When left to it’s own devices, my skin falls somewhere between unfortunate and never-leave-the-house-again. After dutifully going to the dermatologist every three months since I was sixteen, my doctor and I had an explosive breakup when I told her to go fuck herself and then cried as she stormed out of the room. After that I took the Trust No Bitch approach to medical decision-making, and started making exhaustive lists of every medication and product I’d ever taken, taking note of classification and mechanism of action and common side effects. I don’t advocate the belief in the internet as a form of medical training, but if you get the sense your concerns are being ignored, or that just maybe that bitch is even dumber than you are, find a reputable source of information with nothing to sell (like the Mayo Clinic) and advocate for yourself.

 

So about a thousand years later, I’ve done a round of Accutane (generic form, they don’t even make Accutane-brand Accutane anymore) I have a new dermatologist that reminds me of a doctor from a Norman Rockwell painting and regularly gets shipments of good wine from his patients, and on a good day when I’m not stressed and I’m sleeping well and hydrated and everything, I am insanely happy with my skin.

I don’t know if it’s because before my skin was so bad I didn’t have the luxury of criticizing the details, or that the Accutane itself has made my skin more sensitive, but I find anything that isn’t insanely gentle or contains more than 5 ingredients makes my skin very red, very itchy, and very unhappy. And don’t even talk to me about cute packaging. I haven’t even looked at a product with cute packaging in years.

MAC Cleanse Off Oil
I’ve been going back to this one for probably 7 or 8 years. It does have various essential oils, which is usually a big red flag for sensitive skin, but it hasn’t given me any problems and doesn’t make my eyes sting like virtually all the others. The fact it’s an oil does make my contact lenses blur for a few minutes if I get it in my eyes, but I find it worth it because I can take EVERYTHING off at once, waterproof mascara and matte lipstick included, and not have to have a bunch of cotton rounds on hand. It’s just kind of cathartic to have a face full of whore paint, rub some of this weird oil on your face, splash some water over it, and you have your old face again.

Aquanil
This is a hard sell. This is the most horrific packaging I’ve ever seen, and on top of that, I can only find it at a) my Dermatologist’s office, b) various Amazon sellers with names like DermStore and ThisDoesntLookSexyInAMedicineCabinet. The texture is weird. It’s sort of like Cetaphil (which everyone apparently loves but makes my face feel like it’s on fire) but it has a slick, oily feel (despite being oil-free,) doesn’t lather, and doesn’t ever feel like it’s rinsed off, which is usually not just a pet peeve, but a nausea-inducing, offense to my core beliefs.

BUT

This shit is magical. Once I started using this, and got rid of the other fancy products I was using with their availability in actual stores and their sans serif fonts, my face lost it’s perpetual hint of redness, that I just assumed was genetic. It does take a while to stop anticipating the satisfaction of rinsing something off, and my face was a little oilier than I’d like for maybe 2-3 weeks before it adjusted, but now I’m upset if I run out and have to use something else. I use it immediately after the Cleanse Off Oil and it takes of whatever makeup/makeup remover is left, and doesn’t dry it out further.

Adapalene 0.1%
So this is the generic of Differin. It changes the way skin cells are shed, the thinking being a contributing factor to acne is skin cells not being shed from the pore properly, or producing oddly shaped skin cells (nature is cruel) that get caught in the pore, and create a gnarly little hide-y hole for bacteria to proliferate. The 0.1% is the milder strength (there’s also a 0.5%) and I seem to tolerate Adapalene better than Retin A, which is a different drug with the same goal, which is essentially radical exfoliation.

Aczone
I don’t want to be a schill for big pharma, but Aczone is relatively new, so there’s no generic for me to name, which also means shit’s about to get fucking expensive. If Aczone is not covered by your insurance, you’re looking at about $300. After switching providers I’ve been looking for a new means to get this discounted, and I’m so attached to it, I’m actually going slightly insane. Aczone is a topical antibiotic, and for most of my teens and early 20s, it did not exist. I have a severe intolerance to benzoyl peroxide and clyndamyacin which are the two most common topical antibiotics, so I had no respite from whatever breakouts the Adapalene refused to kill. (It’s really common to be prescribed a retinoid, which cleans out the pore, and an antibiotic, which kills the bacteria living in it, in conjunction with one another.) Every time I used antibiotics to spot treat, I assumed they were killing the acne by searing a hole through my face, based on the patches of red, bone-dry flesh they would leave behind. Like finding a patch of weeds and deciding to raze the land. I dot the Aczone on, and it’s like it actually just kills the bacteria without taking a torch to my face. I put it on at night, and when I wake up and my breakouts are diminished if not gone, and I don’t look like Gus Fring. If you’ve never had access to medication that doesn’t burn your face off, it’s magical.

Eucerin Redness Relief
Good, cheap-ish, doesn’t break me out. My face can get pretty dry, especially in the winter, but being so breakout prone anything that says ‘moisturizing’ usually gives me a feeling of terror. I can put this on and know if I break out, it’s not because of it. I’d say it’s a medium level of moisture. In really humid parts of the Summer, it’s kind of overkill (semi side note: I was using Kiehl’s Ultra Facial TONER for a while, that seemed to be good for the Summer,) and in the really cold parts of the winter, I still get some dry patches I can’t seem to sort out. I wish it wasn’t in a jar because touching stuff grosses me out, but all in all if it does it’s job and doesn’t make my skin worse, I can’t complain.