Acne - Rash on Forehead - History of my Acne

[benjamin25]

Hi, I'm a 23 year old male.  

I had mild acne as a teenager up until an incident where I had an episode of very bad poison ivy on my face, neck and ears right before my senior year of high school.  For the year following my acne became progressively worse, and during this time I was using some BP.  My palms/inner hands also became very peely and would go from extremely sweaty/oily to extremely dry.  When I got to college freshman year, I began using clindamycin and retin-a-micro on my skin.  I used no products on my hands and they became better.  The facial products turned my face red and I began to get bad cystic acne on my face, right next to my nose and on the sides of my chin.  A year or so later,  I used accutane, but only for 3 months or so.  The accutane reduced the cysts but made my skin very dry, particularly on my forehead and lips.  I stopped using accutane due to the side effects and basically gave up on my skin.  For the next two years my forehead continued to have very dry, dead looking skin on it and my skin had moderate-severe acne.  I am now out of college and over the past year, I tried using an exfoliating cleanser along with duac gel and finacea as well as doxycycline as an antibiotic.  These products worked well and have cleared up my skin considerably, but my skin remains red and goes from being very dry at times to being very oily at times.  Over the past month I've stopped using all of these products and have tried just using Cetaphil as a facial cleanser, eating better and exercising and using a light oil-free moisturizer.  My skin has begun to look better with the exception of the rash on my forehead.  I'm not sure if I should even call it a rash but it is a patch of extremely red, dry, flaky skin that gets oily later in the day but still feels scaly.  I think it might be due to sun exposure?

Do you think this all might date back to the poison ivy incident?  Any advice on my forehead rash?  Any advice on products for my face?

[Alan Rockoff, MD]

Several parts of your story don't make much sense to me.  First, poison ivy doesn't trigger severe acne.  Second, hand peeling and hand products have nothing to with acne.  Third, the side-effects of Accutane are, in my experience, rarely of ever bad enough to stop the medication, especially after three months.  Having said all that, I would add that you seem to be doing pretty well, but I can't tell from your description whether the forehead symptoms are a different rash (like eczema r seborrhea) or a side-effect of acne medication.  Since you're obviously already seeing a dermatologist, I would suggest asking him or her to have a look and offer an opinion.

Take care.

Dr. Rockoff

[benjamin25]

Adding on to this, I should mention that in addition to the cysts being a rare occurrence, I get a lot of whiteheads now.  I think this is probably due to my skin going from being very dry to being very oily.  The whiteheads mostly occur on my chin and around my mouth.  They have been decreasing in occurrence lately though, but just thought this might help with analyzing the skin on my forehead and what might be going on there.