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Avatar universal

Dehydrated Skin

Hi

I am 41 years old and recently learned from an esthetician that my skin is severely dehydrated due to improper use of retin A.  Two years ago, the prescribing doctor had me using Renova .02% daily on fair skin for several months.  When my skin felt tight (I had no clue this meant I was dehydrated but I didn't like the way it felt) I reduced my use down to 3 days a week for 6 months and then to 2 days for several months, finally down to 1 day a week.  My skin looked great, until about 6 months ago when it started getting lots of crepey lines.  My esthetician said this was caused by the dehydration.  So I went to a different dermatologist whose solution was to stop using retin A for a while and use Oil of Olay on my skin.  I was quite upset that I waited 2 1/2 months to be given the same advice my mother would have given me.  My esthetician told me it would take 12-18 weeks to rebuild the lipids I'd destroyed and that my skin would look worse before looking better.  I've been off retin A for 3 weeks and my skin has become much more crepey and thin looking.  It looks awful and I am praying she is right that it will eventually rebuild itself and look better. Is she right, will the crepey skin get better and plump up once my lipids rebuild?  Or have I caused permanent damage?

To hydrate my skin, besides discontinuing retin A and using a low dose retinol now, I use an intense moisturizer, run a humidifier daily since I live in the north, drink 100oz of water a day, have cut all caffeine and alcohol from my diet, and take flaxseed.  I am desperate for ways to speed up the hydration process so any suggestions would be greatly appreciated.  Like is there medication that helps hydration?  And do you think it's okay that I am even using even retinol or will that keep my dehydrated?

Thank you!
4 Responses
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Avatar universal
@Chumdog90- I am 36 yo and had similar, mild skin problems a few years ago. I tried OTC cleansers for acne but they all made my skin worse. It may sound counter-intuitive, but the product that actually settled my skin problems is thick and greasy. It's a Lush product called Ultra Bland and the main ingredients are peanut oil and rose water. I would cleanse my face with that at night to remove makeup but in the morning I would only rinse my face with warm water or use a mild toner with tea tree oil.
From your description, it sounds like you're over doing it a little. I would give your skin some rest, let it heal, and see what happens! Good luck! :)  
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Avatar universal
I am also 41-years old and have been experiencing something terrible from aggressive exfoliation, plus improper use of Retin-A.   For 4 weeks now I've been experiencing a burning, throbbing, irritating, hypersensitive feeling on the skin in my face.  This all started on March 16, 2009, in trying to help some very mild acne/pimples and dull skin, I aggressively exfoliated my entire face, scrubbing hard with a coarse scrub sponge, using that with crushed Apricot Seed Scrub.  I think I may have also washed my face with Oxy Wash 10% Benzoyl Peroxide after exfoliating.  After the aggressive exfoliation (and possible washing with Benzoyl Peroxide),  I applied Tretinoin .025% (applying more than the recommended amount) to entire, damp face only one time – left it on all night.  The following day, my pores were opened up all over my face – my skin texture was changed - was rough, tough – looked like orange peel skin, leather-like, and crinkled-looking.   It was only slightly irritated at that point, but was able to tolerate cleansers and lotions. Then 4 days later from March 20-23, 2009 (4 nights straight) I applied Differin .50 %, also on a damp face, and left that on each night.  That seemed to send my skin over the edge because by the 4th day of applying Differin I developed some small, painful sores around nose and cheek which are now scarred.   After that I could NOT tolerate any cleansers/lotions – even the most gentle.  Since then I’ve experienced everything as I mention below.   NOTE:  for many months I was using Oxy Wash 10% Benzoyl Peroxide, along with rubbing alcohol or sacylic acid toner as an astringent before I did this on March 16th.  

Lasting, non-improving  symptoms for 4 weeks are as follows:

Constant burning, stinging, irritation, inflammation, and throbbing in face– it literally feels like it’s on fire – like the worst sunburn.

Running intermittent low-grade fevers 99.2-100.5

Noticeable changes and problems have occurred in skin since I did this:

• Skin is rough and tough – texture is not the same as before I did this (it almost has grainy leather, crinkly or orange peel texture & appearance to it –  my skin was smooth and in good condition prior to this)

• Pores have opened and enlarged over entire face.

• Skin appears to have prematurely aged after doing this.

• Skin seems very fragile since this first happened.

• I am easily experiencing deep creases and indentations in skin from lying on a pillow, holding a telephone, etc.  This has been happening every day since I did this.  It’s taking a very long time (over 3-4 hours)
for my skin to bounce back.  In the past, I would very seldom get a crease or two on my face from lying on a pillow in the same position all night, and when it did happen, it bounced back quickly.  

• Where I’ve plucked hairs on my eyebrows since this first occurred, I have some holes where I plucked the hairs out.  This is only above the eyebrows in the area I exfoliated and applied the medications.  I don’t have any holes below the eyebrows, as I didn’t apply anything there.

• Skin feels dry and tight - like it’s been stripped of everything. OTC moisturizers irritate and don’t help.  I’ve never had irritation to any products ever before.  Before all of this, I could pretty much use anything on my face and nothing ever irritated my skin.

• Skin becomes very taught and dry and irritated after washing with water.

• Skin is tight and it hurts to make facial expressions such as opening mouth wide or smiling.

• Skin is tight between and around eyes - it’s pulling/tugging down my eyelids.

• Difficult to raise eyebrows – pulls and tugs between and around eyes.

• Feels as though I’ve lost elasticity in skin

• Skin is producing some oil, but it’s not enough to hydrate.

• Scarring, pitting and ice pick marks have appeared, along with small crevices and  wrinkles.

• The larger, scarred holes (ice pick marks) that I explained are where I used to have blackheads for many years – now they’re enlarged holes.  

• The only scars I had on my face prior to this were two old chicken pox scars from when I was a child – these are now larger, deeper and more prominent.  

• A few existing pimples I had when I did this to my face, along with new ones have not healed properly – they’re raised, red nodules and are now scarred-looking on the surface. My pimples would always heal and disappear prior to this without scarring or discoloration.

• Irregular or round flat brown pigmentations have been appearing all over my face that weren’t there before.  There are other darker, textured & scarred pigmentations and splotchy discolorations that have appeared on face as well.

• Hypersensitive skin – hurts to touch it.  If I lightly rub my fingers across it, it feels like something very sharp is going across my ski – especially in most sensitized, tender areas on cheeks, in between nose & mouth, forehead, in between eyes, chin.  Redness/rash appears if I rub those areas.   I’ve never had any sensitivity or redness in my skin prior to this.

• Skin gets very irritated when I’m in dry heat, whether in a car or a house.  I get a burning, irritated sensation when I’m outdoors or near a window from the UV Rays - even on a cloudy day.

• I get more pain and burning if I blush or when my temperature is up.

• Tears make my face sting (possibly from salt in tears)

• Skin is becoming more and more irritated as time goes on, yet I’m putting nothing on it anymore – just rinsing with water.

• My skin is normally very pale and pasty – it is now darker overall and more pinkish/ rashy-looking between eyes, between lip and nose, underneath lip and in chin area, cheeks – this is where skin has been most irritated, tender, and has had the most burning pain.

Skin was very red and rashy looking when this first occurred – mainly because of all of the further irritation that the cleansers and lotions were causing.  It is not really red anymore unless I touch it.  

Most cleansers, lotions, and ointments now irritate the skin and make it burn and sting.
I’ve tried OTC hydrocortisone cream, triple antibiotic ointment, Cetaphil, Aveeno, Silvadene, Vitamin E oil, Aloe Vera gel, etc.  Most products – even the most gentle - irritate it even worse and don’t help at all.  Had no problem using anything on my face (cleansers, astringents, etc) prior to this.

The constant burning, stinging, irritation, and throbbing have caused lack of sleep for weeks now – most nights I cannot sleep at all – I am extremely uncomfortable.  I have also experienced loss of appetite because of it as well.

More and more difficult to function day-to-day because of all of this – especially due to the burning, throbbing, irritation.

I've been to 3 doctors - 2 of which were dermatologists.  They don't think there is anything wrong and/or can't figure it out.  I'm not imagining this - I know my skin very well and something is very wrong.  What can be done to help heal my skin and bring my skin back to normal?    This does not seem normal as to why I am still experiencing this; things are getting worse and not better.  I would think there would have been some improvement by now.  No one is helping me - I feel so helpless right now.  This has been very intolerable for 4 weeks now and I want the burning, irritation, and throbbing to go away and for my skin to heal and return to normal once again.
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Avatar universal
Thank for the response.  But do you have any suggestions on how to hydrate my skin?  It's definitely dehydrated.  My skin feels tight and my cheeks burn.
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242489 tn?1210497213
MEDICAL PROFESSIONAL
I do not agree with your esthetician.  Retin-A can cause temporary irritation.  It does not "dehydrate" the skin, does not damage the skin permanently (or at all), and the statement that it takes "12-18 weeks to rebuild the lipids [that you] destroyed" is simply not true.  The dermatologist's advice may have sounded homespun but I believe it was accurate.  I can't comment on the "crepey and thin looking" appearance you describe without seeing it in person.  However, Retin-A thickens the skin, not thins it.  I advise you to see a dermatologist in person to help straighten all this out, but in the meantime there is no need for you to feel that your skin has been damaged by Retin-A.

Best.

Dr. Rockoff
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