Face acne and skin care advice please

20 comments

1. I’m assuming you’re a guy, so what’s your shaving routine like? Your razor might have leftover skin on it which spreads bacteria into your pores. Also you might need a heavier moisturizer than just the milk otherwise you’re irritating the skin and causing it to act up. Horse oil creams are really good.

   You could try benzoyl peroxide or sulfur-based products. They’ll typically dry out your skin which is good if your problem is too much sebum. The regular OTC stuff isn’t very good, but Amazon will have some foreign brands.

2. Probably not what you want to hear, but have you tried eliminating dairy from your diet? I had terrible acne for much of my adult life until I got a horrid sinus infection here 5+ years ago. As a matter of course, I always cut dairy from my diet whenever I got a cold (because it helps to thin out the mucous). In this case, the infection went on long enough that I actually noticed my skin improve drastically over the same period, and since then I haven’t gone back.

   In my case, it seems the less processed the dairy, the worse the affect. So milk is no go, while things like butter and hard cheeses are essentially fine (though I still have them in smaller amounts than I used to). If you’re absolutely at your wit’s end, it might be worth trying.

3. Did the derms ever identify and tell you the cause of the acne, because your treatment will depend on that. If it’s adult acne, it could be caused by hormone changes.

   What products are you currently using and what is your skin condition currently like? Does it feel “tight” or does it sting when you apply products? Or do you feel like it produces a lot of sebum so that you’re quite oily by the midday?

   I have acne prone skin, and being on the pill has helped a lot with the acne I would usually get around my period. For skincare, I rotate actives like BHA, Vitamin C and Retinol and leave a day of “rest” in between them, since they can be harsh if used too often. I use Paula’s Choice for actives. It’s a bit on the expensive side but it works for me.

   Btw, I’ve been able to get isotretinoin in Japan, but it wasn’t covered by insurance because I went to an acne clinic and not a derm.

4. Skin clinic in koenji does accutane and one of the drs speaks English. Costs a lot of money though!

5. Have you noticed that your skin gets slightly better when you go on multi-night trips to other places (either abroad or within Japan)? I have pretty horrible acne most of the time, but it’s improved significantly when I stayed in certain cities in Japan, whereas in other cities it was just as bad as in Tokyo. I’m starting to think it might have something to do with the water.

6. 10% benzoyl peroxide face wash + sunscreen twice a day (may need to graduate through 5% first).

   Change to white towels and white pillow cases. Also wash your pillow cases often.

7. Had this problem recently and was able to fix it.
   First, make sure that your shower and sink where you wash your face have a water filter. My skin problems in Japan have 100% been tied to the water quality.
   Second, some face creams and serums with zinc might be a good option to try. Iherb has a few of you can’t find any at your local stores. These kind of products really helped me to fight acne without being too drying. Good luck!

8. Differin gel worked great for me.
   It did take several months to see the effects, and there was an initial “purging” period where my skin was quite dry and red, but this subsided after several weeks.

   I’ve found introducing a heavier moisturiser to help a lot too. The Muji 敏感肌クリーム is fairly cheap and worked well for me.

   You could also try a set of light chemical peels too. The glycolic acid peels at SBC were not overly intense and this combined with differin made a big difference.

   This may sound counterproductive, but double cleansing with an oil based cleanser then a regular foaming cleanser helped to get out the everyday gunk that tends to build up. The pink スピーディオイルクレンジング I’ve found was a good match. The yellow ディープクレンジングオイル gave me even worse breakouts, perhaps as it includes mineral oil.

9. I’ve recently had success using Dove moisturizing face wash, face towels(different towel for face and body), and then dove all in one moisturizer. https://lipscosme.com/posts/3286688 this one from Don Quixote. Gently rub it in, let it sit 30~60 seconds then rinse. Give it a month or so, slow and steady.

   What do you use for shaving? I use a badger brush and muhle shaving soap, then feather blades in a DE safety razor. I’d recommend switching if you don’t currently use a badger brush. It’s good for cleaning the skin.

   I used to use medicated and acne specific products, but after initial gains it would regress pretty quickly.

10. I might look into trying retinol. It speeds up the turn over of your cells, and penetrates pretty deep into the layers of skin. You can get it prescribed from a dermatologist, or use a weaker version available OTC. Kiehl’s makes two products, a weaker and stronger one (a little pricey, but I used them every other night and they lasted a pretty long time). I’ve used both and like both, but I would recommend starting with the weaker formula. If you do go down this route, you’ll have to wear SPF in the daytime and avoid tanning (your face, at least). *Just to note, retinol often has a “gets bad before better” stage at first, so you might potentially have to deal with that.

    You might also want to try some sort of AHA/BHA toner pad. There’s a Korean brand called VT that has one that I quite like that’s available at most big drugstore chains. It’s gentle, and I use it every other night. You could also use it with retinol, but you’d need to do them on separate days, and kind of listen to how your skin is reacting. I’d start with one or the other first and then slowly add in other active ingredients.

11. Some clinics prescribe isotretinoin. But it is not covered by insurance.
    The below are some treatments for acne. If you have already tried all of the insured treatments then I recommend consulting a cosmetic dermatologist and plastic surgeons which can provide you more options.

    Edit: also adapalene gel will have a similar effect since it is retinoid and combined with benzoyl peroxide and antibiotics are the most you can do for topical medication covered by insurance, but I guess you’ve already tried those.
    Oral Antibiotics are effective for short term but not recommended for long, but some can be used chronically.
    There is also Chinese medication (Kampo, 漢方) that has been reported effective, and I’ve seen it do very well in patients who had acne resistant to other medication.
    Vitamins are sometimes effective, but is used more as a supplement to others and not drastic on it’s own.
    Also there are infrared light, tretinoine (topical/oral) and chemical peeling which are private practice.

12. *Not a doctor.

    In my late 20s, I suffered from acne that seemed to come on unexpectedly, especially cheeks chin area.

    Tried everything and after so much research and dermatologist visits, still nothing helped but I got one basic takeaway which was that if skin ph level is too acidic or alkaline (usually humans are too acidic), acne happens.

    So the best thing to do is try to rebalance your skin’s ph level. This could be hormonal, diet, stress, environmental, combination of causes.

    However, you mentioned that your skin looks dry so I guess you need to moisturize more. Also, you mentioned you work out a lot so perhaps you are taking too many showers or washing face too much. Sorry for the assumptions.

    Try changing one thing at a time so you can see if it works. If you aren’t already, I’d try to stick with one shower and face wash each day, followed by moisturizer after and see how that goes for one week. Aiming for dry skin will create more oil so avoid that. Look for less redness, neither oily nor dry skin, and acne healing slightly faster as signs of improvement.

13. I found using this and washing my face three times a day with normal soap (morning, when I get home, and before bed) was effective:

    https://www.amazon.co.jp/Perfection-Quasi-Drug-All-Daytime-Bonus/dp/B0B4Z11S7Q/ref=mp_s_a_1_28?crid=U6E8ZSN1NPHQ&keywords=ウーノ+メンズ&qid=1680156166&sprefix=uno+men%2Caps%2C343&sr=8-28

14. Have you tried tretinoin? After I did a round of Accutane my derm put me onto tretinoin to keep the acne at bay. It’s applied topically and it’s kind of similar to Accutane in that they’re both vitamin a derivatives. You can order tretinoin online for a fairly reasonable price and get it mailed to Japan (it’s not banned like Accutane is). If Accutane worked for you tretinoin might too. There’s different dosage and such, but there’s a lot of information about it online.

15. If you do decide you’re going to use at your own discretion, make sure you do a liver function test regularly.

    Not gonna give you medical advice, but the price difference between Oral Isotretinoin in Japan vs in Bangkok is more than likely to pay for the flight and 2 nights stay if you buy a one year supply.

    Just go to non-name brand pharmacies and ask for acnotin 10mg.

16. For me having horrible acne in my teen and 20s the solution wasn’t antibiotics for me but more so dietary changes, eliminating sugar, coffee, alcohol, and eating better, exercising, resting, getting sunlight, using tretinoin (careful), bha, simple skincare eg rovectin, drink enough water but not too much

17. I bought Accutane meds online from a japanese website and ship here. shipping take roughly 2 week or less. Not very expensive either . But this is taken at your own discretion. PM me if you want the details.

18. I had brutal acne all my life. What you want to do is go to a doctor and get a “curative dose of vitamin A “. Vitamin A is a bit dangerous because too much of it can damage your liver so make sure the doctor is keeping tabs on you. There are several medicines that are basically vitamin A.

    Goos luck

19. Apply Differin gel all over the face at night.

    If you put on make up/ sunblock, you need to deep cleanse with oil cleanser, and double cleanse with foam cleanser at the end of the day.

    Morning also needs to wash face with face cleanser.

20. I’m not a doctor or nutritionist, but even at the age of 35 I would still get acne. However, when I switched to a ketogenic diet my skin completely cleared up and now I actually have people complimenting me on how nice my skin is.