i had perfect skin until around 2012 when i was 25 years old. when i went off the birth control pill i had been taking for over ten years and started getting painful, inflamed breakouts in the lower half of my face, my self-esteem plummeted. my way of interacting with the world changed. i began wearing tons of makeup everyday and spending more time in the mirror. i avoided places that were well lit so that i could hide. i chose how i faced people based on where the worst inflammation was on my face. in other words, my acne was always on my mind. i immediately started buying "non-comedogenic" and "acne-safe" (or rather, marketed-towards-acne) products at the drugstore. i would use a new product for a few weeks and when my skin didn't clear up i would go back to the drugstore and buy a new cleanser and moisturizer. i didn't know much about skincare and was overwhelmed whenever i tried to figure out what was best for me. after a few months of trying tons of different products with no real progress, i went to a dermatologist. side note: i now know that when products claim they are good for acne, non-comedogenic, or free of cloggy ingredients it does not mean much. i would estimate that 95% of the products clients bring in during the initial consult appointment are actually not acne-safe and are actually exacerbating their existing acne and/or creating new seeds - even though they are advertised as such! the dermatologist i went to prescribed two topical products right off the bat: retin-a and clindamycin.

• retin-a is a medication with the active ingredient of vitamin a, which is acne-fighting and beneficial for many people struggling with their skin BUT the formula i was using was in a base with isopropyl myristate which is a 5 on the 0-5 comedogenic scale = as cloggy as it gets! you can read more about comedogenic ingredients and our vetting process here. so while the active ingredient may have been helping, i was getting a dose of super cloggy ingredients simultaneously. retin-a also makes you more photosensitive, but because i was scared that sunscreen would break me out i wasn't wearing it. i got sunburned and gained a few more freckles during this time.
• clindamycin is in a class of medications called lincomycin antibiotics. it works by slowing or stopping the growth of bacteria that cause acne and by decreasing swelling1. since i started this active product at the same time as retin-a i am not sure how it affected my skin, but side effects include dry skin, red skin, peeling skin, increased sensitivity, and even breakouts!

overall my skin became more sensitive, red, dry, and most importantly did not clear up during the use of these two products. so my dermatologist decided to try a more aggressive approach: oral antibiotics. i was prescribed doxycycline and instructed to take it twice daily for 3 months straight, which i did religiously. my skin didn't clear up during this time, and the only changes i observed were negative:

• my digestion became problematic = my gut health declined. there's a link between your gut health and skin health, you can read more about that here.
• my hair started falling out. my dermatologist and primary care physician assured me that it was not caused by the doxycycline but my hair started growing back after i stopped the medication and that was the only change, so i am pretty certain that was the cause. unfortunately my hair has not fully gone back to the way it was before taking this drug.

after 3 months of doxycycline i had a follow-up appointment with my dermatologist. she didn't seem surprised that my skin hadn't cleared up, and decided to "take the next step". i got a prescription for benzoyl peroxide (aka bp). so now i was using 3 topical prescription products and had stopped taking the antibiotic. the bp i got was extremely drying so my skin starting cracking around my mouth and felt raw all the time. i continued using it though, because i thought it was my only hope. over the next year i used those three products daily, but kept getting inflamed acne in the lower half of my face. it would itch in these areas, feel sore to the touch, and never seem to fully come to the surface. if i had an especially painful cyst i would go to another dermatologist about 45 minutes from my house to get a cortisone injection. these injections were expensive, painful, and sometimes caused some little textured scars - and i realize now, didn't remove the actual acne seed. because the seed remained in my skin, the discoloration also remained and many times the cyst would become inflamed again. i started trying to find my own solution to acne. i did tons of internet research and read blogs written by people who struggled with their skin. i used coconut oil to remove makeup (super cloggy and made my inflammation worse). i would pour boiling water on washcloths and place them on my face, then try to pop the deep cysts i had (which always made them bigger and darker in color). i stopped eating dairy altogether and that helped clear up most of the acne in my forehead, but i would still get breakouts in my chin. one day, one of my close friends told me her roommate worked at a place that specialized in adult acne. i looked up skinSALVATION and told myself i would make an appointment if my skin didn't clear up within 6 months of being dairy free. 6 months later i called and scheduled my initial consultation. the first time i stepped foot in skinSALVATION in 2014, i felt relief. it was liberating to be able to go over my whole skin history with somebody who knew what they were talking about. i learned what lifestyle changes i needed to make to clear up my skin. i changed all the products i was using because they all had pore clogging ingredients. i started coming in for treatments (extractions + dermalogical grade peel) every 3-4 weeks. at skinSALVATION we rate the skin's clarity using a percentage, with 100% meaning fully clear and with no acne. if half the pores on someone's face had acne, we would rate the skin at 50% clarity. since i had cut out dairy 6 months before coming in for my consultation, my skin was fairly clear except for the inflammation in my chin. kerry, my esthetician, rated my skin at 80% clear. a summary of my progress over the first year and a half after becoming a client is below. as you can see, my clarity would go up and down depending on how strict i was with the lifestyle changes the estheticians recommended. despite dropping the ball a few times, my skin never got as broken out as when i first started, because i continued using the acne-safe topical products in my home-care regimen and came in for treatments.

• 11/2014 - consultation - clarity: 80%
• 12/2014 - 1st treatment - clarity: 85% i was worried because i didn't peel very much after the treatment, but then learned that the skin doesn't need to literally peel to get the benefits - there is cell turnover happening on a microscopic level
• 1/2015 - 2nd treatment - clarity: 90%
• 3/2015 - 3rd treatment - clarity: 85% skin went down in clarity most likely because it was purging the soy i had in my diet before becoming a client. i also went a little too long between my 2nd and 3rd treatments so this may have slowed my progress
• 4/2015 - 4th treatment - clarity: 90% inflammation had gone down altogether by this time
• 5/2015 - 5th treatment - clarity: 95%
• 6/2015 - 6th treatment - clarity: 97%
• 7/2015 - peel-only - clarity: 97% got just a peel, not a full treatment with extractions since they weren't needed
• 9/2015 - peel-only - clarity: 97% i got a little cocky around this time and started eating soy again
• 10/2015 - peel-only - clarity: 95% the soy started catching up with me and i had some inflammation again
• 1/2016 - 7th treatment - clarity: 85% the soy i ate had officially started purging. i had to learn this lesson the hard way!
• 2/2016 - 8th treatment - clarity: 85-90%
• 3/2016 - 9th treatment - clarity: 90% was better with acne-safe diet but still eating some refined sugar
• 4/2016 - 10th treatment - clarity: 95%

i've learned over time that my skin is the most clear when i implement all the suggestions my sS estheticians make (what a surprise!). i'm the type of person who has to learn lessons on my own though, so despite the knowledgeable advice i received here at sS, i had to connect the dots myself to truly make a change in my eating habits. i can see now when i look through the notes the estheticians took each time i came in that when i ate dairy, soy, or refined sugar, i would abstain and my skin would break out a few months afterwards from purging, then my clarity would go back up a few months after that. now that i am working as an esthetician here at skinSALVATION, i have extra motivation to stay compliant to the acne-safe lifestyle. it would be hard for me to teach people what changes to make if i weren't living by those guidelines myself, right?! so these days my skin has been hovering around 90-95% clarity. i suspect i'm not 100% clear due to some hormonal changes (went off the IUD and some supplements i was taking) - and the acne-safe lifestyle is a daily practice, not perfection. due to my personal struggle with acne, being in a position now where i can help people clear their skin means a lot. in some strange way, i feel like i struggled with acne so i could find this path to being an esthetician. it is so fulfilling to be able to relate to my clients and say "don't worry, i've been there, i have an answer for you". it seems everything happens for a reason! 1. https://medlineplus.gov/druginfo/meds/a609005.html