Life + Health + Vanity + Wearables

About skin, revisited.

Just about a year ago, I wrote a post about my skin, specifically about coping with adult acne at the (then) age of 37. It was tough to write, but I’m glad I did it. I have spent a lot of years of my adult life feeling ashamed for not having great (or even good) skin, and for not finding solutions in the simple, natural methods that have worked for so many. At the time I wrote that post, I’d been following a regimen recommended by my dermatologist for about six months — and my skin was looking pretty good. Not perfect, but I felt better about my face than I had in many years. The only prescription I was using at the time was a combination topical antibiotic/retinoid called Ziana, and it was working really well for me.

This past June (almost exactly one year after after I started the regimen and the Ziana), though, something changed. Suddenly my skin was getting lots of clogged pores, and I was started to get cystic breakouts again. It seemed like it was overnight, and it was very upsetting. First I worried that I’d developed an antibiotic resistance, then I worried my Clarisonic was harboring bacteria (even though I clean it thoroughly after every use and change the brush head as recommended)…I panicked. I waited a couple of months and blamed stress. I blamed lack of sleep. And then I stopped being dumb, and I went back to the dermatologist.

I don’t know why I waited so long. I guess it was that sense of shame again, like the doctor was going to tell me I was doing something wrong or that I was apparently untreatable and was destined to a lifetime of looking like a goblin. She didn’t say either of those things, of course (tip: if you doctor calls you a goblin, find another doctor), but instead said that she suspected the dosage of tretinoin in Ziana (.025%) was too low for me. OK!


So here’s what I’m using now. It’s been about two months, and HELLO! My skin looks pretty good, and every day it looks better. I still have a lot of discoloration from past breakouts, but it’s fading gradually and is relatively easy to cover in the mean time. I don’t think I’ll ever think I look good without makeup on, but at least now I don’t think I look diseased when I walk in the bathroom in the morning. At age 38, I can finally even bring myself to be around a friend (AT HOME! Let’s not get carried away…) in the evening after I’ve washed my face. That’s big for me. I think it’s been about five weeks since I’ve had any sort of breakout, and even then it was minor.

Anyway, here’s the current product lineup:

1. Neutrogena Fresh Foaming Cleanser
Yeah, on some level I still feel like this is chemical-laden, unglamorous garbage and I kind of do wish I could wash my face with, like, virgin coconut oil and fulvic-enhanced mineral water (heh), but it’s $5 and it works so I just don’t even care anymore. I use it twice a day, once in the morning, then twice at night — once to remove makeup, then again right after with my Clarisonic.

2. Clarisonic (20% off at right now, FYI)
I always come back to my Clarisonic. Whenever I think it’s failing me, it turns out it was actually something else. Like I said, I’m diligent about keeping it clean and changing the brush head (I always use the ones made for delicate skin). I love my Clarisonic, and I feel badly for ever doubting it. I’ve actually had a couple of terrifying dreams in which I find myself Clarisonic-less, which is admittedly kind of sad but also very telling and let’s just blame stress for everything.

3. Kiehl’s Midnight Recovery Complex
This incredible serum has mostly taken the place of my former favorite, Huile Prodigieuse, as a nighttime treatment. I still use Huile Prodigieuse during the day if my face feels tight, and it’s great in my hair, but the older I get the dryer my skin…and I needed something more intensive. I’d gone through a couple of sample bottles of the Midnight Recovery Complex when it was first introduced and really liked it, but I didn’t fork over the money for a full-size bottle until last June. It’s wonderful stuff. Magical, even. I only use it at night, and because I just need 2-3 drops to cover my whole face, one bottle will last a really long time.

4. Kiehl’s Creamy Eye Treatment with Avocado
Yep, my old standby for the past five years. As much as I hope to someday find an eye serum that can rid me of my undereye circles, this cream remains the only one I’d found that truly keeps my eye area hydrated in the colder months. No matter how many other eye creams I bring home samples of, I always wind up coming back to this one. Again, as with most Kiehl’s products, the price tag is offset by the generous amount of product. One jar of this eye cream lasts me almost a year.

On to the prescriptions…

5. Retin-A Micro
I actually use a generic version of this, which I think came out to something like $8 for three big tubes with my insurance. My dermatologist prescribed it in .04% retinoid strength, which is nearly double what I was using before in the Ziana (.025%). Unlike Ziana, it does not contain an antibiotic. I use it nightly only, never during the day. Retin-A works by increasing the rate of your skin’s cellular turnover, which means pores are less likely to clog, decreasing pore dilation and (of course) breakouts. It also boosts collagen production, so fine lines and sagginess are diminished. And it really works. Apparently I won’t see the full effects until I’ve been on it for the better part of a year, but it’s made an enormous difference in the clarity and smoothness of my skin already. There was an adjustment period in the form of breakouts and dryness when I started using it, but it wasn’t horrendous — probably in part because I’d already been using a lower dose of retinoids for a year before starting. I do have some adjustment advice, though…

Anna’s Retin-A tips:
✚ Wait at least 10 minutes (preferably 20) after washing your face to apply it. Really for real. Retin-A and water are not friends. If you don’t wait, you are just asking for over-dryness.
✚ ONLY USE A PEA-SIZED AMOUNT. That means a standard green pea, not a chickpea or a lima bean. PEA-SIZED. Squeeze it into your hand, dot it all over your face (avoiding the eye area), then rub it in. It’s not a spot treatment or a mask. Take it easy.
✚ If your skin is getting really dry, apply a light moisturizer first as a barrier. I always put my Kiehl’s serum on right after washing, then wait 20 minutes before applying the Retin-A.
✚ If you feel like you need to skip a night, skip a night. In fact, you might want to start out only using it every other night until your skin adjusts. Everyone is different. Pay attention to how your skin is reacting, and know that the adjustment period of flaking and breakouts is NOT forever.
✚ USE SUNSCREEN during the daytime. Retin-A increases your skin’s sensitivity to light. Don’t mess around with this one. Please.

6. Aczone Gel
Aczone gel is a relatively new medication, but its active ingredient, dapsone, has been used as an anti-inflammatory/antibacterial for a long time…including as a treatment for leprosy. And hey, if it’s good enough for lepers, it’s certainly good enough for me! Seriously though, I’m amazed by this stuff. It’s a gel formula that goes on really nicely, and it’s kept me totally free of any cystic breakouts that Retin-a alone can’t prevent. I use it twice a day (at night after applying Retin-a, and in the morning under my makeup). I saw pretty much immediate results when I started using Aczone — by the next morning anything inflamed on my face had calmed down, and I haven’t had a recurrence since. I don’t even have any tips for using Aczone because it’s so gentle and (at least for me) totally non-irritating.

One downside to Aczone is that it’s new enough that there’s no generic option, and the price tag ($200 for a one month supply!) is prohibitive if you either don’t have insurance or if your insurance won’t cover it (mine won’t, and I have really good insurance). That said, there are coupons you can download to reduce the cost (man, the prescription drug industry is soooooo, so super shady…). I was able to get a three month supply (90g tube) for $25, which is totally worth it. If the coupons stop working…well, let’s not think about that.

So that’s it, really. I still have not found a sunscreen I love, so I won’t share a recommendation. That said, if you have one you love that’s broad-spectrum and nice under makeup, I’d love to know about it! My favorite sunscreen (a lightweight spray from Paula’s Choice) was discontinued a couple of years ago, and I’ve been wandering aimlessly through disappointing alternatives ever since.

One more thing for those of you who have had to deal with similar skin issues: If something isn’t working (even if it used to work!), don’t give up. If you can go to a dermatologist, do it. There are so many options for treating problem skin, and I really, truly believe that improving your emotional health through dealing with those problems is incredibly important. It’s not just about vanity, and there’s not going to be one thing that works for everyone. This has been a very long struggle for me, and I am under no illusion that this is going to work for me forever. I have to do something, though, and it’s a massive relief to have found the right thing for me…for now.

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  • Reply Marlena November 21, 2013 at 11:14 pm

    I haven’t splurged for the clarisonic yet, but I got a Japanese facial brush from my local coop, and that has made a huge difference on my skin. I have rosacea, and I think using the brush helps the medication seep in and my makeup rest a little better, too.

    Fun tip for Kiehl’s stuff: buy your items from the Portland, OR store. They have no sales tax and they ship for free.

  • Reply Vibeke November 21, 2013 at 11:26 pm

    I have sensitive, fair skin and have to use a sunscreen every day. I used Neutrogena for years and finally asked my dermatologist for recommendations because Neutrogena kept breaking me out and was so oily. She recommended EltaMD, and it’s great! They have one especially for acne prone skin which is the one I use. It’s SPF 46 and so lightweight! I put it on after moisturizer and before applying makeup. You can buy it on Amazon for about $20. A little pricey but worth it to be breakout free!

    • Anna @ D16 November 22, 2013 at 9:11 am

      Thanks, Vibeke, I’ll look into the EltaMD!

    • Donna November 24, 2013 at 7:01 pm

      EltaMD sunscreens are amazing. Even the moisturizing version didnt break me out. I think all of the are chem sunscreens though. I first tried it when I visited Shen Beauty in Brooklyn and they provided me with samples to try. Great stuff.

      I’m always thankful for your skin posts. It sounds like we have similar skin and I’m 38 too. This year there’s been a ton of stress in my life and my formerly pretty clear skin is now plugged up and reacting to everything old and new. I’ve wanted to try a Clairsonic to see if it might help and years ago I was on retin A also but that was a decade ago. I’m worried my acne scars are never going to fade. And it’s frustrating cuz I’m a clean eater, eat little meat, no dairy. I do run a lot and wear lots of sunscreen when I do so I think that and stress is clogging my pores and my usual exfoliants are not cutting it anymore. It is depressing when suddenly you find yourself with flare ups you’ve never experienced to such a degree and they leave marks.

  • Reply Jennifer November 21, 2013 at 11:31 pm

    As a 33 year old also dealing with adult acne, HI! For sunscreen, check out Suntegrity. I use their tinted SPF 30 for my face on a recommendation from my esthetician. Like most moisturizers, you want to let it sit for a few minutes before applying make-up, but it gets the job done without contributing to acne, without nasty chemicals and without the tell-tale white smear.

    • Anna @ D16 November 22, 2013 at 9:12 am

      I haven’t heard of Suntegrity before, thank you!

  • Reply Shilo November 21, 2013 at 11:41 pm

    I heartily recommend MD Solar Science Mineral Creme sunscreen. I use the non-tinted formula which I either buy online or at Thompson Chemists on West Broadway. At $30 a tube it’s not cheap, but it goes on matte and has an amazing silky primer-like texture. It’s all physical blockers which is good for irritable skin (as well as for all-day sun protection), but miraculously does not leave a white cast once applied. I actually think it gives me a lightly blurred look ala pressed powder because it is so matte.

    If you’re hesitant, ask Thompson for a sample, they might not have them anymore because of the season, but it’s worth a shot.

    • Anna @ D16 November 22, 2013 at 9:13 am

      Oooh, any excuse to to Thompsons! 😉 And you have the most amazing-looking skin, Shilo…

  • Reply Nicole November 22, 2013 at 12:00 am

    Ever since going off the dreadful birth control, my skin has been a MESS. I want to avoid putting chemicals on my skin, but washing with straight up coconut oil and using tea tree oil as a spot treatment isn’t helping. Breakouts galore! I’ve been eyeing up the Clarisonic but wasn’t sure about splurging on one.

    It’s so strange that bad skin causes such self consciousness and shame, like we’re doing something wrong and that we’re the problem. The only person that’s seeing me without makeup right now is my husband, and even then I still feel like dabbing concealer on the bad spots even though he tells me I’m beautiful. I’m so tired of this battle! Thanks for sharing what works for you Anna…you’ve given me the kick in the pants needed to do something about it instead of stubbornly insisting that the natural methods will work, given enough time. Time to go to a dermatologist I think!

    • Anna @ D16 November 22, 2013 at 9:29 am

      Coconut oil is the worst thing that ever happened to my skin. Actually, oil cleansing in general was a complete disaster for me — I really, really wanted it to work, but it’s not for me. No more shame!

    • Anne B November 22, 2013 at 1:38 pm

      Hi Nicole,

      I mentioned this below, but I use Boscia Purifying Cleanser – I get it at Sephora. It has no parabens, sulphates etc and is GREAT! Pricey but I love it.

    • Nicole November 22, 2013 at 2:20 pm

      Anna, I think the oil cleansing is a bust for me as well! Anne B, thank you so much for the recommendation! I was planning on heading over to Sephora this weekend to find some new cleansers, I’ll have to give Boscia a try. Is it a good makeup removal cleanser also? I’d like something that both removes makeup and cleanses my skin.

    • chris November 24, 2013 at 9:17 pm

      I did OCM for ages. 6 months+? Texture / circulation of my skin improved but acne remained. I switched to a dermalogica cleanser + FINALLY after 20 years of resistance, an oil free moisturizer. I also use a spot treatment. Things were good for a few months, then I got lazy, started going to bed with makeup on (my WORST HABIT I CANNOT KILL)…stop using the spot treatment (fell behind sink and I couldn’t be arsed to take it out)…drinking beer…just indulging in all my lazier, slobbier habits and HI my skin is crap!!

      So basically I have to work t improving my laziness and pray my skin responds. LOL

      One trick: washing my face when I get home from work, as opposed to right before bed.

  • Reply Catherine November 22, 2013 at 12:19 am

    I first discovered you via your skin post last year, and I really appreciate your honesty. I’ve had adult acne issues and have been on Tretinoin (generic Retin-A) and Clindamycin (the antibiotic gel) for almost a year. They have really helped my skin, and I also take Doxycycline, an oral antibiotic, as needed for hormonal breakouts. My skin is so oily that I don’t have any issues with the Retin-A and I don’t even need moisturizer at night when I use it. I use AcneFree cleanser in the morning, which has benzoyl peroxide in it, and Solvere cleanser with salicylic acid at night. I realized a while ago that I’ll never be able to do something simple, and that’s okay. I use Jane Iredale mineral makeup and avoid liquid foundation, and that seems to help, too. And I just discovered Rimmel’s Stay Matte Powder, which is equally as good as Jane Iredale and costs around $5! It’s definitely a struggle to maintain clear skin, but I feel like it is finally looking really good again. Thank you so much for sharing this with us.

  • Reply Samantha November 22, 2013 at 12:25 am

    I appreciate this post so much! I’ve suffered from cystic acne since I was 13 and I’m now 39. I even went on accutane as a teenager which did wonders, but now I go through stages where I’ll get a bad breakout for 4 months in a row and try everything under the sun to get it to stop, and then I’ll go 6 months with clear skin. So frustrating! I have found the best thing for my skin though is salt. I use a salt bar from Dead Sea Soap Products that has been pretty much life changing. It only has three ingredients.

    As for sunblock, I am a long distance cyclist andcan spend upwards of 8 hours in the direct sun while riding. The only sunblock that has never made my skin revolt and still keeps me from getting burned is Neutrogena’s Ultra Sheer Dry Touch Sunscreen. I wish I could say I use a more natural sunscreen product, but I haven’t had much luck with any to keep me from getting burned.

    • Anna @ D16 November 22, 2013 at 9:33 am

      I wish I could use the Dry Touch sunscreen! It gets such good reviews and everyone seems to love it, but it gives me dry, red scaly patches on my face. I do use it on my neck and body, though.

  • Reply tallin November 22, 2013 at 12:40 am

    If you want to give another face wash a shot, I find Trader Joe’s Nourish All-in-One Cleanser is pretty great. And it’s also slightly fancier than the Neutrogena.

    • Anna @ D16 November 22, 2013 at 9:34 am

      Oh, I’m being too hard on the Neutrogena wash. I actually have no complaints other than that it’s not more expensive, haha. If it cost $35 and I had to buy it at Saks I’d probably like it more…which is idiotic, but at least I’m honest about my idiocy. 😛

  • Reply erica November 22, 2013 at 12:55 am

    I love Shiseido Urban Environment Oil-Free UV Protector. I have very sensitive skin. Also, I struggled with painful cystic acne all over my jaw and chin for years until I started using Jane Iredale mineral foundation. In the 8 years I have used it, I have not had more than 2.

    • Anna @ D16 November 22, 2013 at 9:34 am

      I usually like Shiseido products a lot — I’ll get a sample, thanks!!

  • Reply Jen November 22, 2013 at 1:02 am

    Hi Anna. Thanks for this post. I’ve been working at my skin since getting cystic acne after finishing university (I’m almost 40 now). I use DDF Blemish Foaming Cleanser. It works well but if my skin would be happy with the Neutrogena version I’d be thrilled for the price difference. 🙂 I’ve had good luck with G.M. Collin mineral sun screen SPF 25. I just picked up a prescription for Retin-A 0.04%! Have been hesitant to start it b/c of the adjustment period, dryness, sensitivity etc. From your review it sounds like there is a lot of good to be gained, tho. I wasn’t sure what to use for additional moisture at night but I’ll try your suggestions and also your easing-in strategy. Thank you. Have you tried any non-invasive surface treatments that you were happy with? I have quite an uneven surface from before the cysts were under control. Thanks again for the information.

    • Anna @ D16 November 22, 2013 at 9:38 am

      Jen, I actually used that DDF cleanser for a while (I went through two large bottles’ worth), and I have to be honest: I like the Neutrogena much better.

      I’m not sure what you mean by surface treatments. Dermabrasion and that kind of thing? If so, no — but I’m lucky to not having any texture issues after using the Retin A for a couple of months, and I have no scarring beyond discoloration. If that discoloration doesn’t fade after a year or so, I’ll look into other options.

  • Reply Lizzie November 22, 2013 at 1:11 am

    Sorry to hear that you’re still struggling with this. I’ve been fighting acne since I was 13, (26 now) and it’s depressing battle. I actually started using the Neutrogena cleanser after you mentioned it in your last post about this topic, and much like you, I don’t know what’s in that stuff that works so well, but it does and at this point, who cares! I’ve been using it ever since and I really love it, so thank you for recommending it.

    I hope you’re able to find the “answer” someday!

    • Anna @ D16 November 22, 2013 at 9:41 am

      Well, I have found the answer for now! I don’t expect anything to be the solution forever, and that’s OK. Hormones change, body chemistry changes, everything changes…

  • Reply Tram November 22, 2013 at 1:51 am

    Have you tried Mario Badescu Drying Lotion? It’s a spot treatment, sulfur based. It’s very conspicuous and pink and will make you look like a Yayoi Kusama piece, but it’s gentle and it has been the only thing that had worked really well for me.

    I’m a big fan of the Shiseido BB cream, spf35, doesn’t make you look greasy, good, buildable coverage. It’s a little pricey, but it lasts forever. I’m still using the same tube I bought 9 months ago.

    • Anna @ D16 November 22, 2013 at 9:46 am

      Hi Tram, yes, I used MB products for years (there’s a post somewhere on the blog about them…), including the drying lotion. It works quite well as a spot treatment for the occasional isolated blemish, but that’s not what I was dealing with and isn’t what the medications I’m using now are for. I actually have no need for spot treatment anymore because there simply are no “spots” to treat! I am all about taking care of the underlying cause of the breakouts, which in my case was poor cellular turnover.

      But yes, I do agree it’s a great product for people with otherwise good skin who just need to take care of the occasional spot! 🙂

  • Reply heather November 22, 2013 at 2:18 am

    The detailed tips and treatments are amazing, but the best part about your skin-related posts are the honesty about the problem, because, as Nicole says, the shame issues are huge. For myself, it’s the shame that’s resulted in too much denial for too long. Thanks for the reality check. xx

  • Reply Cathy G November 22, 2013 at 3:28 am

    Hi Anna,
    I was also a late-30s mild acne sufferer (nothing in my teens), but now breakouts are rare.
    I have used a combination of Australian organic rosehip brand Sukin and Moo Goo lite face moisturiser for past 4-5 months and am very happy with the results.
    I’ve been meaning to buy a Clarisonic for some time, but with my new regime I don’t see the need.
    I now regulalry get compliments on my complexion!
    I also try to keep chemicals away from my face where possible.
    Good luck and keep up the great blog posts!

  • Reply Natasa November 22, 2013 at 4:05 am

    Thank you Anna for introducing me to Clarisonic – it works wonders for me, although I use it not more then three times a week. I am 34, had acne since I can remember and for some years very bad rosacea as well. I`ve read all possible about skin care, visited expensive dermatologists but thankfully never used antibiotics no matter how bad the condition was…. But at the end found solution that works for me and for the last three years, I can be around my friends with my face washed too.
    What is the most important that I`ve learned is, that our skin (not only on face) is the mirror of our inner-body health and hormonal ballance. I’m not a vegan, but for last three years I eat almost all food organic, bio produced, drink organic Kefir every day and with regular exercise, my body feels cleaner, my digestion is fantastic and when I look at myself in a mirror I see myself looking younger and fresher that ever in my entire life.
    My face regime is: Clarisonic three times a week, Lavera Cleasing Gel (With organic Grape and Ginkgo) and Lavera Mattifying Balancing Cream (With organic Calendula and organic Ginger).
    I know not everything works for everyone but I`ve just wanted to share my exprience with you and your readers.

    • Anna @ D16 November 22, 2013 at 9:50 am

      I wanted so much for changing my diet (I have had a fully vegan diet for about 4 years now) to have a positive effect on my skin, but it didn’t. It has certainly made an enormous difference in my well-being in other ways, but my skin does not seem to care what I put into my body. That too used to make me feel “defective” and ashamed, but I’ve let it go…

  • Reply Grace November 22, 2013 at 6:37 am

    As a sun-avoider, I was really shocked when I found out I had skin cancer last year. Sun protection is so important! I wear Ultrasun Face spf 30 or 50 (50 for the summer months), and really recommend it. It is gentle on my eczema ridden skin, and hasn’t caused any breakouts. Not sure how widely available it is, but it’s brilliant stuff.

    I recently came to the realization that I’m wasting so much money trying new products all the time. Something always ends up irritating my skin! I now stick to 3-4 products, used day in day out, and my skin has never been better. It’s not fun, or exciting, but paring down to basics has worked for me.

    • Anna @ D16 November 22, 2013 at 9:51 am

      Thanks, Grace, I’ll look it up. Hope you’ve been able to nip the skin cancer in the bud — how scary!

  • Reply Rebecca Harbert November 22, 2013 at 7:06 am

    I have had skin cancer and needed to find a sunscreen that I could tolerate. I have found one. It is Neutrogena Ultra Sheer Dry-Touch Sunscreen, Broad Spectrum, SPF 30. I believe it comes in higher SPF but the 30 is the best as far as my face is concerned. It never feels greasy or heavy at all. It is absorbed quickly and I don’t even notice I have applied it. Also is quite affordable.

    • Anna @ D16 November 22, 2013 at 9:51 am

      Thanks, Rebecca. I can’t use the Dry Touch on my face (I’m allergic to something in it, but I don’t know what!), but I know lots of people swear by it.

  • Reply Tara November 22, 2013 at 9:06 am

    I’ve dealt with acne my whole life. As a teenage, I spent 5 years on tetracycline and antibiotic creams and gels. I also made sure my hair was long and strategically pulled in whatever direction my breakout was in. I feel sad for that girl.

    Anyway, as a nutritionist, I now know that what’s in our skin is really a reflection of the terrain. Our livers should deal with toxins. When things get inflamed and pushed to the surface, we’re being sent a message. By just pushing these toxins back into our systems, we’re looking at further complications. I’ve struggled with this for years. Anyone that tells you that our skin is not related to the rest of our bodies is not understanding the connectedness of our whole system.

    If I want cystic acne in a couple of days, I can just eat some grains and vegetable oils and voila! Instant acne. We all have our individual triggers, but share a commonality – inflammation.

    • Anna @ D16 November 22, 2013 at 9:57 am

      Hi Tara, I have an autoimmune disease and have been able to change a great deal (positively) about my health through awareness of inflammatory triggers, but sadly even after many, many years of trying to get my skin to comply with that dietary awareness, I finally had to accept that there is no shame in accepting that some people do in fact need the help of topical chemistry to make a real difference. I am by no means denying that diet is absolutely crucial when it comes to controlling inflammation (that awareness has changed my entire life and has kept me from having to inject myself with drugs on a daily basis for years now!), but it just isn’t going to fix the problem for everyone…including me. I wish it did.

  • Reply Marissa November 22, 2013 at 10:01 am

    I’m a 30-something with problem skin and I’ve switched completely to Kiehl’s. I use their sensitive skin line as well as the midnight recovery concentrate, the avocado eye cream, and even the body lotion. I love the Ultra line as well. Every now and again I pick up a nicely packaged something at the drug store because I can’t help myself, but I use them once and never again. I used to think it insane to spend this amount of money on skincare, but holy smokes – Kiehl’s products go the distance. Cost per use is probably comparable to lesser-priced products at the drug store. I find their staff, at least at the location I frequent, to be extremely knowledgeable and helpful as well. Love Kiehl’s! Will recommend them forever.

  • Reply Erin O. November 22, 2013 at 10:01 am

    Hi Anna! Another 38 year old acne sufferer here. I wholeheartedly agree with your recommendation for the retin-A. I started using it back in June, and now five months later my skin has never looked better. I used to suffer from bumps along my jawline and big cystic pimples on my cheeks. Within the last month my skin has completely cleared up and I have had no additional breakouts. I’ve also seen a huge reduction in blackheads around my nose and chin. My dermatologist warned me that things could get worse before they got better on the Retin-A and to stick with it. I am so glad i did! I use it with La Roche Posay Toleraine cleanser and the Toleraine Ultra moisturizer during the day. I haven’t been using anything at night other than the retin-A but am interested in trying out the Keihl’s serum.
    One question I have for you is about cleaning your Clarisonic. I quit using mine because I became convinced that it was contributing to my breakouts. Would you mind sharing your method for keeping it clean and germ-free?

    • KATE November 22, 2013 at 2:49 pm

      I second that! La Roche Posay Toleriane cleanser is a wonderful product-I’ve been using is for years. I also use the Toleriane Lotion and Cream for winter.
      I am 36 years old and my skin was never really nice-I go though periods of acne/cystic acne mess.
      What I learned through the years is that less is more and gentle treatment is usually a way to go.
      Clarisonic is too harsh for my skin and I rather just use wash-cloth. Over-exfoliating my skin makes my acne worse.

    • Anna @ D16 November 22, 2013 at 2:54 pm

      Have you tried the delicate brush for the Clarisonic? It really should NOT be exfoliating your skin at all — it’s not meant to be used like a scrubbing brush, but just moved over the skin slowly and with a very light hand. I find it much gentler than a washcloth, actually…

      I never do any manual exfoliation to my skin, just chemical exfoliation from the Retin-A.

    • Anna @ D16 November 22, 2013 at 2:59 pm

      Erin, immediately after using my Clarisonic, I remove the entire brush head from the device. Then I wash the brush with warm water and castille soap (Dr. Bronner’s), rinse very thoroughly, then let it dry completely all by itself — I don’t reattach the brush to the device until it’s time to use it again the next night. (I replace the brush head every two months.)

  • Reply J November 22, 2013 at 10:02 am

    I’ve struggled with my weight my whole life…and all that time- I had great skin and hair. It’s what I relied on- I thought “ok- I might be chunky/fat, but I’ve got a good face- and nice hair. we can work with this”…Then somewhere around 29/30- those two things started fading. I went through a really stressful period 2 years ago- and boom- there goes a lot of my hair- thinning, breaking, FALLING OUT. Then in the last year- my skin just isn’t the same- it’s aged. It’s hard…you try not be be vain- but acne and aging hurt….that being said- my fiance struggles- and I mean struggles with extreme psoriasis all over his body. Seeing what he has to go through (hardcore antibiotics and steroids)- gave me some perspective. Our outside is just that- outside. Before our wedding next year, I’m getting a tattoo of a zipper on the side of my ribcage to remind me “this is all outside”. and to remind him- that no matter what he (or his skin) looks like- I love him anyways.

  • Reply Lori November 22, 2013 at 10:06 am

    Does this mean you can go back country camping with me now? or swimming?

    • Anna @ D16 November 22, 2013 at 12:29 pm

      Yes, it’s a miracle! Retin-A has made me want to put on a bikini and sleep outdoors on the ground. It’s the craziest thing… xxx

  • Reply jaclyn November 22, 2013 at 10:20 am

    My current regimen which is working very well (knock on wood!) is:
    Cleanser: Burt’s Bees Peach and Willow Tree Bark Deep Pore Scrub (the liquid part is super gentle and moisturizing, while the peach and willow bark granules let me really get all the grime out of my pores.)
    Moisturizer: Neutrogena Naturals Multi-Vitamin Moisturizer

    Not fancy, super cheap but it works so I’m not fussing with it. After years of dry, red, patchy skin with occasional bright red gross breakouts, my pores are now smooth as ever and my face never feels too tight. I ended up with these products after I left my makeup bag (chock full of Murad, Shiseido, Skyn, etc.)at home while travelling and was left finding a new skincare regimen at Target.

    In the summer I use Boscia Vital Daily Moisture SPF 15 and that in conjunction with my SPF15 face powder, seems to protect me from regular sun exposure just great. The Neutrogena Ultra-Sheer sunscreen was TERRIBLE for me!

    ALSO! Someone else mentioned Clyndimicin and I also had dark spots/scarring from past blemishes and my doctor prescribed me this because it has bleaching properties (I know, SO bad for you!!) and it was a god damn miracle how well it evened out my skin tone. I usually try to avoid synthetic ingredients and chemicals and generally “yucky” things but if I could be a spokesperson for Clyndimicin, I’d do it in a heartbeat! Maybe ask your dermatologist if it would help even out your coloring.

  • Reply Alline November 22, 2013 at 10:32 am

    I never had acne until my mid 30’s, and I guess it was total payback for having none in my teens. Up until a year ago I was experiencing the same thing your going through. Using a product until it didn’t work anymore, then I tried everything. Nothing worked. I finally went to the dermatologist and she put me on some medicine called Solodyn, RETIN-A and recommended I start using Cerve cream and face wash. Well the Retin-A did not work, and I took the Solodyn for two months (which helped a little). I did however start using the Cerve foam wash and the Cerve cream as a moisturizer and I kid you not I haven’t had a breakout in a year. I don’t put anything else of my face at all except the Cerve cream before makeup, and after I wash my face at night I put a little on, and my skin feels terrific. You can get the face wash and cream/lotion at any drugstore. Best stuff ever.

  • Reply Adriana November 22, 2013 at 10:53 am

    forgive me if you have already gone down this road. At 50 i was tired of having blackheads and the occasional breakouts (admittedly nothing, it sounds like, to the degree you have been going through) but tired, none-the-less of dealing with my skin after sooooo many years. I mean, really! went to the derm. She suggested a short course of low dose accutane followed by a short course (four months) of a maintenance dose (3-4 months). Scary literature, signing all kinds of releases, scarier side effects, youngest daughter objects etc, etc. only real problems was incredibly dry lips but i have to tell you my skin has been amazing and the blackheads are gone. Its the first time in my life i can wear some moisturizer, sunscreen and a little blush and head out the door. My wrinkles are another story but I would do it again in a heartbeat.

  • Reply Jenn November 22, 2013 at 11:14 am

    For the last 3 years I had frequent cystic breakouts, dry skin, itchy scalp, greasy hair: you name it, I had it. I turned 40 this year and while I occasionally have a cystic breakout, I’m happy to say that all the other things eventually leveled off. There is hope!

    But then, I should also mention that we switched to an almost exclusively organic diet and I’ve been experimenting with organic beauty products. Not sure if/how significant the change is, but worth mentioning.

  • Reply Natalie November 22, 2013 at 11:16 am

    AMEN to no longer feeling badly about natural methods not working for you! I tried oil cleansing and a host of other natural methods to treat my skin, and they were universally terrible. Oil cleansing, in particular, made me feel like a failure. Just wanted to say thanks for saying that! People love to tell you what will work for you, but the reality is: they are not the person attached to your skin 🙂

    • Anna @ D16 November 22, 2013 at 12:09 pm

      It seems ridiculous to feel like a failure for not getting good results from things like oil cleansing and mineral makeup (I hate mineral makeup with a burning passion), but it’s true! I want these magical things to work for me like they work for (seemingly) everyone else. The years and money I have wasted…sigh.

  • Reply Natasha November 22, 2013 at 11:17 am

    I too have adult acne in my late (almost 40 *gasp!*) 30’s. I have started doing the oil cleansing method and I am pretty satisfied with the results. I can feel the sebaceous filaments coming out of my pores as I massage the oil in my face (I use a Dermalogica oil, but many people just use plain mineral oil). Then I rinse and wash my face with a gentle cleanser (Dermalogica special cleansing gel). After that I use Thayer’s alcohol free toner, Paula’s Choise 2% BHA gel, and then moisturize with Cerave moisturizing cream.

    I ditched my clarisonic as I found it too harsh on my skin and seemed to make things worse. Also, any foundation with mica in it breaks me out something awful!

  • Reply Kate (@shoegirlinDE) November 22, 2013 at 11:40 am

    Thank you so much for your honesty, Anna! I never had to deal much with acne in my life but at age 30, after moving to Europe, I came down with eczema that has just gone from bad to worse and in the past year has spread to my face. It’s been an embarrassing, uncomfortable battle that seems to have no solution – prescription or otherwise. I totally get the shame factor in having huge, bumpy red patches across one’s face. I really appreciate when people like yourself are willing to share what works for you, as it’s easy to feel helpless and alone while hiding behind tons of concealer.

    • Anna @ D16 November 22, 2013 at 12:12 pm

      Kate, have you tried organic/raw apple cider vinegar — diluted as a either a topical or to drink? I know so many people whose eczema has dramatically improved from diligent use of ACV. It’s really remarkable. I have had great success with it myself for treating skin allergies (I am prove to stress hives), and it’s also virtually eliminated the keratosis pilaris bumps on my upper arms.

  • Reply Marina Osorio November 22, 2013 at 12:21 pm

    Hi Anna, I follow your blog since two years. About your skin issue, I’m glad you find something that is working.
    I feel identified with the “don’t know what to do” feeling about my skin which I had for years so I want to share with you my last discovery.
    I had problems with acne combined with rosacea for years and tried a lot of options, with temporary or few results, and lately a friend who studies aromatherapy and makes handmade soaps suggested me one soap with essencial oils which helped a lot…since then I’ve been studing how to incorporate essencial oils and destilated posions from plants to my care routines and by studing my problem and the esential oils for treating them, created a combination that works very good form me.
    *I wash my face with a sonic device simmilar to clarisonic, but cheaper, called….(should I mention it?), I haven’t tried clarisonic but I’m happy with mine. Clarisonic was not available in Spain, and if it’s available now, it’s not as popular as in the USA.
    *With that I use a liquid soap with organic ingredients from the brand Jasön (it’s for hands and face, not very special, but find it’s very respectful with skin)
    *Tonic: A kind of destilated from lavender, not from the flowers, but from the plant (that thing helped amazingly with redness, in spanish is called hidrolato de lavanda, sorry, no idea in english) very cheap an excellent stuff, arount 5-6 euro, organic certified
    *A cream from a local brand that I choosed for the organic ingredients: Rosa damascena hydrosol*, Lavandula latifolia*, Pelargonium gravolens*, Prunus dulci, Calendula officinalis, Buxus sinensis*, Rosa officinalis rubiginosa*, Cananga odorata*, Citrus reticulata*, Cymbopogon martinii*, Sesamum indicum*.

    *In the night two drops of lemon essencial oil in one pea of the previous cream, in the morning two drops of jojoba oil in one pea of my cream/The lemon essential oil is magic against acne and it improves the stains a lot/The jojoba oil great hydrating

    I’m very happy with my discovery, I understand that is about studing a lot about the characteristics of each skin, but after putting all kind of chemicals in my skin (some of them very expensive), I think that I find something that works and want to explain this to everyone… I’m 38/sensitive skin/rosacea/acne

    Ah! forgot: for the dark circles (if the name is that) I use a combination of essencial oils… that’s not magic, I don’t think that that will substitute good sleeping and good eating, but is good for keeping the area fresh, the ingredients are: argan oil, wheat germ, jojoba, lipidic carrot extract; essencial oils from* de: palma rosa, sandal wood, ylang-ylang & carrot.

    Sorry about the not perfect english 🙂

  • Reply Allyson November 22, 2013 at 12:37 pm

    Hi Anna,

    Thanks for writing this. As someone who has struggled with breakouts since I was 11 (I’m 26 now), these sort of posts are really refreshing. No one I knew really had bad acne, weirdly, so I always felt like an ogre compared to all of my pretty friends with their clear complexions. I started wearing a full face of foundation every single day when I was 13 years old. The only silver lining was that it introduced me to makeup, which I love, and I became an expert at covering blemishes!

    But even though my skin has improved since I was younger, I was not prepared for adult acne. First of all, I had spent years when I was younger convinced that once I finally was an “adult” my skin would magically clear up and everything would be fine (that is what happened to both of my parents, who apparently had bad skin when they were younger too). When that didn’t happen, I was actually incredibly bitter. I thought it was completely unfair that I spent my middle school, high school, and college years worrying about my skin, and it wasn’t even going away like it was supposed to. For a while, I actually stopped trying because what was the point? Dermatologist visits, natural methods, whatever — nothing worked. Eventually, just before I was supposed to go on Accutane, I finally decided to try birth control, and that seemed to be it. It actually doesn’t seem to matter what I do in terms of washing my face, or what products I use — as long as my hormones are in check, I get an occasional small pimple I can spot treat. I try to avoid medication but damn, if I had only known I would have tried it in high school.

    This is a really long, rambling comment, but really what I wanted to say was THANK YOU for writing about adult acne. It is the most shameful thing I have dealt with, and I know people think that sounds superficial, but I never imagined it would be WORSE than being young with acne. At least when I was 16 with a horrific breakout, people expected it. It’s hard to explain to someone who doesn’t breakout what it’s like to have to walk into work wishing you could put a bag over your head. I work at a company where I am very young compared to most of my colleagues, and it was hard enough sometimes to feel like people took me seriously. Having a massive breakout all over my face just made it worse — I felt like there was no way people would respect what I was saying when my face looked like I just hit puberty 20 times over. People no longer think that it’s your hormonal age — they think you’re too dirty or lazy to wash yourself. It’s really such an awful feeling.

    I’m glad you’ve found a regimen that works for you now. I think I will try out that foaming cleanser when I finish up my Cetaphil — it works well, but I prefer a foaming cleanser to a gel one. I will also try out the Kiehl’s eye cream too, as I want to start using one regularly. I haven’t found one I liked but I am starting to get fine lines there (gasp!!) and I’ve been going through samples to try to find something I like. Thank you again for your honesty. I always have enjoyed your blog — in fact, I find you kind of a role model because you basically are living the life I’d like to have — but posts like these are what keep me coming back for more. Cheers and best wishes for happy breakout free days ahead!

    • Allyson November 22, 2013 at 3:46 pm

      I was going to leave another comment with some of the products I use, but it ended up being so ridiculously long that I turned it into a blog post on my fledgling blog instead. If any D16 readers have oily skin or just want to read another experience with adult acne, it’s here:

      Once again, thanks Anna for writing this. Not only do I feel quite a bit better, but I updated my blog which is pretty close to a miracle.

    • Anna @ D16 November 22, 2013 at 11:07 pm

      Hi Allyson, thank you for such a kind, thoughtful comment. I sympathize with everything you’ve said here — I’m nodding my head in solidarity. I’ve got about 12 years on you and I wish I could say that it gets better, but the fact of the matter is that we’re all different and there no guarantees. I wish that acne weren’t so widely thought of as being a “teenage” condition, considering 30% of ALL adult women (up to age 60!) suffer from it. That’s an enormous number of people!

      I completely understand what you’re saying about feeling like you won’t be taken seriously. There have been so many times when I’ve been in professional or social situations where I can’t even focus on a conversation because I’m so concerned that I look like I’m dirty or lazy or like I don’t know how to take care of myself because my skin looks bad. It’s a terrible feeling.

      OK, off to read your post now…

  • Reply Keyse November 22, 2013 at 12:43 pm

    I saw your post on twitter, glad you decided on skin care (although, i do love your home posts!).
    I’m pretty sure that i’m testing Kiehl’s Midnight Recovery Complex right now. After making a purchase at Kiehls and being given a sample of the Midnight Recovery Complex I got an email form them asking if I would test a product for them. The bottle isn’t labeled but I’m pretty sure its the Midnight RC.
    I like how it has a lighter smell and feel than Huile Prodigieuse, I think it absorbs faster too. After i’m done testing this out for Kiehls I think I will switch it up and use the Midnight Recovery during the day and Huile Prodigieuse at night. I do have to note that the eczema on my face is not impressed by either products. I have eczema under my bottom lip, I try to avoid getting these products on it. But the eczema on my head LOVES the Kiehls product…oh skin, so mysterious. Always keeping it interesting.

    • Anna @ D16 November 22, 2013 at 11:16 pm

      Eczema is such a giant mystery, I know. I don’t have it myself, but until a few years ago my husband had suffered from it all his life. I hope you can figured out something your face likes! Have you tried Tarte’s new(ish) Maracuja Oil? It’s similar to the Kiehl’s, but it has fewer ingredients and no fragrance (it’s just pure passion fruit seed oil). Maybe worth a shot…

  • Reply Daffodil Campbell November 22, 2013 at 1:06 pm

    Hey Anna I just wanted to reassure you that – even up close during a conversation – I never noticed so much as a freckle on your face. I just wanted to share that. Please don’t be too self-conscious, from the casual observer your skin looks great 🙂 Thank you for this thread, enjoying all of the tips from you AND your readers. And I have a store that sells Kiehls around he corner from my house in very rural Maui, so whoot!

    • Anna @ D16 November 22, 2013 at 11:18 pm

      Ah, thank you SO much. I don’t know that I’ll ever believe you (haha), but I do always worry (a lot) about meeting people in person who have only seen me in flattering selfies (HAH) and having them wonder why I look like a total goblin in real life…

  • Reply Levi November 22, 2013 at 1:21 pm

    Hey Anna-
    Here’s a sunscreen you might want to try- B. Kamins Sun Defense ( It’s non-greasy (they all say they are, but I promise this one actually is), great for sensitive skin, and doesn’t sting if you sweat and it gets too close to your eyes. Plus there’s absolutely no smell, and it lasts all day. It makes an amazing makeup primer too!

    • Anna @ D16 November 22, 2013 at 11:18 pm

      Thanks Levi, I’ll look into it!

  • Reply Anne B November 22, 2013 at 1:36 pm

    Hi Anna,

    I commented last year and I wanted to leave another note now. Thanks again for posting this. It’s still such a struggle to deal with having acne. I mean, I am so preoccupied with my skin I don’t even know whether or not I hate my nose or something.

    After your recommendation of the clarisonic I bought one last year and it really is a miracle. It immediately reduced my cystic acne, obviously my skin is way to sensitive to any small particles that can make it past just washing with my hands. I can’t imagine going back now. I have been using Fresh Seaberry Oil at night for almost a year and I am addicted to it. It changed the consistency of my skin basically overnight. I used to have such oily skin and now I just don’t. AT. ALL. I use the Boscia Purifying Cleanser with my Clarisonic and it has been working for me, it’s another product I wouldn’t give up. My only missing link is a great daytime moisturizer with SPF, I’m still looking.

    I’ve been using Tactuo (called Epiduo in the US) for about a month. It’s a benzol peroxide-retinoid mix. I had previously sworn off benzol peroxide, but this stuff seems to be doing something. Red spots are fading, my pores are way smaller. My skin is definitely drier, but it’s all within reason. It’s a new (i.e. expensive) product too though, at least in Canada.

    Thanks again,


  • Reply amanda November 22, 2013 at 1:37 pm

    I too have lots of clogged pores and occasionally get cystic acne bumps on my chin area. I have not been to a dermatologist because by some lucky miracle my skin has been much better in recent years. Lately, I’m loving the MyChelle line. It’s all natural. I actually get it at the Whole Foods body shop on 7th and 25th (one of the few places you can buy it in person). It’s pricey but all of the products I’ve gotten have really lasted me so far. My favorite is the fruit enzyme scrub….it makes my face feel incredibly clean like no other face wash I’ve ever used. I also LOVE their vitaminA serum, it’s made the texture of my skin so much nicer. Just thought I’d share bc I really do love their stuff a lot and am always so surprised at how well they work. I think they’re having a sale through the end of the month too.

  • Reply Sarah November 22, 2013 at 2:05 pm

    I’ve been on some sort of acne medication since I was fifteen (I’m now 32) and have been on the dreaded Accutane TWICE. (Ugh, I know.) It’s been a good three years since I’ve finally found what works for me and I am so. Happy. I’ve been using Aczone for a good 4+ years and love it because it doesn’t irritate/totally dry out my skin. I use my Clarisonic 2x daily with a natural cleanser and I really love it. I was super skeptical at first, but now I can’t imagine going without it. (I use the sensitive/delicate brush too.) I’m more comfortable with my skin than I’ve been in years.

  • Reply maggie November 22, 2013 at 2:21 pm

    I am only 24, but I have been dealing with acne since the age of 12. I have done EVERYTHING – even accutane, which I highly DON’T recommend – and finally, the simplest things seem to be working. I am drinking a LOT of water, like 15 glasses a day, taking milk thistle (helps the liver push out toxins) and B12. I am also taking prenatal vitamins just for this and I swear my skin has become so glowy.
    Acne is such a pain. It is good to see you have a regime that is working for you.

  • Reply kelly w November 22, 2013 at 2:23 pm

    1) So happy for you about feeling able to be around friends (in your house 🙂 ) sans makeup. That’s a great thing.

    2) What’s this about ACR eliminating keratosis pilaris bumps? (!!!) I would love to try that. Do you drink it, or use topically?

    • kelly w November 22, 2013 at 10:13 pm

      (I mean ACV.)

  • Reply susanna November 22, 2013 at 2:29 pm

    I use Burnout Eco Sensitive. It is a natural sunscreen that is zinc-based, which is supposed to be great for the skin. I have tried everything, and this is the one sunscreen that does make me super oily and breaks me out. I also use my clarisonic daily with Desert Essence Tea Trea Oil Cleanser (13 bucks for 32 oz. It lasts me at least a year!) and BP 2.5% at night. My face broke out during my 2 month bathroom remodel (all DIY; single-bathroom house), because I did not feel like doing my face cleaning routine when showering with a hose in the backyard. It was the worst acne of my whole life (I’m 32). It was that event that led me to buy a clarisonic, which turned out to be exactly what I needed to make my skin normal again (of course, it was not magical and overnight; it took a full 2 months…)

  • Reply Alix November 22, 2013 at 3:09 pm

    Thank you so much for being open about this topic. I, too, have struggled with cystic acne from age 11 until now (26) and it’s an ongoing battle. Forums like this give me hope that I’m not the *only* one who suffers from this, but it is still very tough psychologically .

    However, I’ve also realized over the years that buying the “perfect” cream or “miracle” topical Rx isn’t always the answer for me. Acne is such a complicated, chronic infection and there are so many products that aim to treat the oil production, the p. acnes bacteria, the clogged pores, etc. I also believe (as you experienced with Zianna, which I’m currently using) that our bodies can become “used” to a chemical and after a while, products that were formerly miraculous can lose their effectiveness.

    Here’s to self-love and acceptance!

  • Reply kathleen November 22, 2013 at 4:25 pm

    I, too, was so disappointed when the Paula’s Choice sunscreen spray was discontinued. I’ve found the L’Oreal Paris Sublime Sun Liquid Silk Face Lotion (SPF 50!!!) to be an excellent replacement. It’s nongreasy and is perfect under makeup. Plus, it’s totally affordable. I highly recommend it!

  • Reply Jana November 22, 2013 at 5:17 pm

    At 39 I have come to realize I will probably have acne, at some level, forever. That said, Aczone has been a lifesaver. I’ve been using it for a year now and I love it!

    That business isn’t cheap though….thankfully my insurance covers most of it.

    I hope it continues going well for you!

    • Anna @ D16 November 23, 2013 at 9:18 am

      Yeah, the price is pretty horrifying. My dermatologist said she’d advocate for me with the insurance company if the coupons ever stop working, so…fingers crossed. It’s amazing stuff, though!!

  • Reply Kelly November 22, 2013 at 5:25 pm

    Girl, I totally feel you. So happy that you’re skin is improving.
    For sunscreen, stick with physical sunscreens (zinc and/or titanium dioxide) rather than chemical ones. I like John Masters Organics one, but I’m going to try this one next because I’ve heard great things:

    • Anna @ D16 November 23, 2013 at 9:20 am

      Thanks, Kelly! Looks like a great product.

  • Reply june November 22, 2013 at 6:19 pm


    Thanks for sharing. In my late I had a bad (and embarrassing) bout of angry red pimple outbreak on my face that wouldn’t go away no matter what topical cream I used. So I used more and more opaque make up. Until one day I wad introduced the Proactiv Solution set. I went out that very day to get it and it got better right away. I have much better skin today but I still use the Clarifying Wash to still “maintain”.

    I also use the Clarisonic once a day too. 🙂

  • Reply Nina November 22, 2013 at 6:28 pm

    I know someone already said to try the Shiseido SPF line and I agree! I won’t go on a rant about how great they are. Just go into a Sephora, or to a counter and get a few samples. They are great under makeup! I find they work better than my primer to keep my makeup in place. And they are a higher SPF with a mix of sunscreen ingredients both physical and chemical. Ok… Mini rant. Sorry. But totally a great one.

    • Anna @ D16 November 23, 2013 at 9:16 am

      Thanks Nina, I will definitely check it out!

  • Reply Adel November 22, 2013 at 8:54 pm

    I had fantastic skin all through my teens, then when I was 20 I got the Depo Provera birth control shot, and it screwed me up really bad. I gained weight and my face started breaking out like crazy. I was horrified. I don’t wear makeup — never have and never will — so EVERYTHING was raw and exposed. Sometimes I would rather walk around with a Neosporined band-aid on my face concealing a rather hideous, pussy canker-mass, than have people looking at me like I had facial leprosy.

    It continued on, even with years spending hundreds of dollars on Proactiv and after having 2 kids there was no change. Then my mom told me about her side of the family’s notoriously oily skin, and I realized my skin was desperately in need of moisturizer. That helped a little. Then just these past few months I’ve been supplementing my diet with Naked juices, and everything is clearing up!

    The first 3 weeks I went really hardcore at it, drinking 60 ounces of the juice every day (“drink the rainbow”), with a moderate supper, and my skin was probably 80% better — no new cystic breakout clumps (cluster-zits were my nemesis) and it was pushing out teeny-tiny little blackheads and whiteheads and tiny pimples that would have ballooned into monstrosities, and they were being taken care of with a simple tea tree/sea salt soap bar, witch hazel, and a vitamin A+E cream (as moisturizer). Then I stopped juicing for a week and broke out all over again. There was no way I could keep up at the pace I was going, so now I just have 4x 8oz servings of the “rainbow” juices per day, with lighter meals.

    It’s slow-going, put the scars from all my old breakouts are fading and last week I realized I hadn’t hardly given my facial skin a second-look in the mirror for weeks because there was nothing to pick at or groan about! I have also been using a dead sea mud mask once a week. My skin feels SO soft and wonderful after one of those; it’s the best pampered feeling after all these years of painful sores.

    I hope your regimen keeps up and someday you’ll be free and clear, and maybe even feel up to leaving the house without makeup, and get a nice breeze on your face! Thanks for sharing your story!

    • Anna @ D16 November 23, 2013 at 9:16 am

      I actually don’t really wear much makeup as far as foundation-type stuff goes, but I love wearing eye makeup. LOVE. I have no desire to leave the house without it — and I haven’t for about 25 years. I don’t even want to be IN the house without it. 🙂

  • Reply jessica November 22, 2013 at 10:11 pm

    hearing all these comments from everyone that has struggled with acne makes me feel not so alone. i started breaking out in high school and made a smooth transition to adult acne. did not even know it had started. i was still waiting for teenage acne to end.
    tried everything since the age of 16 to my mid-twenties – benzoyl peroxide, erythromycin stick, retin a. even accutane in college. i had a entire year i barely left my apartment. the accutane definitely helped with the cystic acne i had over my entire face, chest and back but it was pretty harsh and i didnt want to use again. i also already have dry skin so in my 30s i was not looking forward to putting more harsh medication on my face.
    i finally started taking vitamins every day – A and zinc for the acne, C to help with healing and E because it is so good for your skin, not just for acne. and yeah! it actually helped. and gave me a glow as a bonus.

  • Reply sarah November 22, 2013 at 10:42 pm

    Hi Anna, I always enjoy and appreciate your honesty in these posts for your search in finding the right products. I totally loved your latest mascara recommendation! Lately I’ve been trying the less is more approach with only washing my face with soap once a day and then using water at other times. Oddly it’s been working for now, but I hear ya on the constant battle. Thanks again–can’t wait to try the Kiehl’s eye treatment.

  • Reply KatyO November 23, 2013 at 4:18 am

    Hi Anna,
    I, too, have cystic acne, and found a combo of benzaclin (sp) in the AM and retina in the PM is the solution to keep things under control. I occasionally have to resort to oral antibiotics (minocyclin (sp?) ), if things get too bad. Thankfully, I have a good dermatologist!

    I recently found a fabulous sunscreen, which I buy from Kerstin Florian Oil-Free Daily Defense SPF 50. I can’t seem to find it locally here in Oregon, but perhaps there’s a seller in NY somewhere to get a sample. I love this lotion because the SPF is mostly titanium dioxide and it stays quite matte, unlike most sunscreens that leave me feeling horribly greasy.

  • Reply Nina November 23, 2013 at 5:09 am

    Hi Anna,
    I’ve been thinking about getting a Clarisonic for a while now – after reading your post I might have to put it on my x-mas wish list. So, how does one use it?
    I was also wondering if you still use the Huile Prodigeuse? I bought a bottle after having read about it on your blog. I love it (use it at night, when it doesn’t matter if I have shiny skin), and its been great for my rather dry (but prone to outbreaks) skin, especially now in winter time.

    • Anna @ D16 November 23, 2013 at 9:13 am

      Hi Nina, on the advice of my dermatologist, I wash my face once before using the Clarisonic to remove my makeup, then I put a small amount of the same cleanser on the brush and just move it slowly over my face (no pressing, no scrubbing — let the device do the work). The cycle is timed, so it’ll stop automatically and you won’t overdo it. The newer models even have an indicator so you know when to move it do a different part of your face. When I’m done, I remove the brush head, wash it, and leave it to dry overnight.

      Yes, I do still use the Huile Prodigieuse — I mentioned it in the post, but it’s kind of hidden in the section about the Kiehl’s serum. 🙂

  • Reply Erica w. November 23, 2013 at 8:24 am

    I’ve been using La RochePosay for rosacea and acne rosacea and LOVE their products. They are making a big impact on my skin.

  • Reply Monica November 23, 2013 at 12:56 pm

    Hi Anna,

    I’ve been using Retin-a Micro for a little over 7 years if not more and it truly is a game changer. I started off with the 0.1% which i felt was very strong, it made my skin flake for almost a month but then revealed very clear bright but very quite tender skin, which also seemed oddly strong. I used that for a long time until a very very cold winter made it impossible, as my skin would never stop flaking with it no matter what i did. I took a bit of a break from it and when I went back to the derm the 0.04% had been introduced. I find this percentage to be so so mild compared to the other one, I often wonder if it’s working LOL.
    I don’t think i would have been able to use a Clarisonic daily with the stronger one and while i have one i don’t use it daily, only once in while if i get flakies from too much nose blowing or something or just general dryness that moisturizer can’t fix.
    You may also like CeraVe foaming cleaner, it contains hyaluronic acid, so it helps attract moisture into the skin makes your moisturizer and serum work better. For sunscreen, I live in a Canada and normally in the winter the sun is out is during the day and darkness falls quite fast, so I don’t really spend much time outside in sunshine hours, so my sun protection is mainly from my foundation. In the summer however, when it is impossible to escape from the sunshine, I normally use Clarins UV Plus applied over my moisturizer or else La Roche-Posay Anthelios Ultra Fluid Lotion for super extended sun exposure. I find that some of the French brands are doing such a good job with sunscreens, they are light as water or a very thin lotion but cover so well and are most importantly not drying.
    Also not listed in your tips and you may already know this but it is so important not to wax your face (eyebrows, upper lip, sides of face etc) when on Retin-a, the wax will pull the top layer of your skin off. I’ve been getting threading done for years and learned the hard way the first time. Red raw skin is not cute and hurts!
    Good luck with the Retin-a it really is amazing if you can stick with it, results are seen in the long term, so don’t give up on it.

  • Reply Clarissa November 23, 2013 at 12:57 pm

    I use Cleanance from Eau Thermale Avene after using the regular Neutrogena soaps and bars for years. I noticed a difference the same day. My skin wasn’t tight and I actually stopped getting acne. It’s fairly expensive but after using the soap, a toner and a moisturizer ( I didn’t realize my skin actually needed one to balance out the oil) I saw pretty great results. Plus, I only need about one bottle for the entire year.

  • Reply Maureen November 23, 2013 at 4:30 pm

    I also recommend the EltaMD sunscreens! I use the one for acne prone skin and haven’t had any issues. So far I’ve had good luck with some of the Glytone products (along with my Clarisonic) for keeping things under control. I use the mild gel wash (zero irritation). I’ve also been pleased with the Gentle Cream Exfoliant from Dermalogica I use it once a week and it keeps my skin very smooth and helps with clogged pores. Now if only I can find something that will eliminate blackheads! Is it possible? Are you out there, holy grail?? Good luck on your continued skin quest, Anna! Keep us posted 🙂

  • Reply Joy November 23, 2013 at 4:47 pm

    Thanks for sharing! I’ve been trying to change up my routine for a while so this came at a great time.

  • Reply Emily November 23, 2013 at 8:53 pm

    I’ve been struggling with a variety of skin problems since my mid-30s. Lately the 2 things I’ve been battling are cystic acne and perioral dermatitis. What’s working great for me right now is Cerave cleanser, Clarins tonic, clarins eye cream, and in the winter Cerave day cream (with SPF) / Cerave night cream. In the summer I change my day cream because the Cerave is a little too heavy for me – this past summer I used Clarins day cream with SPF (the most expensive one, of course, ugh!) and it worked great (despite the cost). It was a little bit heavy for me, but I didn’t end up with a super shiny face.

    I also recenly discovered 2 over the counter adult acne treatments: Acnevir (contains resorcinol, salicylic acid and sulphur) for day (it’s a clear gel) and Adult Acnomel (resorcinol and sulphur). Acnomel is a weird clay like paste (texture is like toothpaste) so I use it at night. Both have really helped prevent break outs, and if I feel a cystic pimple starting, I put it on and it helps it heal really fast.

    The jury is still out on the clarisonic for me. I use it only once a week or so because I’m worried about it aggravating the dermatitis.

    I haven’t solved my problem, but I’ve managed to keep a pretty decent status quo for the time being, and am not currently using any prescription treatments (I did 3 months of Oracea – low dose doxy – and also topical erythrimycin and sulphur. It helped get things under control but after 3 months I didn’t see any continued improvement, so I stopped all 3).

    Thanks Anna for writing about this. It’s really really helpful to read people’s comments and see what works for them.

  • Reply Kristy November 23, 2013 at 11:53 pm

    I bought the biggest bottle of Kiehl’s Midnight Recovery serum 3 years ago and it’s just about finished now, so a pretty good investment I think! I’ve used it every night and I think, though I guess I can’t be sure until I stop using it, that it’s improved my skin overall. But the smell is just amazing, I find it so relaxing. I’ve tried tons of night serums since turning 30 (I’m now 37) and I think my favourite is still Origins Plantscription night serum. I’m not sure if this might be too oily for you Anna but I’ve been using the Origins Plantscription daily moisturizer with SPF 25 and it’s great – you only need a small amount and it doesn’t stink like sunscreen and helps with aging, etc. Plus it’s got tons of all natural stuff in it which I love. I really appreciate these posts, thanks Anna!

  • Reply sara November 24, 2013 at 5:00 pm

    Thank you so much for sharing (and thanks to everyone in the comments, too)! I’ve also struggled with adult acne and I complete to relate the feelings of shame and embarrassment that come along with the breakouts. Mine is largely hormonal-based and worsened after I stopped taking oral birth control. I tend to gravitate toward more natural solutions and in searching for a solution over the years I’ve tried dozens and dozens things to little avail. Like you, I tried the oil-cleansing method and using mineral makeup, both of which I did not like.

    Recently I tried some products from the Devita skincare line and so far I’m really liking them. Not a miracle cure by any means and they’re a little pricey, but I like the ingredients and they seem to be working pretty well. My skin is very sensitive and dry in addition to the breakouts, and the aloe vera cleanser isn’t too drying, plus the moisturizers are wonderful and leave my skin so soft. You might want to try their eye cream — it’s bit less expensive than the Kiehl’s one and I absolutely love mine. Their sunscreen is great great as well.

    I’m also interested in the ACV method you mentioned for keratosis pilaris. I’ve had it since I was a baby both on my upper arms and on my cheeks (luckily it’s not too red on my face, mostly just bumpy). My new moisturizers help, but I’d like to try ACV. Do you take it internally or topically?

  • Reply Nickie November 24, 2013 at 6:14 pm

    I’ve struggled with acne for nearly twenty year so I definitely understand the frustrations and confidence issues. I’m glad you’ve found a combination of products that are working for you!

    Regarding sunscreen, I really love TiZo3 from Solar Protection Formula. It’s SPF 40 and slightly tinted. The color might be a bit dark for your complexion but there is also a version that is untinted (TiZo2). Both are available on Amazon. It goes on really smoothly over my moisturizer and is super lightweight so I can put my makeup on over it without a problem. Good luck!

  • Reply sky November 24, 2013 at 8:58 pm

    I am having a breakout of painful cystic acne and am hesitant to see a dermatologist (i dunno why) but I finally went to see a GP and got a 0.1% retin-A prescription on top of clindamyacin to “calm things” down a bit. I really appreciate your recommendations, esp Clarisonic. I have been debating whether to get one because I worry it will be too harsh on delicate skin.

    For sunscreen, I have been using Avene’s SPF 50+ , but I live in Singapore and Avene products are readily available, not sure if you can easily get them stateside.

  • Reply Sarisa November 24, 2013 at 10:45 pm

    Have you tried the Neutrogena Naturals Purifying cleanser? I love it, have gone through several bottles at this point. Sounds like you are pretty happy with your cleanser, though.

    As for sunscreen, I’ve been a HUGE fan of the Elta MD products. I used to use the UV Clear 46 but recently switched to UV Physical Broad Spectrum 41–I like it because it’s a bit tinted and is an awesome primer; no problems whatsoever putting makeup over it. When I’m doing sports, I like to use the Neutrogena Clear Face sunscreen, which is great because it literally feels like there is nothing on my skin. I don’t use it as my everyday sunscreen because I’d rather have a physical sunblocker like zinc oxide rather than something like avobenzone that breaks down over time. I tried Suntegrity because the ingredient list seemed really awesome, but I found that it felt kind of heavy/greasy. Wow, okay. I am a huge sunscreen geek.

    Oh, and just so you know I’m also in my 30’s and although I am lucky not to deal with cystic acne, I definitely get some lovely hormonal breakouts from time to time.

  • Reply Ria November 25, 2013 at 11:19 am

    As a 51 y/o acne sufferer I understand what you are going through. There is an all natural, healthy skin cleanser, that works great for acne prone skin. It is Zum facial oil, I know, OIL?? yes it is not petroleum based but, plant based. So when water is added it foams and then rinses away completely. I use it with my Clarisonic and haven’t had any breakouts since. I even have been able to quit using any medication. Here is the link to the site but, I just buy mine at my local health food store.

  • Reply Anna November 25, 2013 at 2:38 pm

    Thanks, Anna and everyone, for their good recommendations.

    I have some mild facial scarring from acne and on days when I don’t have to be out in public or at work I apply generic scar treatment gel (name brand is Mederma) to parts of my face several times a day. It works pretty well to help the scars fade.

  • Reply Kimberly Marsden November 26, 2013 at 4:47 pm

    Your skin looks gorgeous, like a porcelain doll! Never would have guessed you had acne issues. I’m 38 with darker skin, so sadly, I have scarring. I recently broke out in two pimples that have taken months to go away. Thanks for your post.

  • Reply Hilary November 27, 2013 at 9:58 am

    I just want to say thanks for the tip to wait at least 10 minutes before applying your Retin-A treatment. I’ve been using an AHA/antibiotic blend and I was getting constant red, flakey skin. And, I don’t know why I didn’t think of putting a moisturizer on prior (I use Nuxe oil as well) before my treatment. No more red flakiness!

    Thank you!

  • Reply Char November 27, 2013 at 10:05 pm

    I just wanted to share that I also had a bad problem with cystic adult acne. It was horrible and painful and always scaring. I could not find any products that would rid it. After many different dietary changes I found ‘the one’ two years ago and have been acne free since then. It’s not a fad diet, but a traditional diet. It’s based on the guidelines for eating provided by the Weston A Price Foundation (WAPF). There is also a book called “Nourishing Traditions” which has a lot of great info. Weston A Price was a dentist who went around the world studying teeth and found that it was nutrition that directly caused good (straight and cavity free) teeth and optimal health. Another great book on this is “Healing Tooth Decay Naturally”. On a very basic level we need to eliminate refined sugars, refined grains and get plenty of healthy fats in our diet.
    I truly believe that this is the way humans must eat to avoid acne, hormone problems, diseases, cancers, etc.
    now that I am acne free the only product I ever put on my face is coconut oil which is very “budget friendly”!

  • Reply Katie December 2, 2013 at 6:05 pm

    I’m glad you found a solution that’s working for you Anna! I was suffering from terrible cystic acne along my chin and jaw last winter and it was so frustrating and depressing. I felt like holing up inside and it really lowered myself confidence. I’m also aczone and ziana and they are working like a charm! Aczone is pretty amazing! I almost fell over when I first filled prescription because my insurance for some reason wouldn’t cover aczone even with the coupon. They still wanted me to pay $200! Insane! Luckily, my dermatologist just needed to call the insurance company and authorize me. Kind of a pain, but worked out in the end.

    I’ve heard good things about the Elta sunscreens. I’m using the Clinique Super City Block SPF 40. What I like about that one is it sort of acts like a primer. I’ve also heard good things about Kiehl’s SPF.,default,pd.html?start=2&cgid=face-sun-care

    And I used a SPF from SkinCeuticals. It was light, but a tad greasy for me. Nothing a little powdering couldn’t handle.

    Dark Circle recommendations, but not tested yet. The ladies at Kate Somerville suggested her CytoCell Dark Circle Eye Cream. I ordered some (30% off right now. Ends tonight.) Also this one from Zelens is crazy expensive, but I’ve read good reviews. Only available at SpaceNK.,en_US,pd.html?start=5&q=zelens

  • Reply Steph December 11, 2013 at 5:39 pm

    Hi Anna, I’ve never commented before but I wanted to thank you so much for these posts about your skin. It’s really helpful to know from other “sufferers” about what is working and what is not. I too suffer with the same issues you described and I know how hard it is to talk about. What you said about being “bare faced” in front of strangers or friends really hit home for me. Thanks so much for your recommendations, I am going to try both of the Kiehls’ products you mentioned. I am curious to know what you think about the connection between food and acne – did you notice a difference after becoming vegan and cutting out dairy?

  • Reply Rebecca December 12, 2013 at 9:01 am

    Sorry I’m a little late to the party with this comment but I have suffered with acne since a teenager, I am now early 40s. Doctors said it would go away once I had a baby, I’ve had two and still get spots! That was until last year when I discovered a home based light treatment lamp which has worked wonders for me.

    I’m not sure if it is available in the US but it’s called Lumie Clear the UK:

    It’s not that cheap but if it had been available 20+ years ago I could have saved myself a small fortune on potions and products! Beauty salons and dermatologists can also offer a more intensive versions of this and marketed and red/blue light therapy, it really does work and very gentle on the skin. Really hope someone can benefit from learning about it!

  • Reply Melissa January 1, 2014 at 6:20 pm

    Hi Anna!

    I found your blog via ‘A Beautiful Mess’, and I love it! I am grateful for your willingness to openly share about your struggles with acne. I, too, have been struggling with acne for many years. I am working with a naturopath on some diet changes and am now using a gluten-free skincare called Exuberance. I also got my Clarisonic back out. I am beginning to see changes in my skin (hallelujah!).

    Would you share about your makeup routine, too? I’d love to know what makeup (foundation, etc.) is working for you. I know you mentioned mineral makeup is the enemy. I just fouud out mine was packed full of whest, and I guess that’s pretty common.

    Thanks again for sharing. It’s so refreshing to hear I am not struggling alone.

    • Melissa January 1, 2014 at 6:22 pm

      How did I miss my typos! :/

  • Reply gayleen January 9, 2014 at 9:13 pm

    I really have used Jan Marini’s Daily Face Protectant as my sunscreen for over 5 years and I love it! Every once in a while I try a more trendy sunscreen (yep I have Elta MD and Skinceuticals in my medicine cabinet) but always go back to Jan Marini for my acne prone skin.
    Thanks for your other tips, I am going to try a couple esp. Kiehl’s 🙂

  • Reply Anna February 9, 2014 at 10:32 am

    Hello,Anna.It is kinda late comment,but maybe you will see it. I am as well an adult acne sufferer with huge and clogged pores.Before I started a low carb diet I had to do an acid peeling with ultrasonic peeling every week cause my skin produced the sebum so rapidly and it looked just nasty.It’s been half a year now since I started low carb diet and what a change with my skin .I don’t need to do peeling every week now,just occasionally, once in a month or two.My skin does’t produce that much sebum now,I wouls it even become dry and no breakouts at all !

  • Reply Lena April 25, 2014 at 11:31 pm

    Hi Anna,

    I am going to second another comment regarding the Elta MD sunscreens. Since all of them are non-comedogenic and fragrance/paraben-free, they really lend well to acne prone skin or skin that is sensitive. They just came out with a tinted daily SPF 40 moisturizer that is phenomenal! Their products aren’t cheap, but I think worth the money because I get fewer breakouts and their Zinc Oxide is a whopping 9%, hard to say for a lot of other products. I bet that you can find their products for less online. Also check out Eminence organic clear skin probiotic products. This skincare line uses organic ingredients derived from plants, fruits, and vegetables. Their probiotic products are specifically formulated for acne prone skin and work by replentishing the good bacteria in your skin, much as an oral probiotic does for our gut. I use the masque and I sleep in it when I am not using topical Retin A medications.

  • Reply Linda May 8, 2014 at 7:53 pm

    was wondering if you can recommend me a good at home peeling.
    I was just wondering if you know where I can buy it and if you try it before besides the retinoid.



    • katerina from greece May 18, 2014 at 4:06 pm

      do you know what is felted soap? is the healtier peeling ever. without chemicals, only pure soap and merino wool, which is very gentle for your skin, face and body. if you try it once…

  • Reply katerina from greece May 18, 2014 at 3:52 pm

    try to use pure olive oil soap instead of neutrogena… the olive oil is a miracle, and if yoy try a n olive oli soap with lavender extract or pine for example you will remember me!

    • Anna @ D16 May 19, 2014 at 12:21 am

      Hi Katerina, as I’ve said, oil cleansing (regardless of the type of oil) does not make my skin happy. I’ve tried many times—unfortunately, it’s not for everyone.

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