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Dermatologist Appointment Thursday - What to ask for?
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cat301
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Tue Sep 20, 2011 7:29 am      Reply with quote
Good morning. I made an appointment with a dermatologist on Thursday. Here's some info about me....

I went through a phase as a teenager where I tanned frequently. Now I'm so worried about wrinkles and aging I'd rather be pale than bronzed.

I live in SW Florida, but I'm pretty cautious about staying out of the sun. However, I haven't been as diligent about sunscreen on a daily basis and protective clothing as I could be. For instance, I wear SPF 30 on my face every day, but not on my arms, and not always on my neck and chest. I booked an appointment for 2 reasons. First to get a good exam from the doc. Part two is for vanity. I am 33 years old, fair skinned, dark haired, I have some brown spots from tanning when I was in my late teens. I have oily skin, some large pores, a lot of blackheads, mostly nose and chin, but some on the cheeks. I also have some milia, mostly around my eyes. I think it's hideous. Friends say they don't notice it.

I was using Dermalogica Dermal Clay Cleanser and Daily Microfoliant & Olay Reginerist DNA Moisturizer. I wasn't really impressed with the Dermalogica products. My pores were still really congested. During the last week I started using Cerave moisturing cleanser, Dr. Haushka Cleansing Cream once or twice daily, Walgreens Alpha Hydroxy Face Cream & stuck with Olay Reginerist DNA Moisturizer. I'm purging some and the black heads are lessening. I've ordered a Clarisonic Mia. I will have it tomorrow. I wear a full face of makeup every day. I tend to get VERY oily this time of year, so after my moisturizer I wear a mattifier, right now it's by ProActiv. Then after my mattifier I use a primer (Smashbox photo finish). I use a long wearing liquid foundation, powder, etc on top of that. I'd love to be able to have makeup optional days.

I'm hoping for retin-A from the dermatologist. Also, I've read a little about copper peptides. Is Copper Peptide serum something a dermatologist would perscribe/recommend? Any questions I should ask? Any hints, tips, suggests, etc? I'd like to have, at long last, have makeup optional skin. I've been snooping around the forums for a little while. For this reason I started using the Walgreens Alpha Hydroxy & The Dr. Haushka Cleansing Cream. So far I feel like I'm moving in the right direction.

I look forward to hearing your expert ideas and suggestions.
GirlieGirl
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Tue Sep 20, 2011 11:44 am      Reply with quote
You may or may not find your derm helpful for anti-ageing, it really depends on the derm. But You can definitely ask about retin-a. That and daily SS are 2 of the best things you can do for your skin and they are proven.

You might want to consider Triluma, its a combo of fluocinolone acetonide/hydroquinone/tretinoin. This will be very helpful for your brown spots. You only use it for 12 wks then you could switch over to retin-a. Be prepared none of these rx's will be covered by insurance.

Copper peptides are not rx. Some people like them, some don't. I have tried them but did not find them helpful.

You said you were very oily, do you actually have any dryness? If not you can skip the moisturizer. It doesn't prevent wrinkles.
cat301
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Tue Sep 20, 2011 12:03 pm      Reply with quote
GirlieGirl wrote:
You may or may not find your derm helpful for anti-ageing, it really depends on the derm. But You can definitely ask about retin-a. That and daily SS are 2 of the best things you can do for your skin and they are proven.

You might want to consider Triluma, its a combo of fluocinolone acetonide/hydroquinone/tretinoin. This will be very helpful for your brown spots. You only use it for 12 wks then you could switch over to retin-a. Be prepared none of these rx's will be covered by insurance.

Copper peptides are not rx. Some people like them, some don't. I have tried them but did not find them helpful.

You said you were very oily, do you actually have any dryness? If not you can skip the moisturizer. It doesn't prevent wrinkles.


Forgive me. What is daily SS?

In the heat in Florida, I'm a big greaseball. I'm dry in the winter though. There is no middle ground. I guess I've always used moisturizer because my SPF is a moisturizer too. I hadn't thought of just using SPF with no moisturizer. I need to look into that. Thanks for the info on Triluma. I will talk to the doc about it.

As much as aging is a concern, so are blackheads & acne breakouts. I have like 2 lines on my my forehead and I'm starting to show fine lines under my eyes. My moms eyes look bad. She's 57ish and just a lot of lines under the eyes. I want to nip this in the bud before it's too late.
GirlieGirl
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Tue Sep 20, 2011 2:18 pm      Reply with quote
SS = sunscreen

I'm in SW FL too, the weather is tough on our skin. I've gotten into the habit to putting SS on my arms, hands and decollete after I finish my face.

Are you sure none of your current skin care/make up are causing your breakouts? I'm acne prone wouldn't be able to use some of the items you mentioned. Have you tried BHA and benzoyl peroxide for your breakouts?
cat301
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Wed Sep 21, 2011 6:18 am      Reply with quote
It's definitely possible that some of my products are making my skin worse. Which ones would you recommend I drop? I have not tried BHA. What should I buy? I do have persagel and I dot that on my blemishes and that seems to help some.
GirlieGirl
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Wed Sep 21, 2011 7:09 am      Reply with quote
The thing with acne is you need to work on prevention by using acne products daily. I'm a big of Paula's Choice BHA. She has many options but I like the liquid from the acne line. What % BP is persagel? You really only need to use 2.5%. Paula's choice, acne.org, neutrogena, proactive all offer 2.5%.

Walgreens Alpha Hydroxy Face Cream isn't a good option for those who are acne prone, it does contain pore clogging ingredients. I also think you would benefit from switching over to BHA instead.

I broke out from the Smashbox primer. My skin doesn't like silicone, its very much a YMMV ingredient.

I don't think either cleanser you are using are good at removing makeup but are fine for morning use.
cat301
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Thu Sep 22, 2011 5:59 am      Reply with quote
Doc gave me Retin-A .025 and a topical antibiotic to start with. He suggested a Tagament prescription to bring down testosterone, which causes oiliness. I told him I wanted to wait on the Tagament and see how I do without it.

Now I need to do some research how else I should revamp my skincare routine.
GirlieGirl
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Thu Sep 22, 2011 6:39 am      Reply with quote
.25% is a good place to start, the cream or gel?

Did he do blood work? He cant assume your testosterone is high without testing you.
cat301
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Thu Sep 22, 2011 6:42 am      Reply with quote
No, he didn't do blood work, I had blood work done a month ago and my testosterone is in the normal range. Normal levels of testosterone for a woman is 8-48. Mine is 40. He says it doesn't matter. I don't know how it could possibly not matter. He said it's not about the actual lab results. It's about how the skin reacts to the amount of testosterone your body produces. Hmmmm.....I decided to skip the Tagament though.
GirlieGirl
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Thu Sep 22, 2011 7:23 am      Reply with quote
I think you did the right thing. Oily skin can be caused by other things too. I think once you get your skin in better balance you will be able to judge.
cat301
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Thu Sep 22, 2011 9:44 am      Reply with quote
Another question. I just went to the pharmacy to pick up my prescriptions. My insurance won't cover either prescription because I'm over 30. Apparently in their book of rules, people over 30 do not get acne. Should I call the doc and ask for his assistance to get the insurance to cover at least some portion of it? Am I out of luck? I coughed up the 56 dollars for the Retin-A but passed on the $165 topical antibiotic. Suggestions?
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Thu Sep 22, 2011 11:33 am      Reply with quote
Quote:
Apparently in their book of rules, people over 30 do not get acne.


Buwahahahahah!

And people under 60 don't get heart attacks.
cat301
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Thu Sep 22, 2011 12:22 pm      Reply with quote
Ok, I called doc since I can't afford the topical antibiotic and insurance won't cover it. He said he called in another prescription for me. It's Clindamycin. He wants me to mix it with OTC Benzoyl Peroxide and use that during the day. IS anyone for or against this? Is there anything wrong with using the Retin-A without the Clindamyxin/BP?
GirlieGirl
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Thu Sep 22, 2011 2:50 pm      Reply with quote
Some insurances are like that, luckily mine still covers my meds. Unfortunately if thats your plans policy then you are stuck paying.

Yes you can totally mix the BP & clindamycin yourself. I use to do this. You may not need both but they do work well together. Don't use at the same as retin-a though. Retin-a and BP used at the same time inactive each other. I would recommend using something antibacterial as part of your acne treatment. It really best to treat acne both ways.

Do know which version of clindamycin he rx'd you? I like the gel best, the liquid is in an alcohol base which can really irritating.
cat301
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Fri Sep 23, 2011 6:57 am      Reply with quote
I will pick up the Clindamycin later today and let you know.

I used the Retin-A last night. I'm using it very cautiously. I washed with with Cerave Moisturizing Cleanser and then let my skin dry for an hour before putting on the Retin-A. I was careful to keep it away from the corners of my nose. I need to be more careful with it around my mouth. I felt a little irritation there, but it doesn't look bad. I am not going to use Retin-A again tonight. I will wait and see how I feel and maybe use it again tomorrow night. I'd like to use it every other day or every third day until I get somewhat adjusted to it. Does anyone have any input about this? Is that a good way to get started with Retin-A?

This morning I applied La Roche Posay Anthelois 60 Ultra Light Sunscreen Fluid. Then Smashbox Primer and makeup as usual.

I started using my Clarisonic Mia on Wednesday. I think my skin is looking better already.

In the last 3 days I've ordered the following:

Burnout Kids sunblock
PSF Skincare:
Gentle Cleansing Castille
BHA 2% Solution
DAME Gel
H.A. Serum
Biocopper Serum (Free Gift)
Skinbiology:
Super CP Serum
Emu Oil
Super COP (bonus sample)

I guess maybe I've gone overboard? I'm going to have to get a second job to pay for my new obsession.

I look forward to advice, suggestions, etc.
cat301
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Fri Sep 23, 2011 7:12 am      Reply with quote
GirlieGirl wrote:
.25% is a good place to start, the cream or gel?

Did he do blood work? He cant assume your testosterone is high without testing you.


Cream.
GirlieGirl
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Fri Sep 23, 2011 9:02 am      Reply with quote
Oh thats alot of stuff you ordered. I would not use any of the acids/treatments till your skin has adjusted to the retin-a.
Ottawa Shopper
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Fri Sep 23, 2011 7:07 pm      Reply with quote
I find for makeup stuff, when I tried the smashbox primers they made my skin feel greassy.

I normally have combination skin and dry cheek area and in the summer it was worse.

The only primer I tried that I found did not make my skin feel oilier is DHC velver skin coat-also it seems you do not need to use as much of it as other brands.
cat301
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Thu Oct 06, 2011 10:05 am      Reply with quote
OK, I've got myself a bit of a routine now.

AM:

PSF Gentle Castille on a microfiber cloth to remove flakes from Retin-A

PSF 2% BHA every 3 or 4 days (wait 30 minutes)

Skin Biology Emu Oil S:1-2 drops spread thinly over face

Burnout KIDS

H.A. Serum

Smashbox Primer

Makeup

P.M. PSF Gentle Castille on Clarisonic Mia

Retin A .025 every 3rd night

Emu Oil on the nights I don't use Retin-A

Unpetroleum Jelly on lips to prevent dryness.

At some point I'd like to up the Retin-A & BHA and add Super CP Serum, but I want to take it real slow.

I need to add, I think the Burnout KIDS is keeping me from being an oil slick. I no longer use a "mattifier" and I never get that slip and slide effect with my makeup anymore. no shine either. I apply my makeup in the morning and I don't have to blot or touch up at all. The only thing I don't love about the Burnout is that it makes a tacky base for my foundation, and if I try to use foundation without a primer I absolutely cannot blend it or get a smooth application. It ends up looking like I put my foundation on with a spatula in the dark. A primer is a MUST to get it to go on smooth. My blackheads have improved a TON. I have very few active pimples. So far I haven't gone thru that bad Retin-A purge. I think taking it slow and waiting 30 minutes between washing my face and applying Retin-A has helped a ton.

My skin was ALMOST clear enough this morning that I thought about going to work without foundation. I almost did. Maybe soon I can do that. Smile I'm thrilled to death with my progress so far. I had a problem with flakies at first, but since I started using the microfiber cloth in the morning instead of my Clarisonic Mia, I don't have any flakes at all.
oasisjc
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Thu Oct 06, 2011 10:54 am      Reply with quote
Hmm so you're not using the topical antibiotic at all?

Would you say your pore sizes have also improved?

I'm glad everything is working out for you!
cat301
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Thu Oct 06, 2011 10:55 am      Reply with quote
Nah, topical antibiotic didn't seem to do anything for me.

My pores seem smaller.
GirlieGirl
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Thu Oct 06, 2011 11:10 am      Reply with quote
Looks like you have a good routine going. The only thing I'd suggest is to apply HA before the SPF.
cat301
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Thu Oct 20, 2011 10:16 am      Reply with quote
I've been at this for almost 30 days. I still have some blackheads on my nose and I still have some pimples coming to the surface but they are healing super quickly.

I haven't had a problem with too much irritation or flaking. I'm using Retin-A about 5 nights a week. I only skip it if I forget or if I feel a little too dry.

Skin overall looks improved. I noticed today, the wrinkle that I couldn't help but notice when I looked in the mirror a month ago has diminished quite a bit. I'm half tempted to call the doc and ask if I can be bumped up to a higher dosage, but maybe I should leave it alone for now.

All in all, considering that I've only done this regimen a little less than 30 days, I've had very good results.

I'd like to start using the copper peptides I bought (Skin Biology Super CP) but is that too much right now? I don't want to overdo it. Also, what else can I do for the blackheads that are still hanging around?
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Thu Oct 20, 2011 11:12 am      Reply with quote
Brilliant that you are so much more positive about your skin! Very Happy I wouldn't rock the boat if you are getting results within a month, your skin may well continue to clear and hydrate for some weeks. Have you tried a simple steam and gentle extraction for the remaining blackheads?

HA serum should be applied to freshly cleansed skin, you may find the extra hydration is enough to plump up that wrinkle. You may find your old oiliness and breakouts were partly the result of irritation rather than sebum and hormones alone. As you know some physical sunscreens based on zinc can help normalise oiliness, and have antibacterial properties.

What tool are you using to blend your foundation - have you tried dabbing/ rolling with a damp Beauty Blender sponge or synthetic flat top brush (Sigma F80 kabuki gets rave reviews) with a stippling motion?

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Sensitivity, forehead pigmentation & elevens, nose & chin clogged pores. Topicals: Aloe vera, squalane, lactic acid, Myfawnie KinNiaNag HG: Weleda calendula, Lanolips, Guinot masque essentiel, Flexitol Naturals, Careprost. Gadgets: Vaughter dermarollers, Lightstim.
cat301
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Thu Oct 20, 2011 11:29 am      Reply with quote
I stipple with a MAC 187. The difference is night and day with my oiliness. I use the Burnout Kids daily and never have to retouch my foundation or blot my oily skin.

I need to try steaming and extracting. I'm afraid of doing more damage though.

I did start using H.A. Serum under my sunscreen. I had seen a post that said to use it on top of sunscreen but that was obviously a mistake.

Like I said previously, I've tried to use foundation without a silicone primer and i just can't get it to spread. It goes on VERY thick and unevenly and I like a lighter coverage. I've even tried lightly spritzing with Evian mist as I'm blending foundation but it just kind of makes a mess and I don't get a good application.
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