I remember when I was 13 years old, I had grown very conscious of the pesky pimples that would show up on my face uninvited, just living there for weeks rent-free. During that time I was living in Singapore, a tropical island known to be humid all year round which made it utterly impossible to conceal the pimples because the makeup would just melt off at some point during the day (not that staying on would have made much of a difference as it was impossible to find a concealer that matched the true tone of my brown skin with an olive undertone back then)!
I remember going to beauty stores with my mother and dropping into the cart anything that had “acne-prone skin”, “fights acne” and anything anti-acne written on it. My mother suggested I try some natural home remedies (typical Indian mother), claiming that it is “better for the skin” and worked wonders for her when she was my age. I had tried everything. Multani mitti (fullers earth), besan (gram flour), turmeric, honey, lemon, toothpaste… everything! But nothing seemed to do the trick. I even drank a syrup called Safi Natural Blood Purifier that claimed to detoxify the body's impurities and give you glowing skin- but all it did was make me want to vomit. I would later go on to learn that your body detoxes itself and acne is caused by hormonal imbalances, not blood impurities.
After having tried it all, I convinced my mother to take me to a dermatologist. I remember it being a very short trip, I wasn’t exactly prepared nor aware of what needed to be brought up other than the pesky acne that I wanted to get rid of asap. The dermatologist observed my skin for a few seconds and started writing on the prescription paper. We were out of there within 5 minutes and went straight to the pharmacy. The prescription I was given was for two things- a benzoyl peroxide face wash and 1% Retin-A cream. I was not properly walked through what retinoids were or what their side effects may be at the time.
I went home happy that I finally got an expert opinion and found the holy grail for my acne. I know it sounds dramatic, but most teenagers are. I started using the products straight away that very evening. In the morning, I woke up feeling like my face had a heartbeat of its own. It really felt like it was pulsing, tight and stretched but I was convinced it meant that the products were working. The day after my skin began peeling and how! The first week was met with lots of dryness and flaking, which although not ideal I did not mind as I could see my acne scars were literally peeling off my skin. In my naive head at that time, strength automatically equated to results. I noticed my active acne shrinking and the formation of new ones becoming less frequent. I thought I finally made it and was done with acne.
From ages 15 to about 22, I had decent skin more or less with a few zits making an appearance from time to time. It wasn't crystal clear skin but it wasn't bothersome either. I started trying out new face washes and moisturisers with no specific logic (my go-to were Clean & Clear, Neutrogena and Clearasil- the ones that were heavily marketed at the time) and my Retin-A usage had dropped. Around this time I had also switched to retinol as I figured I no longer needed the heavyweight retinoids like Retin-A. (If these terms are confusing, please check out my blog on the different kinds of retinoids available in OTC and prescription based formats to better understand what they are and what they do.)
Unfortunately, around the time I was 23, my acne gradually started to come back. I had made the mistake of thinking I knew better than experts and that I knew the approach this time around. I went and got OTC retinol. However, the acne would not budge, instead, it just intensified. It became flaring, red and inflamed cystic acne. It actually made my teen acne look cute. I spiralled back to my drugstore in desperation of picking up anything anti-acne and figured my acne should clear up soon as I am no longer a teenager.
When I was 27, my adult acne was at its peak. During this time I was also diagnosed with Hashimotos and had to have a total thyroidectomy. I was not sure when my thyroid issues began but retrospectively it clarified a lot of things for me related to my energy levels, my moods, my weight gain and my acne vulgaris. Post-surgery, my skin took a back seat as my efforts were purely focused on healing my body internally and getting my hormonal health on track.
When I turned 29, I decided it was time to visit a dermatologist again. This time I made sure the doctor listened to all my skin concerns, my skincare regime, my medications, my lifestyle and basically anything and everything related to my health as well as my family history. The doctor customised a medium and long term regimen for me to implement so that I could simultaneously work on getting rid of old acne scars, current active acne and future acne from showing up. This is when and where I realised I had not been advised the best way I could have been by the dermatologist back when I was 13. The following is what has been prescribed to me:
Clean face using salicylic acid (2%) with glycolic acid (1%) face wash. When applying the face wash, let it sit there for a minute or two before washing it off. I am using D’Acne Face Wash Foaming by Glenmark.
Apply Micro Tretinoin Gel, pea-sized amount every night all over the face, except eye area. Before I would just apply tretinoin on active acne or acne-prone areas only, this worked to make pimples go away faster but did nothing to prevent them and left my skin with an uneven skin tone. So applying it all over my face made the world of difference in reducing acne overall and getting brighter and even skin. I use Retin-A Micro 0.1% by Janssen.
Wear sunscreen every day, at least 30 minutes before stepping out into the sun. If you have oily skin like me, use gel-based sunscreens and moisturisers. I use Rivela Gel Sunscreen by Cipla.
Apply Clindamycin And Nicotinamide on active acne. I use Faceclin Gel by Abbot.
Take Isotretinoin 10mg at bedtime for two weeks, then 5mg at bedtime for one month. I’m taking Isotroin-10 by Cipla.
I have just recently entered my 30’s and my skin has never been this clear, bright and plump. That is not to say I don’t have any active acne coming up every now and then or that my scars have completely vanished, but I have noticed an immense reduction of both. I can see that my skin is finally glowing and my tone is finally evening out all over. It’s become more smooth and supple, and I can honestly say that my skin looks healthier and more youthful now than it did for most of my 20s!
I’m sure you know that what works on someone else's skin doesn't necessarily have to work for you, but I hope now you also know that what worked for you 5 years ago also doesn't necessarily have to work for you now. Our skin keeps changing due to innumerable factors and we have to change how we care for it accordingly. On this journey, our best bet will always be consulting with dermatologists.