It's been ages since I last wrote about my skincare routine, and I thought it was high time for an update! All of my drugstore-priced, longtime favorite "holy grail" products are still in there, but the set of prescription products I use has changed slightly.
As I suspected, once I started my current job, I was no longer able to see my fancy dermatologist on my new insurance plan, but it's turned out not to be a big deal. My general practitioner has been happy to prescribe my acne-related medications, so it's all good. Insurance co-pays continue to be weird for my topical prescription medications, but that's not exactly new, as I'd already experienced paying anywhere from $40 (with manufacturer coupon) to as much as $80 per refill (a number I was previously shy about disclosing) on my old plan. Alas.
Please keep in mind that I'm not a medical professional, and can only speak to my personal experience with various skincare products and routines. To the extent that one has the misfortune of suffering from moderate to more severe acne (my sympathies!), the best first step for me has always been to start with the doctor or dermatologist, and what they prescribe.
As I suspected, once I started my current job, I was no longer able to see my fancy dermatologist on my new insurance plan, but it's turned out not to be a big deal. My general practitioner has been happy to prescribe my acne-related medications, so it's all good. Insurance co-pays continue to be weird for my topical prescription medications, but that's not exactly new, as I'd already experienced paying anywhere from $40 (with manufacturer coupon) to as much as $80 per refill (a number I was previously shy about disclosing) on my old plan. Alas.
Please keep in mind that I'm not a medical professional, and can only speak to my personal experience with various skincare products and routines. To the extent that one has the misfortune of suffering from moderate to more severe acne (my sympathies!), the best first step for me has always been to start with the doctor or dermatologist, and what they prescribe.
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As background, I have long had bad skin. Its main problem, for at least 18 years now, is acne, primarily the big, icky, under-the-skin kind that could hang out for a month or more, even when I was on both Retin-A Micro 0.1% (the highest dose) and the contraceptive Yasmin or its generics. I get other, more typical breakouts with smaller blemishes too, but those heal so quickly in comparison, and are so easily covered up with makeup, that they've always been easy for me to ignore. Doctors sometimes refer to my acne as cystic, though anecdotally, there may be a distinction between what I typically get (which eventually "comes to a head"; can pop, often by accident; and is then helped along by hydrocolloid bandages, in my case the CosRx Pimple Master Patches) and actual "cysts" which, on the thankfully rare occasions I've had them, tend to be smaller and and less inflamed most days, but also don't ever "come to a head" and start healing. Instead, they hang out for months on end before, sometimes, mysteriously disappearing.
Various combinations of additional products, including some over-the-counter ones, have helped reduce the frequency, size, and average healing time of my icky, under-the-skin blemishes. But even now that my skin has turned a bit of a corner, mainly thanks to prescription spironolactone, I still don't have perfect skin. I also don't think "perfect skin" is possible for me, it's just not a realistic goal, and I've long since accepted that.
Even if I never got another blemish again (unlikely!), the aftereffects of the years-long battle with acne will remain, mainly in the form of some oddly textured skin on my cheeks and chin. While those patches don't quite rise to the level of what's in photos of atrophic acne scarring, they're still noticeably bumpy if one gets really up close and personal, and the condition appears to be permanent. Nearly a decade of daily Retin-a Micro use hasn't been able to make that odd texture go away. Most days, I also have small dark spots left over from recently healed blemishes, but those, at least, tend to fade significantly over time, sometimes within as little as four to five weeks. (Though with my ongoing acne issues, by the time one dark spot has faded, another has popped up.) Whatever can be done about the oddly textured, slightly bumpy scarring, it's probably going to be expensive, and not covered by health insurance.
Some may remember the hullabaloo surrounding that silly The Outline article claiming that the entire skincare industry is one giant con. Many objected, including at Man Repeller, Racked, and Vox. Had I been paying attention then, I definitely would have objected too. From years of experience, including months-long periods where I stopped the Yasmin or dialed back the Retin-A Micro, only to find that I really couldn't do that if I valued the appearance of my skin, I've learned my lesson that, at least for me, there are times when extensive use of clinically-proven skincare ingredients (whether prescription or over the counter, and in my case, oftentimes both) is absolutely necessary, even if I just want to eke out a few weeks in an average month when I don't have one of those big under-the-skin blemishes hanging out.
In the meantime, however, I've also learned that "more" is not always better when it comes to those more clinically proven "active" ingredients. Indeed, though there was a time that my skin did very well with one of those Korean or East Asian skincare market-inspired 10-plus step skincare routines of legend (both morning and night), I may have been slightly in denial about how well it was actually working for me overall.
When that routine was working for me, as it did most of the time, it was fabulous! My skin got almost completely clear of those gross breakouts, for as little as two weeks to as long as a few months at a time (all of which is excellent results by my standards), and it often had an attractive "glow" that can't be replicated now that I've cut certain more expensive items from my routine. (In my experience the Missha First Treatment Essence, a SK-II dupe, is pretty unique in imparting a certain "glow" I don't get from any other product. Though your mileage may, of course, vary.) During the good times, my skin even got to the point where I honestly thought it looked better without makeup than with! Though I must admit, one factor there was that I don't have particularly excellent makeup skills.
When that routine wasn't working, however, probably because the combination of all those active ingredients, mainly the BHA (whether from the Paula's Choice 2% BHA Liquid or the one-two combination of the CosRx BHA Skin Returning A-Sol and BHA Blackhead Power Liquid) was a bit "too much" for my skin, I'd get irritation-related breakouts, or my skin would get red and blotchy, or dry and flaky, and would need quite a few days of rest with a dialed-back "gentle, moisturizing products only" routine. I used that 10-plus step skincare routine, switching a few products in and out, for nearly three and a half years before the dermatologist asked me to take a step back, to let my prescription products better do their work. Since then, I've realized that, while my previous routine was great sometimes, those "good skin" months or weeks were always punctuated by semi-regular bouts of irritation-related breakouts. So maybe that super-extensive skincare routine wasn't the best idea after all.
Please follow the link below to read about my current routine!
Even if I never got another blemish again (unlikely!), the aftereffects of the years-long battle with acne will remain, mainly in the form of some oddly textured skin on my cheeks and chin. While those patches don't quite rise to the level of what's in photos of atrophic acne scarring, they're still noticeably bumpy if one gets really up close and personal, and the condition appears to be permanent. Nearly a decade of daily Retin-a Micro use hasn't been able to make that odd texture go away. Most days, I also have small dark spots left over from recently healed blemishes, but those, at least, tend to fade significantly over time, sometimes within as little as four to five weeks. (Though with my ongoing acne issues, by the time one dark spot has faded, another has popped up.) Whatever can be done about the oddly textured, slightly bumpy scarring, it's probably going to be expensive, and not covered by health insurance.
Some may remember the hullabaloo surrounding that silly The Outline article claiming that the entire skincare industry is one giant con. Many objected, including at Man Repeller, Racked, and Vox. Had I been paying attention then, I definitely would have objected too. From years of experience, including months-long periods where I stopped the Yasmin or dialed back the Retin-A Micro, only to find that I really couldn't do that if I valued the appearance of my skin, I've learned my lesson that, at least for me, there are times when extensive use of clinically-proven skincare ingredients (whether prescription or over the counter, and in my case, oftentimes both) is absolutely necessary, even if I just want to eke out a few weeks in an average month when I don't have one of those big under-the-skin blemishes hanging out.
In the meantime, however, I've also learned that "more" is not always better when it comes to those more clinically proven "active" ingredients. Indeed, though there was a time that my skin did very well with one of those Korean or East Asian skincare market-inspired 10-plus step skincare routines of legend (both morning and night), I may have been slightly in denial about how well it was actually working for me overall.
When that routine was working for me, as it did most of the time, it was fabulous! My skin got almost completely clear of those gross breakouts, for as little as two weeks to as long as a few months at a time (all of which is excellent results by my standards), and it often had an attractive "glow" that can't be replicated now that I've cut certain more expensive items from my routine. (In my experience the Missha First Treatment Essence, a SK-II dupe, is pretty unique in imparting a certain "glow" I don't get from any other product. Though your mileage may, of course, vary.) During the good times, my skin even got to the point where I honestly thought it looked better without makeup than with! Though I must admit, one factor there was that I don't have particularly excellent makeup skills.
When that routine wasn't working, however, probably because the combination of all those active ingredients, mainly the BHA (whether from the Paula's Choice 2% BHA Liquid or the one-two combination of the CosRx BHA Skin Returning A-Sol and BHA Blackhead Power Liquid) was a bit "too much" for my skin, I'd get irritation-related breakouts, or my skin would get red and blotchy, or dry and flaky, and would need quite a few days of rest with a dialed-back "gentle, moisturizing products only" routine. I used that 10-plus step skincare routine, switching a few products in and out, for nearly three and a half years before the dermatologist asked me to take a step back, to let my prescription products better do their work. Since then, I've realized that, while my previous routine was great sometimes, those "good skin" months or weeks were always punctuated by semi-regular bouts of irritation-related breakouts. So maybe that super-extensive skincare routine wasn't the best idea after all.
Please follow the link below to read about my current routine!









