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Subj: Over exfoliated my entire face
I apologize for the length of this, but I need to give you as many details as possible in order for you to help me. I am a 41-year old female from northern Illinois. On March 16, 2009, in trying to help some very mild acne/pimples and dull skin, I aggressively exfoliated my entire face, scrubbing hard with a coarse scrub sponge, using that with crushed Apricot Seed Scrub. I think I may have also washed my face with Oxy Wash 10% Benzoyl Peroxide after exfoliating. After the aggressive exfoliation (and possible washing with Benzoyl Peroxide), I applied Tretinoin .025% (applying more than the recommended amount) to entire, damp face only one time - left it on all night.
The following day, my pores were opened up all over my face - my skin texture was changed - was rough, tough - looked like orange peel skin, leather-like, and crinkled-looking. It was only slightly irritated at that point, but was able to tolerate cleansers and lotions. Then 4 days later from March 20-23, 2009 (4 nights straight) I applied Differin .50%, also on a damp face, and left that on each night. That seemed to send my skin over the edge because by the 4th day of applying Differin I developed some small, painful sores around nose and cheek which are now scarred. After that I could NOT tolerate any cleansers/lotions - even the most gentle. Since then I've experienced everything as I mention below.
NOTE: for many months I was using Oxy Wash 10% Benzoyl Peroxide, along with rubbing alcohol or sacylic acid toner as an astringent before I did this on March 16th. Lasting, non-improving symptoms for 7-8 weeks are as follows: Constant burning, stinging, irritation, inflammation, and throbbing in face- it literally feels like it's on fire - like the worst sunburn. Running intermittent low-grade fevers 99.2-100.5. Noticeable changes and problems have occurred in skin since I did this:
· Skin is rough and tough - texture is not the same as before I did this (it almost has grainy leather, crinkly or orange peel texture & appearance to it - my skin was smooth and in good condition prior to this)
· Pores have opened and enlarged over entire face.
· Skin appears to have prematurely aged after doing this.
· Skin seems very fragile since this first happened.
· I am easily experiencing deep creases and indentations in skin from lying on a pillow, holding a telephone, etc. This has been happening every day since I did this. It's taking a very long time (over 3-4 hours) for my skin to bounce back. In the past, I would very seldom get a crease or two on my face from lying on a pillow in the same position all night, and when it did happen, it bounced back quickly.
· Where I've plucked hairs on my eyebrows since this first occurred, I have some holes where I plucked the hairs out. This is only above the eyebrows in the area I exfoliated and applied the medications. I don't have any holes below the eyebrows, as I didn't apply anything there.
· Skin feels dry and tight - like it's been stripped of everything. OTC moisturizers irritate and don't help. I've never had irritation to any products ever before. Before all of this, I could pretty much use anything on my face and nothing ever irritated my skin.
· Skin becomes very taught and dry and irritated after washing with water.
· Skin is tight and it hurts to make facial expressions such as opening mouth wide or smiling.
· Skin is tight between and around eyes - it's pulling/tugging down my eyelids.
· Difficult to raise eyebrows - pulls and tugs between and around eyes.
· Burning has traveled around eyes and eyelids and on lips (NOTE: I never applied anything there.
· Feels as though I've lost elasticity in skin
· Skin is producing some oil, but it's not enough to hydrate.
· Scarring, pitting and ice pick marks have appeared, along with small crevices and wrinkles.
· The larger, scarred holes (ice pick marks) that I explained are where I used to have blackheads for many years - now they're enlarged holes.
· The only scars I had on my face prior to this were two old chicken pox scars from when I was a child - these are now larger, deeper and more prominent.
· A few existing pimples I had when I did this to my face, along with new ones have not healed properly - they're raised, red nodules and are now scarred-looking on the surface. My pimples would always heal and disappear prior to this without scarring or discoloration.
· Irregular or round flat brown pigmentations have been appearing all over my face that weren't there before. There are other darker, textured & scarred pigmentations and splotchy discolorations that have appeared on face as well.
· Hypersensitive skin - hurts to touch it. If I lightly rub my fingers across it, it feels like something very sharp is going across my ski - especially in most sensitized, tender areas on cheeks, in between nose & mouth, forehead, in between eyes, chin. Redness/rash appears if I rub those areas. I've never had any sensitivity or redness in my skin prior to this.
· Skin gets very irritated when I'm in dry heat, whether in a car or a house. I get a burning, irritated sensation when I'm outdoors or near a window from the UV Rays - even on a cloudy day.
· I get more pain and burning if I blush or when my temperature is up.
· Tears make my face sting (possibly from salt in tears)
· Skin is becoming more and more irritated as time goes on, yet I'm putting nothing on it anymore - just rinsing with water.
· My skin is normally very pale and pasty - it is now darker overall and more pinkish/ rashy-looking between eyes, between lip and nose, underneath lip and in chin area, cheeks - this is where skin has been most irritated, tender, and has had the most burning pain. Skin was very red and rashy looking when this first occurred - mainly because of all of the further irritation that the cleansers and lotions were causing. Most cleansers, lotions, and ointments now irritate the skin and make it burn and sting. I've tried OTC hydrocortisone cream, triple antibiotic ointment, Cetaphil, Aveeno, Silvadene, Vitamin E oil, Aloe Vera gel, etc. Most products - even the most gentle - irritate it even worse and don't help at all. Had no problem using anything on my face (cleansers, astringents, etc) prior to this. The constant burning, stinging, irritation, and throbbing have caused lack of sleep for weeks now - most nights I cannot sleep at all - I am extremely uncomfortable. I have also experienced loss of appetite because of it as well. More and more difficult to function day-to-day because of all of this - especially due to the burning, throbbing, irritation.
General doctor felt I may have stripped away my epidermis and received a chemical burn from multiple retinoids. She had me on Silvadene for a week, but I couldn't use it consistently as it further irritated my skin. It didn't seem to help. Before March 16, 2009 I had pretty good skin - it was smooth with just very mild acne- just a few pimples here and there - no enlarged pores or rough texture - no pits or scarring, except for the 2 chicken pox scars from childhood. I had under a handful of small, round pigmentations for as long as I can remember, but now countless pigmentations have appeared since I did this. I know my own skin very well and I've NEVER had any of these problems prior to doing this - all of this happened to my skin AFTER I aggressively over exfoliated and applied Tretinoin, followed by applying Differin 4 days later for 4 straight days. I have never experienced anything like this ever before. I want to know what is happening to my skin and if it is permanently painful and permanently damaged. If I would have known that this would have been the result from what I did/used, I would have never, ever done any of this or used these products on my face in this manner.
My main concern right now is the burning pain, tightness, severe irritation, extreme sensitivity of my skin from what I used/did and the fact that it is not getting any better. What can be done to help heal my skin and bring my skin back to normal? This does not seem normal as to why I am still experiencing this; things are getting worse and not better. This has been very intolerable for 7-8 weeks now and I want the burning, irritation, and throbbing to go away and for my skin to heal and return to normal once again. Thank you,
AskDocWeb: It sounds like you need the help of a specialist rather than your regular health care provider. A dermatologist is the expert to consult in dealing with this sort of chemical burn.
I wanted to know if I can apply a bit of moisturizer on my face before applying retin a so that it doesn't dry out my skin much.
AskDocWeb: There are too many unknowns. Moisturizers have a variety of ingredients, each of which has a different chemical reaction when mixed with Retin-A. Then there is no way to know how your skin will react to the chemical reaction between the Retin-A and the moisturizer. It is safer to follow the instructions and then use a moisturizer afterward.
Subj: Using Retin A for 20 years!
Here Go`s :-) In my teens I add bad boils on my face, thats when I 1st met retin A :-) Well I've been using retin A now for 20 years!! plus sunblock! also I've not been sunbathing for 20 years between the hours 11pm to 3pm I don't tan anyway:-( I'm now 45, and people say I look around 27! I also get asked for ID when buying wine etc!! I've now got the skin I wanted in my teens!! It's lovely young fresh skin. So if you're using retin A stick with it.
AskDocWeb: Please not that it is not clear from the above post if Dave is a man or if Dave's female partner is using his email account.
Subj: My skin is getting more oily
I have been using retin-a for about 8 weeks. At first I had mild redness, peeling, increased acne but it has slowed down a lot and I have actually noticed improvement in my skin with a few pimples still here and there. The problem I have noticed the last couple of weeks is that my skin is getting more oily. I use Cetaphil face cleanser and lotion(very mild)...any products that would be better?
AskDocWeb: Although it is not listed as a side effect, several women have reported that their skin became more oily. A couple have noted that they obtained better results by switching to the gel because the cream made their skin very oily.
My skin is very sensitive, any Neutrogena or Aveeno lotion gives me a burning sensation. The only brand I could use was Shiseido, but I want to change to a less expensive one. I also use SPF 40 everyday, after moisturizer. I have been using Retin-A micro on and off for 6 months now. I had a terrible burning sensation during the first month, so I used once a week, then twice a week and now I am able to use everyday. Sometimes I give my skin a day off. I also use a moisturizer right after Retin-A (which today I learned reduces its effect). But even with it, I can see my skin tightening and now changing very rapidly. Questions I have: (a) can I use Roc Retinol Correction eye cream and its daily moisturizer partner? Off course if it gives me allergy I will stop. What I want to know if it is safe to use with Retin-A. (b) Are there any moisturizers that cannot be used with Retin-A?
AskDocWeb: RoC Retinol combines an AHA (glycolic acid) with retinol in the same formulation, which is an unstable combination. In fact, Dr. Leslie Baumann, dermatologist, author of The Skin Type Solution, and chief of the department of cosmetic dermatology at the University of Miami, says that AHA and retinol should not be used together: "Retinol is a highly effective ingredient, but it is unfortunately not a terribly stable one! Alpha hydroxy acids (such as glycolic acid and lactic acid) inactivate retinol, and the two should not be used together." We haven't heard of any moisturizers that can't be used with Retin-A, just make sure your moisturizer doesn't contain any acids (AHA, glycolic acid, lactic acid, etc.). Choosing a moisturizer is often a matter of trial and error.
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