from not getting any new painful cystic pimples since yesterday morning, my face doesn't look any different. It's actually super greasy today and looks like a leathery texture. It's terrible. Hopefully tomorrow will bring better results!

Day 5: Well yesterday I was feeling the slightest bit encouraged about my skin, but I didn't want to jinx anything, so I kept quiet. Today I actually think it looks a little bit better. I broke down and popped a few of the big ones last night (so much regret.) so they are obviously red because of the blood that gets stuck...sorryforthat....but my forehead and cheeks are actually looking a little clearer. And something strange has happened for the past few nose is totally clear! I popped an extra 2000 IU of D3 last night, so maybe I'll up the D3 for the next couple of days to see if it helps at all. I'm also going to my boyfriend's lake house for memorial day weekend, so if I can catch a few rays that would be fantastic for my skin. I'm worried about swimming and having to be makeup free because his whole family will be there, but I guess I'm just going to have to put on my big girl panties and realize that no one gives a damn about my stupid acne but me!

I forget that sometimes...

I just touched my back and realized it's way smoother then earlier this week. I am almost elated, but still worried that acne gods will anger if I celebrate.

Day 9: Okay, here's the thing: my back is like a baby's bottom except for two big cystic lesions. My face...not so much. I got plenty of new pimples over the past few days and some painful ones, too. I decided that since my back is behaving wonderfully it has to be the Burt's Bees face wash and moisturizer that's causing all the breakouts. Not only that, but I've noticed that my face is scarring. I stopped using the Burt's bees yesterday, and I got some Cetaphil last night. I think the Burt's Bees was too drying for my face. My mom got me some Sea Buckthorn Seed oil, so I'm going to try that, too. It seems like if you have oily skin, it means you don't have enough oil in your skin. Whiiiiiich is very counter intuitive, but I'm going to give it a try.

NEW REGIME: Zinc, Vitamin A, 6000 iu of Vitamin D3, Vitamin E, about 10 g of Fish Oil, Borage Seed oil. Use Cetaphil twice a day, with Sea Buckthorn Seed Oil twice a day, and Oil of Olay with spf in the morning only. 

Please let this work.

Day 4: Alright so now it's day 4 of the new regime, so here's an update. I had a lot of whiteheads yesterday...which is how the other regime started so I'm not necessary thrilled or excited about "purging" which is what some people would say it is. I'm not a believer--yet. Also, all the reviews I've seen have touted the sea buckthorn oil's ability to squelch redness, which I have not noticed yet, although I've also had the incredible urge to pick my face since it's filled with tender little pustules that need to be popped. Or so my brain thinks. Do I sound negative? 

We'll see in a few days if this is the way to go or if I need to try something with some sort of acid again. OH, I've also used honey and cinnamon on a few of the bigger spots twice within the past 4 nights. Just as an FYI.


Day 8: Now that it's been about a week on the new regime, I have to say I think I'm actually clearing up a little bit. I didn't want to say anything prematurely, but some of the acne that was on my cheeks is gone, and a few of the smaller bumps around my jawline and hairline are gone. I'm still getting cystic acne on my cheeks and t-zone, however. I have to buy another bottle of the Sea Buckthorn Seed oil, although I'm not sure if that is what is helping or the fish oil. I've actually been taking about 7 g of it a day now (6 1200 mg pills spread out during the day). And I just ordered some organic fish oil that has an orange flavor...hopefully that will cut back on the fishy burps *gross*. I sorta stopped with the Get Gorgeous tea...I didn't see any results. I like the taste so I'll drink it casually, just not 4 CUPS A DAY. It's...a little excessive.

I'll update again in a few days!

~feeling more optimistic~

Day 10: Well My skin is still getting a little better in terms of the little pimples, but I really am still getting a lot of painful, cystic pimples. And in places I never used to get near my upper lip, and around my eyebrows. Basically high-movement places. It's still perplexing, and I'm not sure if this routine is going to address those types of lesions. I'll keep going, though, and let you know if it gets better!

Day 14: So I've been taking the Fish Oil for about 15 days now, and I'm seeing some slight improvement in the acne on my forehead. I'm not seeing any progress in the painful, cystic acne around my temples, on my cheekbones and around my mouth, however. I've been following thelovevitamin's blog about her skin care routine, and I decided that I'm really a dummy for not seeing that my acne is hormonally linked until now. I get worse acne right after my period is over, and I'm having a flare-up now in my early twenties, when my hormones are adjusting from puberty. Also, I've always had irregular periods (starting early and lasting more then a week) and recently they've changed to being very short. This is a RED FLAG that my skin issues are hormonal. In addition, my bacne is much better (probably from the supplements) so since my face isn't getting better it's obviously not because of a deficiency in vitamins and minerals.

So on Saturday I bought some DIM plus! I'm really excited to think that this could finally be the missing part of my skin-problem puzzle. I'm taking two in the morning and two at night, and I'm also adding Turmeric into the mix as another anti-inflammatory (in addition to the fish oil). The manager at Vitamin Shoppe in Crofton was just as helpful as could be. I was about to buy some milk thistle, but we consulted and decided that if the tea with burdock root and chasteberry didn't do anything, then milk thistle would seem redundant (since it has the same liver-cleansing benefits). 

I'm really excited that DIM also has a ton of other benefits-- if the excess bad estrogens are my problem, then I should also benefit from reduced fatigue, fat-loss, and mood-boosting properties. I've already felt a benefit to my mood from taking the fish it can only get better!

I really hope I get into the holistic nutrition program I applied to...I'm learning so much just trying to figure out my own problems. If this works for me, I'll be so excited to help others on their journey to optimum health.

Day 16: Okay guys. I'm really jazzed right now. I haven't noticed too much of a help yet from DIM plus, but I have really figured out a lot about my hormones, and I'm actually really confident that this is going to be the plan that works for me. Also, I think it's making me more energetic, positive, and clear-minded because I have felt like I could conquer the world these last few mornings.

Since I've been doing the raw honey masks, I've noticed some more white heads and I unfortunately succumbed to picking last night. I know it doesn't help, but in my convulted mind I feel like I'm helping rid my face of toxins when I do it. Anyways I picked and then immediately put on a honey mask so I couldn't do any more damage. I have noticed this morning that my skin isn't as oily (and it usually is oily by this point in the day). I'm considering trying a topical progesterone as well because I'm certain my hormones are way out of whack. Let's look at my symptoms that I have been ignoring for, oh, about two years now.

1) Irregular periods: I have not had a month where I haven't spotted for the past two years. Sometimes I spot up to two weeks out of the month, and then have my period for the week following the two weeks.

2) Recent change in period: My week of period has changed from a full week to about 2 days in the past 6 months.

3) Crying at the drop of a hat. I have had issues with crying since about senior year of high school. I even went on antidepressants because I cried every time I thought about school and the MCATs. I realize now that, while I definitely did need to deal with my stress at the time, I was not depressed and did not need to take meds for it. Thankfully I came to my senses about 6 months after starting taking them.

4) Stubborn fat. I eat a 90% whole foods diet, and do intense weight training and cardio 4 days a week. However, I've still held on to stubborn fat around my hips and thighs. This is attributed to high levels of estrogen and lower levels of progesterone (and therefore high levels of testosterone). 

5) Acne that varies with my cycle. My acne always gets worse right after my period. This is opposite of many women who have worse acne right before their periods. My conclusion is that, since I'm on BC I do not ovulate,and thus do not produce the copious amount of progesterone that a woman with a normal cycle would, it must be that my estrogen levels are lower at the point, which leads to a clearing of acne right before levels start to peak again. I looked at a lot of hormone charts to decide this, and took into account that hormones would not immediately produce acne, but must have a lag time to allow change.

I can't believe I've just been pushing these issues to the back burner, when it's obvious that my anxiety and skin issues have been caused by hormonal imbalances. I know that birth control is the root cause of this, but I can't risk not being on contraceptive. If this trial with DIM does not prove to be effective, I know I'll have to take another measure to fix the problem.

Day 30: Well I have switched birth control. As soon as I start my period my acne gets better...which is pretty much opposite of the normal so I could only assume it is my birth control that has caused this terrible outbreak. I started Loestrin around Dec to help with breakthrough bleeding (monophasic vs triphasic) and although it helped a little, I started noticing that my face was oily around Feb. I have never had oily skin, so this seemed weird to me, but since my period was different too I just kinda attributed it to a young adult change in hormones. It is pretty clear to me now that my acne is because of the Loestrin: Loestrin has moderate androgen activity due to the type and level of progestin (progestin is the word used for any compound that elicits progesterone activity). I am already quite athletic, so taking something that increases my androgens (the biggest and most well-known androgen is testosterone) would have a compound effect and probably tip me in the wrong direction as far as my androgen/progesterone balance is concerned. 

I did a lot of research and decided to talk to my doctor about three main birth controls I was interested in taking: Yaz or Yasmin, Mircette, or Zovia. We had a really good conversation and I made sure to mention that I have had issues with a) (obviously) Acne, b) Break-through bleeding, and c) depression/anxiety in the past. My issues with anxiety were probably related to the ortho-tri cyclen which I took for about a year over 2011 to 2012, coinciding with my MCAT prep and testing. I never put the two together, and instead of asking about the timing of the symptoms in relation to the birth control switch, doctors put me on Pristiq. Obviously I should have done some more research about the anxiety, but since I was anxious about not having enough time for classes and test prep I guess it makes sense that I didn't.

Anyways, we decided on Yaz, because it has the same spirinolactone-like activity as yasmin, but a lower dose of estrogen to combat side effects such as nausea, mood swings, and weight gain/bloat. Today is my second day on it and hopefully things will start clearing up soon *pleaseohpleaseohplease*

Day 37: So I have been on Yaz for a week now, and here's the changes I have noticed: not much. My skin has been oilier the past two days, and there maybe a slight reduction of smaller pimples. The large, painful, cystic ones, however, are still at large...and I mean large.  I have at least 10 of them at the moment. Beautiful.

I know it's still really early, so I'm optimistic. I haven't had any side effects, yet, except a slight dizziness which I also experienced when I was on spirinolactone, so I'm pretty sure it's due to the Yaz. No breakthrough bleeding, headaches, sore breasts, etc. so that's good at least :)

I decided to start some topicals while waiting for the Yaz to kick in, since I'm only doing occasional raw honey masks, Cetaphil twice a day, and sea buckthorn seed oil/Oil of Olay for moisturizer. 

I went to Mom's today and picked up some Dr. Ohhira Kampuku bar because I've never tried a probiotic fash wash before. I also got Pure and Clear acne gel, and Pure and Clear Nourishing Moisturizer because I was out of moisturizer anyways, and I thought maybe I should try one that's meant for oily skin. So basically another $30 for more acne products. Sigh.

Day 39: (Day 11 on yaz): After looking up lots and lots of reviews on Yaz, I feel comfortable that my face is reacting to the birth control. I have a lot more cystic spots then I did before, and they're the deep painful kind, but yet have a head. I'm strangely calm about it, because I know there's an adjustment period, and I'm expecting that after a month they'll be gone. That's only another two weeks! I can do that! The smaller pimples have started to clear up, and I'm liking the new face products I got the other day. The lotion works well, not greasy, and the spot treatment smells fantastic and makes my face feel cool--like it's working haha. Whether or not that's true....

Day 46: (Day 18 on Yaz): Today is June 11, 2013 I've been trying to stop looking up forums about Yaz because there aren't any new ones that I haven't read's just not healthy. Stressing is only going to make it worse. And when I say worse, I cringe because I'm not sure if anything could really get worse. The only clear parts on my face are my nose, and the underside of my eyes surrounding my tear ducts. Otherwise there are cystic pimples. The ones on my cheeks are angry, too. They sorta blend together into one huge mass of inflamed redness that occasionally grows heads, but heads that don't do anything to deflate the mass when prompted. I know I shouldn't "prompt" but from the side view my face is like a hilly mass. Is this making you feel sick? Apparently a lot of people had bad cystic issues around the second and third week, and possibly continuing until the second month. This is quite disheartening, but I have to remember that the terrible-osity from Loestrin didn't show up until 4 months after taking the pills. I'm about to start a master's program in nutrition and integrative health in the fall, and I feel like people will jump to the conclusion that I must not be serious about health since I'm obviously not taking care of myself. People probably aren't that jump-to-conclusion-y, but I'm just projecting the worst. September--that's two months after I started taking the Yaz...all of my body parts are crossed in hopes that this will help. Oh look, my acne is crossed too...

Day 105 on Yaz: Today is September 6, 2013 I stopped posting about my progress for a while because, well, there wasn't anything new to report. Until about day 84 on Yaz there was only sadness and acne to be had. BUT THEN I noticed there were fewer lumps forming. I noticed a slight improvement, and then I would get a breakout and my hopes would be crushed. But at this point I can tell it's definitely better. There are fewer new pimples each day, and only a few in the past week have been cystic. Yaz has definitely decreased the quality of my skin, however, which makes it hard to tell what's hyperpigmentation, what's a scar, and what's an active pimple. Actually, before Yaz I've never had a problem with hyperpigmentation or scarring. My skin has always bounced back...literally. I can tell now that I have at least a few ice pick scars around my mouth, one crater-like scar on my forehead, and then a ton of red hyperpigmentation on my lower cheeks that is slowly slowly fading. I've been using 100% pure aloe vera every night and morning before moisturizing to help encourage healing. The cystic pimples I have gotten in the past couple of weeks have been behaving they pop easily when I wash my face, and then drain so there is a huge black hole left behind. 

To be honest, if you're reading this contemplating Yaz or any other birth control to help your acne, and not just as a contraceptive, I would advise against it. Yes, I'm finally getting my skin under control, but I believe it would have subsided by now if I had just stopped taking any birth control at the same I started taking Yaz. The cause of my acne was birth control, the cause of my WORSE acne was MORE birth control, and the cause of my poor skin quality even after the acne is subsiding is the more birth control. Pumping estrogen and drospirenone into my body every day is probably also increasing my chances for developing breast and ovarian cancer. I know if I stop taking the Yaz, I'm most likely going to go through another 3 months of break outs while my body adjusts, and I just as well could have already been done with that detox by now. 

Hindsight is 20/20, but please use my experience as a case study for you, so you don't have to deal with dry, pitted skin after already dealing with the emotional burden of acne. 

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