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  • Priya Mukherjee

I Have Come To Terms With The Fact That I Will Never Have Perfect Skin

And That's Okay.


Skin can definitely be a touchy subject (pun apologetically intended) for many individuals here in the United States.


Based on a report from the American Academy of Dermatology, 50 million Americans across the nation are affected by skin conditions that fall under the definition of “acne vulgaris” every single year. 


Interestingly enough, acne is considered a “Western” affliction. 


According to a 2020 study from the American Journal of Clinical Dermatology, “only when indigenous people moved to westernized cities did acne reportedly become a problem, proving the impact of environment and lifestyle on the skin disease.”


While I have many things to say about the impact of American lifestyle on health and wellness and the undeniable fact that something about our habits and way of life is making many of us sick–I will have to break that down further in a future blog post.


But for now, a good start is the topic of acne as a whole, what I’ve learned about dealing with it and what I’m doing to combat it. 


I have come to terms with the fact that I will probably never have perfect, clear, skin, and that is okay. 


I started developing adult acne around the time I was 22. Because the ways I treated it initially were uninformed and damaging, my skin only got worse. It's only now at age 25, after almost 3 full years of research, understanding my skin and body, and honestly just pure experimentation, that I can somewhat more confidently address the way my body decides to rebel against me every so often in the form of pustules on my face. 


I wanted to break down how I did this so maybe I could help others too. So here are the 3 most important things to understand:


1. Your Body 

A. Hormones 

B. Underlying conditions


2. Your Diet 


3. Your Products

A. Prescription Medications

B. Over The Counter Products


Starting first at where it all begins.


Your Body


While acne can feel like an isolated problem that starts and ends with your face, it's oftentimes a holistic representation of greater changes happening in your body. Combating acne starts with pursuing overall health in the form of yearly doctor visits and blood-work to identify anything that could be contributing to an abnormal baseline. 


One crucial development to me understanding my acne, was discovering that I had underlying PCOS (Polycystic Ovarian Syndrome). 


This underlying condition was causing a constant hormone imbalance in my body that contributed to the turbulent nature of my skin: fine one month and violent break-outs the next. The victorious feeling after this discovery was pretty short-lived because determining the source of my acne was one thing and finding the perfect solution for it, a whole other. But at the same time, it has been a crucial starting point to even make progress.


There are manyyyyyyy resources available on the internet about hormone imbalances, PCOS, and much more and I’ve linked some here: PCOS and Hormonal Acne, What Is Hormonal Acne, How Hormones and Acne are Correlated.


Making sure you're on the same page as your body is the first step in making sure you're helping yourself in this fight against acne.


The next most important thing about your body is what you’re putting into it. 


Your Diet


In Indian Ayurveda, the belief is that “beauty begins at breakfast”. This notion is not only ancient but also studied in many peer-reviewed journals including JAMA Dermatology, exploring the relationship between adult acne and dietary behaviors. The foods we consume have a direct correlation to our internal and external health. 


When I was younger, I was always hyperconscious of my diet to honestly, probably an unhealthy extent. Now, as I navigate my PCOS, hormonal imbalances, and changing tastes - I have become hyperconscious of my diet in a way that I hope is much more healthy. 


The most important thing to remember is that: what works for one individual is not exact for anyone else. This is a big part of the reason why I, personally, don’t share “What I Eat In A Day” food routine videos because to me, it would be unfair to imply that my results with fitness and wellness are only stemming from my diet - as if genetics, environment, fitness routines, stress levels and so many other factors don’t also play huge roles. 


Some key things about healthy skin that I’ve learned follow the tenets of the average healthy diet with the following caveat:  


Because acne is in many ways a disease of inflammation, by avoiding inflammatory foods, I have definitely seen progress in the way my body and skin reacts. 


Examples of inflammatory foods include but are not limited to: red meat, processed meats, fried foods, sugar sweetened beverages, etc. But honestly, I am human and I think there’s a clear mental health benefit to indulging in your occasional sweet treat. So give yourself grace.


But if you want to generally follow an anti-inflammatory diet, a good measure of it is available here at Hopkins Medicine.


Another rule of thumb is introducing healthy fats, nuts, fresh fruits and vegetables, into your diet. Basically everything you’ve been hearing your whole life. And of course plenty of water. 


Some additional things I put in my body for overall well being and skin health is: 

  1. 2 cups of Spearmint Tea a day - Spearmint tea has clinically proven effects to help with the hormonal imbalances caused by having PCOS (PubMed)

  2. A Fish Oil supplement - Studies show that Fish Oil reduces inflammation and helps with body collagen production (PubMed)

  3. A One-A-Day Multi-Vitamin supplement - Just for general vitamins and supplements that I may not be getting in my daily diet


What you put in your body can definitely make or break your health.


While you don’t need to put every single thing under a microscope before you put it on your plate, some intentionality behind eating can do wonders.


Finally the last thing (which many consider the first thing) to think about when it comes to your acne, is your products. 


Your Products


Acne medications have been around for decades and because of that we have frankly, years and years of clinical studies on what works and what doesn’t. 


If you go to a dermatologist or even just from casual conversations, you may be aware of the different medications commonly prescribed. From Accutane, to Birth Control, to Spironolactone and Tretinoin, chances are, one of these medications rings a bell.


In my skin journey, I chose to not go the oral medication route and wanted to deal with my hormonal imbalance in my own ways.


However the one medication that I did get a prescription for is: Tretinoin. 


Tretinoin is Vitamin A derivative. Retinol is the over-the-counter lower-intensity Vitamin A derivative that you may or may not be familiar with. Its a common anti-aging/well-aging ingredient in many skincare products.


The thing about tretinoin is that due to it being a much higher, concentrated form of Vitamin A, your skin can react quite strongly. 


When I first started using Tretinoin in Fall of 2022, my skin freaked out.


I developed whiteheads all over my cheeks and broke out horrendously. My (bad) solution to this was? To use MORE Tretinoin. I know anyone who is reading this and has used Tretinoin is gasping in horror.


For clarity, Tretinoin (or tret as I call it affectionately for short), is so strong and good at doing what it does because it causes accelerated cell turnover. If you use too much, too soon, and your skin doesn’t get a chance to adjust, you will experience dryness, skin sloughing off, and also breaking out. 


The breakout period or “purge” isn’t supposed to last longer than about 6 weeks and its generally looked at as: it gets worse before it gets better, but I couldn’t hack it and I quit the product entirely about 5 weeks in. 


Now fast forward to March of 2024, I’m back on tret.


I’m smarter now.


More equipped for the purge. And truly I do know better and have a better sense for what to expect. 



I have been doing the following 4 things to help my skin ease into the Tretinoin therapy. 


  1. Moisturizer Sandwiching - Layering barrier repairing moisturizer before and after applying Tretinoin to my skin.

  2. Small Amounts and Infrequent Usage - Using only the smallest pea sized amount all over my effected areas, and starting with 1x every 7 days, to then moving to 2x a week, and then ending at 2-3x a week. 

  3. Skin Cycling Tret Day 1 Only Moisturizer Day 2 Chemical exfoliant (an AHA/BHA) on Day 3 Back to Moisturizer Day 4 Exfoliant Day 5 Moisturizer Day 6 Tret Day 7

  4. Listening To My Skin - If my skin is feeling dry and tight that day - I will not use any medication or exfoliants and will just hydrate and moisturize


All in all, my skin journey has been on-going for a while and I’m hoping that I’ll see the success with Tretinoin that I’ve been seeking for years. 


But if I don’t, I’m working on fighting away that obsessive feeling that: once my skin is cleared up my life will magically become better.


My skin is beautiful no matter how it looks, texture and acne is human and at the end of the day; perfect skin is incredibly and deeply overrated. 


Now the real challenge is saying that exact sentence to myself the morning of a particularly aggressive period that is in cahoots with a particularly aggressive breakout. 


Will I be able to? 




Fingers crossed. 



Disclaimer

Ultimately what I share is not medical advice and should not be taken as such. These are my anecdotal experiences and research that I collated to convey MY specific point of view, and should be considered as only that.


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